Lateral dural sinus thrombosis in childhood

Area of Science:

• Pediatric Neurology
• Medical Imaging
• Infectious Diseases

Background:

• Dural sinus thrombosis (DST) is a rare but serious condition in children.
• Etiologies include infection, trauma, and inherited coagulation disorders.
• Diagnosis and management remain challenging, necessitating clear diagnostic and therapeutic guidelines.

Purpose of the Study:

• To elucidate the causes, diagnostic methods, and treatment strategies for pediatric dural sinus thrombosis (DST).
• To evaluate the utility of contrast-enhanced computed tomography (CECT) in diagnosing DST.
• To assess the efficacy of anticoagulation, surgical sinus drainage, and internal jugular vein (IJV) ligation.

Main Methods:

• Retrospective chart review of 15 pediatric patients diagnosed with DST via CT scans between 1986 and 1996.
• Analysis of CT findings and clinical outcomes.
• Correlation of etiology with clinical presentation and treatment response.

Main Results:

• Etiologies were categorized into infection (n=6), trauma (n=6), and coagulation disorders (n=3).
• CECT accurately diagnosed DST in all cases; Fusobacterium necrophorum identified in septic cases.
• Septic DST patients underwent mastoidectomy and sigmoid sinus drainage; anticoagulation with IV heparin was administered, obviating IJV ligation.
• Coagulation disorders included protein C or S deficiency.

Conclusions:

• CECT is a highly sensitive tool for diagnosing DST in children.
• For septic DST, the recommended treatment involves antibiotics and early surgical drainage.
• Anticoagulation therapy is advised for pediatric septic DST patients during hospitalization.