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

Mohammad Wasay1, Alper I Dai, Mohsin Ansari

  • 1Aga Khan University, Karachi, Pakistan. mohammad.wasay@aku.edu

Journal of Child Neurology
|January 11, 2008
PubMed

Insights

Pediatric cerebral venous thrombosis (CVT) primarily impacts infants under six months. Neonatal CVT carries a high mortality rate, and many survivors experience neurological deficits, highlighting treatment gaps.

Area of Science:

  • Pediatric Neurology
  • Vascular Neurology
  • Child Health

Background:

  • Cerebral venous thrombosis (CVT) is a significant cause of stroke in children.
  • Understanding the epidemiology and clinical spectrum of pediatric CVT is crucial for improved outcomes.

Purpose of the Study:

  • To analyze clinical findings, risk factors, and outcomes in a large multicenter cohort of children with CVT.
  • To identify prognostic indicators and evaluate current treatment strategies for pediatric CVT.

Main Methods:

  • Retrospective analysis of 70 pediatric patients diagnosed with CVT across 5 US centers.
  • Data collection included demographics, clinical presentation, neurological findings, predisposing factors, imaging, treatment, and outcomes.

Main Results:

  • CVT predominantly affected infants (<6 months), with seizures and coma being common presentations.
  • Infection and perinatal complications were the most frequent predisposing factors.
  • Hemorrhagic infarcts occurred in 40%, and mortality was 13% overall, reaching 25% in neonates. Only 25% received anticoagulation or thrombolysis.

Conclusions:

  • Pediatric CVT is a serious condition, particularly in neonates, with significant morbidity and mortality.
  • Seizures and coma at presentation are associated with poor prognosis.
  • Underutilization of anticoagulation and thrombolysis suggests a need for optimized treatment protocols.

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