Posttraumatic intracerebral venous thrombosis: an infant who has fallen off a hammock

Area of Science:

• Pediatric Neurology
• Neuroradiology
• Hematology

Background:

• Cerebral venous thrombosis (CVT) is a rare but serious condition in infants.
• Trauma is a potential risk factor for CVT, but may not always be immediately reported.

Observation:

• A 45-day-old infant presented with acute neurological deterioration including drowsiness, pallor, and respiratory failure.
• Initial history denied trauma, but later revealed a fall from a hammock.
• Cranial imaging identified extensive cerebral venous sinus thrombosis, subdural hematoma, cerebral edema, and infarction.

Findings:

• Despite the absence of cranial fractures on imaging, the infant was diagnosed with extensive cerebral venous sinus thrombosis.
• Magnetic resonance imaging confirmed thrombosis in the sigmoid, superior sagittal, and straight sinuses.
• The infant experienced diffuse cerebral edema and infarction in the right posterior temporal, parietal, and occipital lobes.

Implications:

• This case underscores the critical need to consider trauma, even minor falls, as a potential cause of CVT in infants.
• Early diagnosis and prompt anticoagulation therapy, such as with unfractionated heparin, can lead to favorable outcomes.
• Healthcare providers should maintain a high index of suspicion for trauma-induced CVT in pediatric patients presenting with neurological symptoms.