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创伤性小脑水肿:小儿患者幕下发育性静脉异常的罕见表现

Trauma-Induced Cerebellar Edema: A Rare Presentation of Infratentorial Developmental Venous Anomaly in a Pediatric Patient.

作者信息

Micovic Mirko, Zivkovic Bojana, Vukasinovic Ivan, Nedeljkovic Aleksandra, Nedeljkovic Zarko, Bascarevic Vladimir

机构信息

Clinic of Neurosurgery, University Clinical Center of Serbia, Dr Koste Todorovica 4, Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, Dr Subbotica 8, Serbia, 11000, Belgrade, Serbia.

出版信息

Cerebellum. 2025 May 19;24(4):100. doi: 10.1007/s12311-025-01852-9.

Abstract

INTRODUCTION

Developmental venous anomaly (DVA) is a common cerebral vascular variant, typically considered benign and clinically silent. We report an exceptional case of a symptomatic infratentorial DVA in a 9-year-old child that became clinically evident after a minor head trauma.

CASE REPORT

The patient presented with neurological symptoms indicative of posterior fossa involvement, including headache, nausea, and ataxia. MRI revealed a cluster of abnormally dilated medullary veins in the right cerebellar hemisphere converging into an enlarged collector vein, consistent with a DVA. Significant cerebellar edema was identified in association with detected vascular malformation. The patient was managed conservatively with antiedematous therapy and analgesics, which led to rapid resolution of symptoms and complete recovery.

CONCLUSION

This case demonstrates that DVAs can become acutely symptomatic secondary to significant vasogenic edema following even minor head trauma, likely due to transient hemodynamic disturbance without thrombosis or hemorrhage. Our findings challenge the perception of DVAs as invariably benign entities and warrant further investigation into their post-traumatic pathophysiology.

摘要

引言

发育性静脉异常(DVA)是一种常见的脑血管变异,通常被认为是良性的且临床上无症状。我们报告一例9岁儿童有症状的幕下DVA的特殊病例,该病例在轻度头部外伤后临床表现明显。

病例报告

患者出现提示后颅窝受累的神经症状,包括头痛、恶心和共济失调。磁共振成像(MRI)显示右小脑半球一群异常扩张的髓静脉汇聚成一条增粗的引流静脉,符合DVA表现。发现与检测到的血管畸形相关的明显小脑水肿。患者采用抗水肿治疗和镇痛药进行保守治疗,症状迅速缓解并完全康复。

结论

该病例表明,即使是轻度头部外伤后,DVA也可能因显著的血管源性水肿而急性出现症状,可能是由于短暂的血流动力学紊乱,无血栓形成或出血。我们的发现挑战了DVA始终是良性病变的观念,有必要进一步研究其创伤后病理生理学。

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