儿童脑静脉窦血栓12例临床特征分析

【摘要】
目的 探讨儿童脑静脉窦血栓形成（cerebral venous sinus thrombosis，CVST）发病的危险因素、病因、临床表现、影像学表现及诊治方法。
方法 对2003年1月至2011年6月在北京天坛医院儿科及神经内科就诊的12例儿童脑静脉窦血栓进行回顾性分析。
结果 所有患儿均表现出颅高压症状。鼻窦炎（7例，58.3%）可能为儿童CVST主要发病病因。颅脑磁共振成像（magnetic resonance imaging，MRI）和磁共振静脉成像（magnetic resonance venography，MRV）显示最常见的受累静脉窦为乙状窦和横窦（各11例，占97.1%）。经降颅压、抗凝及对症支持治疗，8例痊愈，4例遗留神经功能缺损。
结论 CVST患儿常以颅高压症状就诊，感染为儿童CVST的最主要危险因素，神经影像学检查能为确诊提供依据，及时治疗可改善预后。

Analysis of Cerebral Venous Sinus Thrombosis in 12 Cases of Children

Objective To explore the risk factors, speculated etiology, clinical manifestations, imaging examination, diagnosis and treatment in children with cerebral venous sinus thrombosis（CVST）. Methods A retrospective study was performed in 12 cases that were diagnosed with CVST in Beijing Tiantan Hospital from Jan. 2003 to Jun. 2011. Results All patients had symptoms resulting from high cranial pressure. We speculated that nasosinusitis（7 cases, 58.3%） may be the main causes. The most common involved venous sinus was sigmoid sinus or transverse sinus. After reducing the intracranial pressure, anticoagulation and supportive treatment, 8 cases cured, and 4 cases had neural function detect. Conclusion Infection is the most important risk in CVST, and the symptom of high cranial pressure is very common. The diagnosis can be confirmed by the neuroimaging, especially magnetic resonance imaging（MRI） and magnetic resonance venography（MRV）. Timely therapy is very necessary to improve outcome.