关键词: 新生儿, 脑白质静脉梗死, 脑脓肿

Abstract:

Objective To investigate the risk factors, clinical manifestations and imaging characteristics of cerebral deep white matter venous infarction in neonates. Methods The clinical data of 8 neonates with cerebral deep white matter venous infarction confirmed by cranial imaging during January 1, 2017 to December 31, 2019 were retrospectively analyzed, and the etiological factors, clinical manifestations and imaging characteristics of the neonates were analyzed and summarized. Results Among the 8 neonates with deep white matter venous infarction, 6 were premature and 2 were full term. The mean gestational age was (32.2±3.9) weeks and the mean birth weight was (1932.0±794.0) g. The age of onset ranged from 1 day to 30 days. Five neonates underwent pathological examination of placenta, including 4 cases of chorioamnionitis and 1 case of intervillous thrombus. Four cases were complicated with purulent meningitis, 3 cases had a history of perinatal hypoxia, and 1 case had intrauterine rubella virus infection with polycythemia. Among the 8 neonates, 4 had fever, 3 had transient seizures, and 2 were asymptomatic. One patient underwent puncture at the site of craniocerebral infarction, and 60mL of bleeding like fluid was aspirated, and bacterial culture was negative. Cranial MRI was performed between 2 and 54 days after onset. MRI showed that white matter venous infarction mostly occurred in the frontal parietal white matter (6/8), with enhanced signals surrounding the lesions. Cerebral infarction site could be accompanied by liquefaction and cavity, which is easily confused with cerebral abscess. Conclusions Chorioamnionitis, purulent meningitis and perinatal hypoxia are the main inducing factors of neonatal deep white matter venous infarction. The clinical manifestations of cerebral venous infarction are easy to be ignored. Their MRI findings are often confused with cerebral abscesses, and attention should be paid tothe identification.

Key words: newborn, cerebral white matter venous infarction, cerebral abscesses