Neonatal sinovenous thrombosis: presentation and association with imaging

Few studies have examined when children with neonatal sinovenous thrombosis come to medical attention, risk factors associated with time of presentation, what clinical presentations are more likely to occur early or late, or whether the timing of presentation or severity of clinical presentation correlate with radiographic findings. Chi-square and Fisher's exact tests were used to explore associations in a cohort of 59 neonates with sinovenous thrombosis. Most (66%) came to medical attention within 48 hours of birth (defined as early presentation). Most (88%) had multiple comorbidities. Respiratory distress (P = 0.005), hypoxia (P = 0.02), poor tone (P = 0.05), fetal distress (P < 0.001), preterm delivery (P = 0.044), and low Apgar score (P = 0.018) were associated with early presentation. Infant dehydration was associated with late presentation (P < 0.001). Time of presentation was not associated with radiographic severity. Presentation with difficult-to-control seizures was marginally associated with hemorrhage (P = 0.096) but no other measure of radiographic severity. Neonates with sinovenous thrombosis often present within 48 hours, with multiple comorbidities and presenting signs, some of which are associated with time of presentation. Neither timing of presentation nor presence or absence of severe seizures can be used to predict findings on radiographic imaging.