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脑静脉窦血栓形成:12 岁女孩水痘感染的罕见并发症。

Cerebral sinus venous thrombosis: a rare complication of varicella infection in a 12-year-old girl.

机构信息

Departments of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Departments of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Paediatr Int Child Health. 2022 Aug-Nov;42(3-4):165-168. doi: 10.1080/20469047.2023.2242173. Epub 2023 Aug 4.

Abstract

Varicella infection can present with a variety of neurological manifestations, the most common of which are cerebellitis and encephalitis. A 12-year-old girl presented with headache, altered sensorium, blurring of vision and status epilepticus 2 weeks after she developed varicella lesions. Imaging demonstrated cerebral venous sinus thrombosis involving the left transverse sinus, sigmoid sinus and internal jugular vein with a haemorrhagic infarct in the left parieto-occipital region. Measures were taken to decrease the intracranial pressure, and she was commenced on anti-convulsants (phenytoin) and heparin infusion, following which she improved and was discharged after 2 weeks. Repeat imaging undertaken 3 months later demonstrated a resolving thrombus, and a pro-coagulant work-up at follow-up did not show any underlying pro-thrombotic state. Neurological complications post varicella are rare, with encephalitis and ataxia being the most common. Cerebral sinus venous thrombosis secondary to varicella is very rare with only one case reported in a child.

摘要

水痘感染可引起多种神经系统表现,最常见的是小脑炎和脑炎。一名 12 岁女孩在出现水痘损伤后 2 周出现头痛、意识改变、视力模糊和癫痫持续状态。影像学显示左侧横窦、乙状窦和颈内静脉脑静脉窦血栓形成,左侧顶枕叶有出血性梗死。采取措施降低颅内压,并开始使用抗惊厥药(苯妥英钠)和肝素输注,之后她病情改善,2 周后出院。3 个月后复查影像学显示血栓正在溶解,随访时的凝血功能检查并未显示任何潜在的血栓形成状态。水痘后出现神经系统并发症较为罕见,脑炎和共济失调最为常见。水痘引起的脑静脉窦血栓形成非常罕见,仅在一名儿童中报告过一例。

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