Cerebral Venous Thrombosis in Children

從民國七十三年五月至民國八十四年四月共有16個病人被斷為腦靜脈竇血栓。他們的年齡分布從一個月大至16歲（平均年齡2.5歲）。對於嬰兒而言，其臨床表現主要是抽搐和意識的改變；且主要和頭部外傷、腹瀉或脫水有關。所有嬰兒在追蹤的一至十年中分別有輕至重度的運動障礙。相較之下，較大的小孩主要是以頭痛(37%)或意識改變(50%)表現；且常和敗血症或局部感染有關：雖然有4個大於1歲的小孩最後預後並不好，但是都與原先腦血管栓塞較為廣泛有關。MRI和MRA比CT的診斷價值高，近年來已漸漸取而代之。我們認為，小孩子的靜脈竇血栓預後較嬰兒為佳，但仍須視原先腦傷害的嚴重程度而定，由於嬰兒常以難控制的抽搐來表現，對於這類嬰幼兒，腦靜脈竇血栓須列入鑑別診斷。

關鍵字

腦靜脈竇血栓；兒童

並列摘要

From May 1984 to April 1995, a total of 16 patients (12 females, 4 males) with cerebral venous thrombosis, diagnosed by computed tomography (CT), conventional cerebral angiography, magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA), were reviewed retrospectively. The age ranged from 1 month to 16 years of age (average: 2.5 years) with 8 below 1 year of age. The presenting symptoms for infants were mental change (75%) and seizure (100%), mainly generalized (63%) in character. Associated illness was mainly closed head injury, diarrhea or dehydration. All infants had mild to severe motor handicap in a 1 to 10 year follow-up. In contrast, older children frequently presented with headache (37%) or consciousness change (50%), and were more frequently associated with sepsis or local infections. Four (50%) of them recovered completely, but two died and two were finally in a vegetative state. For the four patients with poor prognosis, all had severe initial insults and widespread sinus thrombosis. MRI and MRA are better than CT for the diagnosis of cerebral venous thrombosis. It was concluded that prognosis for venous thrombosis cases in infants is worse than in older children, but this also depends on the severity of initial insults. For infants who present with intractable seizures, cerebral venous thrombosis should be taken into account when the seizures are difficult to control.

並列關鍵字

cerebral venous thrombosis ； children

國際替代計量

Cerebral Venous Thrombosis in Children

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