Reul J, Weber U, Kotlarek F, Isensee C, Thron A
Abt. Neuroradiologie, Rheinisch-Westfälisch-Technischen Hochschule Aachen.
Klin Padiatr. 1997 May-Jun;209(3):116-20. doi: 10.1055/s-2008-1043939.
The syndrome of raised intracranial pressure without any space-occupying lesion (pseudotumor cerebri) is still of unknown etiology. To some degree, secondary causes can be found. With respect to the therapeutical possibilities, a clinically important cause is the thrombosis of a major cerebral sinus. In children it is sometimes associated with otitis media. However, clinical signs of mastoiditis can be missed because of previous antibiotic treatment. We observed 11 children with pseudotumor cerebri. Four children suffered from an occlusion of a lateral major sinus after otitis media. The treatment with heparin in the acute stage and later on with acetylsalicylic-acid led to complete recovery. Our results suggest that the thrombosis of a major cerebral sinus induced by an otitis media is a frequent cause of pseudotumor cerebri in children and should be excluded by MRI or angiography in any doubtful case. In contrast to the treatment of adults, long term anticoagulation is not necessary.
颅内压升高但无任何占位性病变的综合征(假性脑瘤)病因仍不明。在某种程度上,可以找到继发原因。关于治疗可能性,一个临床重要原因是大脑主要静脉窦血栓形成。在儿童中,它有时与中耳炎有关。然而,由于先前的抗生素治疗,乳突炎的临床体征可能会被漏诊。我们观察了11例假性脑瘤患儿。4例患儿在中耳炎后出现外侧主要静脉窦闭塞。急性期用肝素治疗,后期用乙酰水杨酸治疗后完全康复。我们的结果表明,中耳炎引起的大脑主要静脉窦血栓形成是儿童假性脑瘤的常见原因,在任何可疑病例中都应通过磁共振成像(MRI)或血管造影排除。与成人治疗不同,不需要长期抗凝。