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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Cerebral sinovenous thrombosis in children

G deVeber1, M Andrew, C Adams

  • 1Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada.

The New England Journal of Medicine
|August 11, 2001
PubMed

Insights

Cerebral sinovenous thrombosis (CSVT) in children, particularly neonates, often leads to severe outcomes. Seizures and venous infarcts are key indicators of poor prognosis in pediatric CSVT cases.

Area of Science:

  • Pediatric Neurology
  • Vascular Neurology
  • Pediatric Critical Care

Background:

  • Cerebral sinovenous thrombosis (CSVT) is a significant neurological disorder in children, necessitating further research into its prevention and management.
  • Understanding the epidemiology and risk factors of pediatric CSVT is crucial for early diagnosis and intervention.

Purpose of the Study:

  • To investigate the incidence, clinical characteristics, risk factors, and outcomes of cerebral sinovenous thrombosis in pediatric patients.
  • To identify predictors of adverse neurological outcomes in children diagnosed with CSVT.

Main Methods:

  • Data collected from the Canadian Pediatric Ischemic Stroke Registry between 1992 and 1998.
  • Inclusion criteria: Children aged 0-18 years with symptomatic and radiographically confirmed CSVT.
  • Analysis of demographic data, clinical presentation, risk factors, treatment, and outcomes.

Main Results:

  • The incidence of CSVT was 0.67 per 100,000 children annually, with neonates being the most affected population.
  • Common clinical features included seizures (58%), diffuse (76%) and focal (42%) neurological signs.
  • Identified risk factors: head/neck disorders (29%), acute (54%) and chronic (36%) systemic illnesses, and prothrombotic states (41%).
  • Venous infarcts occurred in 41% of cases; 53% received antithrombotic agents.
  • Adverse outcomes: neurological deficits in 38%, mortality in 8% (half attributed to CSVT).
  • Predictors of poor outcomes were seizures at presentation and venous infarcts.

Conclusions:

  • Pediatric CSVT predominantly affects neonates and is associated with significant morbidity and mortality, impacting approximately half of the affected children.
  • The presence of venous infarcts or seizures at the time of diagnosis indicates a higher likelihood of poor neurological outcomes.
Abstract

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