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Does intracranial venous thrombosis cause subdural hemorrhage in the pediatric population?

L A McLean1, L D Frasier, G L Hedlund

  • 1Department of Radiology, University of Utah, Salt Lake City, Utah 84132-2140, USA. Logan.McLean@hsc.utah.edu

AJNR. American Journal of Neuroradiology
|February 21, 2012
PubMed

Insights

This study found no evidence that intravenous thrombolysis (IVT) causes subdural hemorrhage (SDH) in children. These findings challenge previous research suggesting a link between IVT and SDH in pediatric patients.

Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Child Abuse Pediatrics

Background:

  • Subdural hemorrhage (SDH) in children without clear trauma is often attributed to abusive head trauma (AHT).
  • Intravenous thrombolysis (IVT) has been hypothesized as a potential cause of acute SDH, mimicking traumatic injury.

Purpose of the Study:

  • To investigate the association between non-traumatic intravenous thrombolysis (IVT) and the occurrence of subdural hemorrhage (SDH) in pediatric patients.
  • To evaluate whether IVT can be an initiating event for SDH in infants and children.

Main Methods:

  • Retrospective review of neuroimaging studies for 36 pediatric patients who underwent IVT.
  • Assessment for the concurrent presence of SDH in patients with IVT.

Main Results:

  • No cases of SDH were observed in the 36 pediatric patients with IVT.
  • Extensive IVT did not correlate with the presence of SDH.
  • Three cases initially diagnosed with IVT were reclassified as false positives due to mastoiditis and traumatic SDH.

Conclusions:

  • The study findings do not support the hypothesis that IVT causes or is associated with SDH in neonates, infants, or children.
  • Current literature suggesting IVT as a cause of pediatric SDH may require re-evaluation.

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