DU Yue, Zhang Jing-Hua, Li Jun-Liang, Wang Zhou-Ping, Wu Mei-Gui
Center for Newborn Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Apr 15;27(4):500-504. doi: 10.7499/j.issn.1008-8830.2411146.
The patient, a 20-day-old male, was admitted due to respiratory distress that had persisted for 20 days after birth. The main clinical manifestations included gradually worsening respiratory distress and edema. The patient received treatment including mechanical ventilation and diuretics. Echocardiography indicated cardiomegaly, pulmonary hypertension, and heart failure. A comprehensive systemic examination revealed a significant blowing vascular murmur upon auscultation over the anterior fontanelle and bilateral temporal regions. Further imaging studies including cranial magnetic resonance imaging, magnetic resonance angiography, and magnetic resonance venography showed marked dilation of the superior sagittal sinus, transverse sinus, and sigmoid sinus, leading to a definitive diagnosis of dural arteriovenous fistula. After a multidisciplinary consultation, the patient underwent cerebral angiography and partial embolization of the left parietal arteriovenous fistula. Postoperatively, the patient was treated with positive inotropes, diuretics, and fluid restriction. Ultimately, the patient was weaned off the ventilator and discharged in improved condition. This article reports a case of neonatal dural arteriovenous fistula presenting with respiratory distress and discusses the multidisciplinary approach to managing this condition, which aids in early disease recognition and guides clinical decision-making.
该患者为一名20日龄男性，因出生后持续20天的呼吸窘迫入院。主要临床表现为呼吸窘迫逐渐加重和水肿。患者接受了包括机械通气和利尿剂在内的治疗。超声心动图显示心脏扩大、肺动脉高压和心力衰竭。全面的系统检查发现，在前囟门和双侧颞区听诊时可闻及明显的吹风样血管杂音。包括头颅磁共振成像、磁共振血管造影和磁共振静脉造影在内的进一步影像学研究显示上矢状窦、横窦和乙状窦明显扩张，最终确诊为硬脑膜动静脉瘘。经过多学科会诊后，患者接受了脑血管造影和左侧顶叶动静脉瘘的部分栓塞术。术后，患者接受了正性肌力药物、利尿剂治疗并限制液体摄入。最终，患者脱机，病情好转后出院。本文报告了一例以呼吸窘迫为表现的新生儿硬脑膜动静脉瘘病例，并讨论了管理这种疾病的多学科方法，这有助于早期疾病识别并指导临床决策。
