新生儿出血性及梗死性脑血管病诊治探讨

Clinical features of parenchymal hemorrhage and cerebral infarction of the newborn

摘要:

目的：提高对新生儿脑血管病的认识,探讨其临床发病特点及诊断方法。方法：选用不同的影像学方法对9例由于脑血管畸形所致的新生儿脑实质出血, 17例不同部位脑梗死患儿进行了检查、确诊,并依据神经系统症状,分析临床发病特点。结果：9例脑实质出血发生于额叶、颞叶和枕叶,其中7例在生后72h内发病; 10例因脑血管发育异常致大脑前动脉、中动脉、后动脉供血区梗死; 7例继发于不同疾病,为分支血管供血障碍所致的继发性脑梗死。典型的临床特征是频繁惊厥。结论：新生儿脑血管病最显著的临床症状是频繁惊厥,影像学检查为确诊提供了科学依据,早期治疗对预后有改善作用。

Abstract:

OBJECTIVE: To explore the clinical features and diagnosis of neonatal cerebrovascular disorder. METHODS: The medical documents of 26 cases of neonatal cerebrovascular disorder (parenchymal hemorrhage, n=9; cerebral infarction, n=17) were analyzed retrospectively. RESULTS: Based on clinical neurological symptoms, the diagnosis of neonatal cerebrovascular disorder was confirmed with different imaging techniques. Parenchymal hemorrhage in 9 cases occurred in frontal, temporal and occipitals lobules. Seven out of 9 cases presented within 72 hrs after birth. Of the 17 cases of cerebral infarction, 10 resulted from cerebrovascular malformation and infarction occurred in different blood supply areas: anterior cerebral artery, middle cerebral artery and posterior cerebral artery. Another 7 cases of cerebral infaction were secondary to systemic diseases and presented with branch cerebral artery blood flow disorder. Repeated convulsion was the characteristic symptom in all cases with neonatal cerebrovascular disorder. CONCLUSIONS: This study reported the clinical features of neonatal cerebrovascular disorder. Imaging examination can provide a definitive diagnosis of this disorder.