ABSTRACT
Objective@#To summarize the clinical presentations and imaging features of cerebral venous sinus thrombosis (CVST) in 5 newborns.@*Methods@#The clinical data of 5 newborns with CVST admitted to Department of Neonatology of Maternal and Children Hospital of Hubei Province from February 2017 to April 2018 were analyzed retrospectively. The risk factors, clinical presentations, imaging manifestations and treatment of CVST were investigated.@*Results@#Of the 5 full term neonates, 4 were males and 1 female, with 4 aged less than 7 days and 1 more than 7 days; one with the history of maternal gestational diabetes mellitus, one with maternal gestational hypertension. The clinical presentations included seizures (3 cases), fever (3 cases), dehydration (1 cases), lethargy (2 cases), hypoglycemia (2 cases), thrombocytopenia (2 cases). Electroencephalogram (EEG) showed electrical seizures in 3 cases. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed 4 cases of intracranial hemorrhage, 3 cases of cerebral parenchymal infarction. For the sites of the thrombi, 4 were in the superior sagittal sinus, 3 in straight sinus, 2 in transverse sinus and 1 in sinus confluence. CT showed intracranial hemorrhage in 2 cases and venous sinus dilatation in 2 cases. Doppler ultrasound showed 2 cases of intraventricular hemorrhage and 2 cases of changes of venous sinus blood flow. Three neonates were treated with anticoagulant and thrombolytic therapy, followed by recanalization of the veins and discontinuing of seizures.@*Conclusions@#Seizure is the main clinical presentation of CVST. The main radiologic manifestations are cerebral infarction and hemorrhage. Timely brain MRI and MRV are helpful in the early diagnosis and treatment of CVST.
ABSTRACT
Objective To evaluate the relationship between the cytokine levels in the serum and cerebrospinal fluid and the brain injury in preterm infants. Methods From August of 2012 to August of 2013,51 preterm infants were included and 46 infants were survived. All of them were born at the Maternal and Child Hospital of Hubei Pro-vince,with GA≤32 weeks and high risk factors of intrauterine infection and suffering from early onset sepsis. Ac-cording to the screening findings of cerebral ultrasound and/or MRI,the infants were divided into normal group(n=28) and abnormal groups(n=18) with intracranial hemorrhage or white matter damage. The levels of interleukin(IL)-6,IL-1β and tumor necrosis factor-α( TNF-α) in the serum within 12 hours after birth and in cerebrospinal fluid within 72 hours after birth were investigated. The differences in cytokines between two groups were compared with t-test and Chi-square test,and high risk factors of brain injury were analyzed by Logistic regression models. Results The ab-normal group had higher incidence of clinical maternal chorioamnionitis[44. 44%(8/18 cases) vs 14. 29%(4/28 ca-ses),χ2=5.168,P=0.038] and higher white blood cell count[(11.51±9.03)×109/L vs(6.95±5.64)×109/L,t=-2. 107,P=0. 041]. In the abnormal group,the levels of serum IL-6 [(44. 83±16. 31) ng/L],and IL-6,IL-1βand TNF-αin cerebrospinal fluid [(51. 85±15. 65) ng/L,(11. 95±2. 58) ng/L and(193. 11±67. 25) ng/L] were higher than those in the normal group[(36.83±8.76) ng/L,(42.56±12.89) ng/L,(10.26±2.91) ng/L and(160.56± 29. 02) ng/L,respectively] with the statistical difference(t=-2. 687,-2. 250,0. 269,-2. 243,P=0. 010,0. 029,0. 044, 0. 030). Maternal chorioamnionitis,higher serum TNF-αand cerebrospinal fluid IL-6 were high risk factors for brain in-jury(P=0. 014,0. 031,0. 047). Conclusion Increased systemic and cerebrospinal fluid cytokine levels are possibly re-lated to the preterm brain injury when intrauterine infection occurred.