儿科创伤后脑静脉鼻血栓:成功解决与里瓦洛克萨班
Yuxuan Zhang1, Hui Liu1, Hongfang Ding1
1Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying, Shandong, China.
Case reports in pediatrics
|August 4, 2025
概括
大脑静脉鼻血栓 (CVST) 在儿童中很少见,在头部创伤后的初始CT扫描中经常错过. 迅速的MRI/MRV和使用新型口服抗凝剂 (如利瓦洛克萨班) 的抗凝剂导致了成功的康复.
科学领域:
- 儿科神经学 儿科神经学
- 神经辐射学神经辐射学
- 血管神经学 血管神经学
背景情况:
- 大脑静脉鼻血栓 (CVST) 是儿童中风的不常见原因,占儿科中风的0.5%-1.0%.
- CVST很少与封闭性创伤性脑损伤相关,这给诊断带来了挑战.
研究的目的:
- 突出儿童患者中创伤后CVST的诊断挑战.
- 强调儿童头部创伤有持续症状的全面成像检查的重要性.
- 评估新型口服抗凝剂 (NOAC) 在治疗儿科CVST时的疗效和安全性.
主要方法:
- 一个7岁女孩的病例报告,出现神经症状后轻度关闭的脑损伤.
- 最初的CT扫描有微妙的发现,其次是MRI和MRV用于诊断.
- 用埃诺沙巴林治疗与里瓦罗克萨班桥接.
主要成果:
- 由于微妙的初始CT发现,CVST的诊断被推迟了.
- 核磁共振和核磁共振检测证实了CVST.
- 在没有出血并发症的情况下,Rivaroxaban实现了完全的血栓分离.
结论:
- 儿童的创伤后CVST呈现出诊断困难,往往会忽视早期成像征兆.
- 在儿科脑创伤中对成像的警解释对于及时的CVST诊断至关重要.
- 里瓦罗克萨班证明了作为儿科CVST的治疗选择的有效性和安全性.
相关概念视频
Venous Thrombosis III: Interprofessional Care
22
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
22
Venous Thrombosis IV: Nursing Management
23
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
23
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
44
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
44
Venous Thrombosis I: Introduction
41
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
41
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
36
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
36
Pulmonary Embolism III: Nursing Management
41
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
41


