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Thalamic stroke secondary to straight sinus thrombosis in a nephrotic child
Chih-Chong Lin1, Chun-Chung Lui, You-Lin Tain
1Department of Pediatrics, Division of Pediatric Nephrology, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan, Republic of China.
Insights
Nephrotic syndrome can cause cerebral sinus thrombosis, leading to stroke in children. Early diagnosis with MRI venography and anticoagulation therapy, including low-molecular-weight heparin and warfarin, effectively improved outcomes.
Area of Science:
- Pediatric Neurology
- Pediatric Nephrology
- Vascular Neurology
Background:
- Steroid-resistant nephrotic syndrome (SRNS) is a severe kidney disorder in children.
- Cerebral sinus thrombosis (CST) is a rare but serious complication, potentially leading to neurological deficits.
- Thrombotic events are a known risk in nephrotic patients due to altered coagulation factors.
Observation:
- A 7-year-old boy with SRNS presented with status epilepticus and coma.
- He was diagnosed with thalamic stroke secondary to straight sinus thrombosis.
- Magnetic resonance imaging with venography (MRV) was crucial for diagnosing the cerebral sinus thrombosis.
Findings:
- Anticoagulation therapy with low-molecular-weight heparin (LMWH) and warfarin was initiated.
- The patient demonstrated significant neurological recovery following treatment.
- This case underscores the link between nephrotic syndrome, CST, and stroke.
Implications:
- Early diagnosis of CST in nephrotic children is critical and achievable with MRV.
- Prompt anticoagulation therapy is effective in improving neurological outcomes for pediatric CST.
- This case emphasizes the need for vigilance regarding thrombotic complications in pediatric nephrotic syndrome.
Abstract:
A 7-year-old Chinese boy with steroid-resistant nephrotic syndrome developed thalamic stroke secondary to straight sinus thrombosis. He was hospitalized due to status epilepticus and coma. The child recovered after treatment by low-molecular-weight heparin (LMWH) and warfarin. This case highlights the importance of magnetic resonance imaging with venography in the early diagnosis of cerebral sinus thrombosis (CST) in nephrotic children and the effectiveness of anticoagulation therapy in improving the neurological outcome.