Cerebral venous sinus thrombosis in children: a multicenter cohort from the United States

J Child Neurol. 2008 Jan;23(1):26-31. doi: 10.1177/0883073807307976.

Abstract

This study presents a large multicenter cohort of children with cerebral venous thrombosis from 5 centers in the United States and analyzes their clinical findings and risk factors. Seventy patients were included in the study (25 neonates, 35%). The age ranged from 6 days to 12 years. Thirty-eight (55%) were younger than 6 months of age, and 28 (40%) were male. Presenting features included seizures (59%), coma (30%), headache (18%), and motor weakness (21%). Common neurological findings included decreased level of consciousness (50%), papilledema (18%), cranial nerve palsy (33%), hemiparesis (29%), and hypotonia (22%). Predisposing factors were identified in 63 (90%) patients. These included infection (40%), perinatal complications (25%), hypercoagulable/hematological diseases (13%), and various other conditions (10%). Hemorrhagic infarcts occurred in 40% of the patients and hydrocephalus in 10%. Transverse sinus thrombosis was more common (73%) than sagittal sinus thrombosis (35%). Three children underwent thrombolysis, 15 patients received anticoagulation, and 49 (70%) were treated with antibiotics and hydration. Nine (13%) patients (6 of them neonates) died. Twenty-nine patients (41%) were normal, whereas 32 patients (46%) had a neurological deficit at discharge. Seizures and coma at presentation were poor prognostic indicators. In conclusion, cerebral venous thrombosis predominantly affects children younger than age 6 months. Mortality is high (25%) in neonatal cerebral venous thrombosis. Only 18 (25%) patients were treated with anticoagulation or thrombolysis.

Publication types

  • Multicenter Study

MeSH terms

  • Anticoagulants / therapeutic use
  • Brain Infarction / mortality
  • Causality
  • Child
  • Child, Preschool
  • Cohort Studies
  • Comorbidity
  • Consciousness Disorders / epidemiology
  • Cranial Nerve Diseases / epidemiology
  • Cranial Sinuses / pathology*
  • Cranial Sinuses / physiopathology*
  • Female
  • Humans
  • Hydrocephalus / mortality
  • Infant
  • Infant, Newborn
  • Male
  • Mortality
  • Muscle Hypotonia / epidemiology
  • Papilledema / epidemiology
  • Paresis / epidemiology
  • Prognosis
  • Retrospective Studies
  • Sinus Thrombosis, Intracranial / drug therapy
  • Sinus Thrombosis, Intracranial / mortality*
  • Sinus Thrombosis, Intracranial / physiopathology*
  • Thrombolytic Therapy / statistics & numerical data
  • United States / epidemiology

Substances

  • Anticoagulants