Abstract：
BACKGROUND: Cerebral venous thrombosis (CVT) is a cerebrovascular disorder that accounts for 20% of perinatal strokes. CVT incidence ranges from 0.67 to 1.12 per 100,000 newborns, while the incidence of \"deep medullary vein thrombosis\" (DMVT), a subtype of CVT, cannot be accurately estimated. This study aims to analyze the case history of CVT in the neonatal period, with a specific focus on DMVT.
METHODS: Newborns diagnosed with CVT, with or without DMVT, between January 2002 and April 2023, were collected using the Italian Registry of Infantile Thrombosis (RITI). Cerebral MRIs were reviewed by an expert neuroradiologist following a standardized protocol.
RESULTS: Forty-two newborns with CVT were identified, of which 27/42 (64%) had CVT, and the remaining 15/42 (36%) had DMVT (isolated DMVT in 9/15). Symptom onset occurred in the first week of life (median 8 days, IQR 4-14) with a male prevalence of 59%. The most common risk factors for CVT were complicated delivery (38%), prematurity (40%), congenital heart diseases (48%), and infections (40%). Seizures were the predominant presenting symptom in 52% of all cases. Hemorrhagic infarction was higher in cases with isolated DMVT (77%) compared to patients with CVT without DMVT (p = 0.013). Antithrombotic treatment was initiated in 36% of patients. Neurological impairment was observed in 48% of cases at discharge, while 18 out of 31 infants (58%) presented one or more neurological deficits at long term follow up. Conclusion: DMVT occurs in over a third of neonates with CVT. Multicentric studies are essential to establish standardized protocols for therapy, neuroimaging, and follow-up in these patients.
METHODS: Newborns diagnosed with CVT, with or without DMVT, between January 2002 and April 2023, were collected using the Italian Registry of Infantile Thrombosis (RITI). Cerebral MRIs were reviewed by an expert neuroradiologist following a standardized protocol.
RESULTS: Forty-two newborns with CVT were identified, of which 27/42 (64%) had CVT, and the remaining 15/42 (36%) had DMVT (isolated DMVT in 9/15). Symptom onset occurred in the first week of life (median 8 days, IQR 4-14) with a male prevalence of 59%. The most common risk factors for CVT were complicated delivery (38%), prematurity (40%), congenital heart diseases (48%), and infections (40%). Seizures were the predominant presenting symptom in 52% of all cases. Hemorrhagic infarction was higher in cases with isolated DMVT (77%) compared to patients with CVT without DMVT (p = 0.013). Antithrombotic treatment was initiated in 36% of patients. Neurological impairment was observed in 48% of cases at discharge, while 18 out of 31 infants (58%) presented one or more neurological deficits at long term follow up. Conclusion: DMVT occurs in over a third of neonates with CVT. Multicentric studies are essential to establish standardized protocols for therapy, neuroimaging, and follow-up in these patients.
摘要：
背景：脑静脉血栓形成（CVT）是一种脑血管疾病，占围产期中风的20％。CVT发生率为每100,000名新生儿0.67至1.12，而“深髓静脉血栓形成”(DMVT)的发生率，CVT的一个子类型，无法准确估计。本研究旨在分析新生儿期CVT的病史,特别关注DMVT。
方法：诊断为CVT的新生儿，有或没有DMVT，在2002年1月至2023年4月之间，使用意大利婴儿血栓形成登记处（RITI）进行了收集。根据标准化方案，专家神经放射科医师对大脑MRI进行了审查。
结果：确定了42例CVT新生儿，其中27/42（64%）有CVT，其余15/42（36％）患有DMVT（9/15的孤立DMVT）。症状发生在生命的第一周（中位数为8天，IQR4-14)，男性患病率为59%。CVT最常见的风险因素是复杂的交付(38%)，早产（40%），先天性心脏病（48%），感染（40%）。在所有病例中，癫痫发作是主要的症状。与无DMVT的CVT患者相比，孤立的DMVT患者的出血性梗死较高（77％）（p=0.013）。36%的患者开始抗血栓治疗。48％的病例在出院时观察到神经功能障碍，31名婴儿中有18名（58％）在长期随访中出现了一种或多种神经功能缺损。结论：超过三分之一的CVT新生儿发生DMVT。多中心研究对于建立标准化的治疗方案至关重要，神经影像学,并对这些患者进行随访。
方法：诊断为CVT的新生儿，有或没有DMVT，在2002年1月至2023年4月之间，使用意大利婴儿血栓形成登记处（RITI）进行了收集。根据标准化方案，专家神经放射科医师对大脑MRI进行了审查。
结果：确定了42例CVT新生儿，其中27/42（64%）有CVT，其余15/42（36％）患有DMVT（9/15的孤立DMVT）。症状发生在生命的第一周（中位数为8天，IQR4-14)，男性患病率为59%。CVT最常见的风险因素是复杂的交付(38%)，早产（40%），先天性心脏病（48%），感染（40%）。在所有病例中，癫痫发作是主要的症状。与无DMVT的CVT患者相比，孤立的DMVT患者的出血性梗死较高（77％）（p=0.013）。36%的患者开始抗血栓治疗。48％的病例在出院时观察到神经功能障碍，31名婴儿中有18名（58％）在长期随访中出现了一种或多种神经功能缺损。结论：超过三分之一的CVT新生儿发生DMVT。多中心研究对于建立标准化的治疗方案至关重要，神经影像学,并对这些患者进行随访。
