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Related Experiment Videos

Neonatal dural sinus thrombosis.

M I Shevell1, K Silver, A M O'Gorman

  • 1Department of Neurology, Montreal Children's Hospital, Canada.

Pediatric Neurology
|May 1, 1989
PubMed
Summary
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Dural sinus thrombosis is an under-recognized cause of neonatal seizures in term infants. Most infants, especially those without perinatal asphyxia, experience normal neurodevelopment and have a low risk of seizure recurrence.

Area of Science:

  • Neonatal Neurology
  • Pediatric Radiology
  • Vascular Neurology

Background:

  • Dural sinus thrombosis (DST) in neonates is rarely documented, with an unclear clinical presentation.
  • Neonatal seizures are a common presentation, but the underlying cause is often not identified.
  • Understanding DST in term infants is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the clinical presentation, diagnosis, and outcomes of dural sinus thrombosis in term newborns.
  • To identify risk factors and associated conditions in neonatal dural sinus thrombosis.
  • To evaluate neurodevelopmental outcomes and seizure recurrence in affected infants.

Main Methods:

  • Retrospective review of 17 term infants diagnosed with dural sinus thrombosis in the neonatal period.

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  • Diagnosis confirmed by unenhanced computed tomography (CT) showing a dense sagittal sinus and small ventricles.
  • Ancillary studies including cerebral angiography and nuclear flow scans were used in select cases.

    • Main Results:

    • Neonatal seizures were the presenting symptom in 15 out of 17 patients, predominantly within the first week of life.
    • Only 4 patients had evidence of perinatal asphyxia; 3 had predisposing conditions; none had identifiable hypercoagulable states.
    • In infants without perinatal asphyxia (11/12), neurodevelopmental outcomes were normal. Two of 4 infants with perinatal asphyxia experienced neurologic sequelae.

    Conclusions:

    • Dural sinus thrombosis is a significant, under-recognized cause of seizures in term neonates.
    • Normal neurodevelopmental outcomes are probable in neonates with DST who do not have perinatal asphyxia.
    • The risk of seizure recurrence is low following neonatal dural sinus thrombosis, particularly without perinatal asphyxia.