[1例新生儿出现呼吸窘迫的硬脑膜动静脉瘘]。

Q3 Medicine
Yue DU, Jing-Hua Zhang, Jun-Liang Li, Zhou-Ping Wang, Mei-Gui Wu
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引用次数: 0

摘要

患者为一名20天大的男性,因出生后持续20天的呼吸窘迫入院。主要临床表现为逐渐加重的呼吸窘迫和水肿。患者接受机械通气和利尿剂等治疗。超声心动图显示心脏肥大、肺动脉高压和心力衰竭。全面的全身检查显示前囟门和双侧颞区听诊有明显的吹性血管杂音。进一步的影像学检查包括颅磁共振成像、磁共振血管造影和磁共振静脉造影显示上矢状窦、横窦和乙状窦明显扩张,最终诊断为硬脑膜动静脉瘘。在多学科会诊后,患者接受了脑血管造影和左顶叶动静脉瘘的部分栓塞。术后,患者接受正性肌力、利尿剂和限液治疗。最终,患者停掉呼吸机,出院时病情好转。本文报告一例新生儿硬脑膜动静脉瘘表现为呼吸窘迫,并讨论多学科方法来处理这种情况,这有助于早期疾病识别和指导临床决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Dural arteriovenous fistula in a neonate presenting with respiratory distress].

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.

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来源期刊
中国当代儿科杂志
中国当代儿科杂志 Medicine-Pediatrics, Perinatology and Child Health
CiteScore
1.50
自引率
0.00%
发文量
5006
期刊介绍: The Chinese Journal of Contemporary Pediatrics (CJCP) is a peer-reviewed open access periodical in the field of pediatrics that is sponsored by the Central South University/Xiangya Hospital of Central South University and under the auspices of the Ministry of Education of China. It is cited as a source in the scientific and technological papers of Chinese journals, the Chinese Science Citation Database (CSCD), and is one of the core Chinese periodicals in the Peking University Library. CJCP has been indexed by MEDLINE/PubMed/PMC of the American National Library, American Chemical Abstracts (CA), Holland Medical Abstracts (EM), Western Pacific Region Index Medicus (WPRIM), Scopus and EBSCO. It is a monthly periodical published on the 15th of every month, and is distributed both at home and overseas. The Chinese series publication number is CN 43-1301/R;ISSN 1008-8830. The tenet of CJCP is to “reflect the latest advances and be open to the world”. The periodical reports the most recent advances in the contemporary pediatric field. The majority of the readership is pediatric doctors and researchers.
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