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蝶窦炎的血管和神经并发症

Vascular and Neurological Complications in Sphenoid Sinusitis.

作者信息

Khaladkar Sanjay M, Julakanti Sravya, Pandey Ankita, Paidlewar Sayali, Sharma Ojasvi

机构信息

Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Aug 5;16(8):e66181. doi: 10.7759/cureus.66181. eCollection 2024 Aug.

DOI:10.7759/cureus.66181
PMID:39233955
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11373369/
Abstract

Although the cavernous sinus and internal carotid artery are in close proximity to the sphenoid sinus, vascular complications in sphenoid sinusitis are rare due to the intervening mucosa and bone. Variations like dehiscence or aggressive infection can cause vascular complications, leading to cavernous sinus thrombosis, while perivascular inflammation of the internal carotid artery can result in stenosis or occlusion. Untreated or aggressive sphenoid sinusitis can cause neurological complications such as cerebral infarcts, meningitis, subdural empyema, cerebral abscess, and cranial nerve injuries. Magnetic resonance imaging (MRI) of the brain with angiography can depict these complications at an early stage. Additionally, mastoiditis can cause dural venous sinus thrombosis, which, if left untreated, can result in venous infarcts. We report a case of an 11-year-old male with sphenoid sinusitis who developed a left middle cerebral artery (MCA) territory infarct, cavernous sinus thrombophlebitis, subdural empyema, and meningitis. He also developed left transverse and sigmoid sinus thrombosis due to left mastoiditis.

摘要

虽然海绵窦和颈内动脉与蝶窦紧邻，但由于其间的黏膜和骨质，蝶窦炎的血管并发症很少见。诸如骨质缺损或侵袭性感染等变异情况可导致血管并发症，进而引发海绵窦血栓形成，而颈内动脉的血管周围炎症可导致狭窄或闭塞。未经治疗或侵袭性的蝶窦炎可引起神经并发症，如脑梗死、脑膜炎、硬膜下积脓、脑脓肿和颅神经损伤。脑部磁共振成像（MRI）联合血管造影可在早期发现这些并发症。此外，乳突炎可导致硬脑膜静脉窦血栓形成，若不治疗，可导致静脉梗死。我们报告一例11岁男性，患有蝶窦炎，并发左侧大脑中动脉（MCA）供血区梗死、海绵窦血栓性静脉炎、硬膜下积脓和脑膜炎。他还因左侧乳突炎并发左侧横窦和乙状窦血栓形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/e80fa1c68c77/cureus-0016-00000066181-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/b46c4144cb4e/cureus-0016-00000066181-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/b6085d4b93a6/cureus-0016-00000066181-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/11bdd43af846/cureus-0016-00000066181-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/e366f135ac55/cureus-0016-00000066181-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/dccb796fd7f6/cureus-0016-00000066181-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/16fde4fab693/cureus-0016-00000066181-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/4b1d0e938fb0/cureus-0016-00000066181-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/e80fa1c68c77/cureus-0016-00000066181-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/b46c4144cb4e/cureus-0016-00000066181-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/b6085d4b93a6/cureus-0016-00000066181-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/11bdd43af846/cureus-0016-00000066181-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/e366f135ac55/cureus-0016-00000066181-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/dccb796fd7f6/cureus-0016-00000066181-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/16fde4fab693/cureus-0016-00000066181-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/4b1d0e938fb0/cureus-0016-00000066181-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6677/11373369/e80fa1c68c77/cureus-0016-00000066181-i08.jpg

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本文引用的文献

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Different causes and diverse outcomes of extremely rare septic cavernous sinus thrombosis complicated with internal carotid artery stenosis.极为罕见的感染性海绵窦血栓形成并发颈内动脉狭窄的不同病因和多样结局。
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