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[Clinical and radiological features of cerebral venous thrombosis in a children cohort]
M López-Espejo1, M Hernández-Chávez1, I Huete2
1Unidad de Neurología, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
Insights
Pediatric cerebral venous thrombosis (CVT) features vary by age. Chronic conditions, deep CVT, and brain ischemia are linked to poor outcomes in children.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Pediatric Critical Care
Background:
- Cerebral venous thrombosis (CVT) is an uncommon condition in children.
- Limited research exists on pediatric CVT, particularly regarding age-related differences and outcomes.
Purpose of the Study:
- To investigate clinical and radiological features of non-neonatal pediatric CVT.
- To compare these features based on patient age.
- To analyze associations with functional impairment or mortality at hospital discharge.
Main Methods:
- Observational cohort study of children over 30 days with first CVT.
- Diagnosis confirmed by magnetic resonance imaging/venography.
- Functional impairment assessed using the modified Rankin scale; logistic regression used for outcome analysis.
Main Results:
- 21 patients (42.8% female, median age 6.27 years) were included.
- Younger age associated with diagnostic delay, lower Glasgow Coma Scale scores, seizures, sinus rectus thrombosis, and intracranial hemorrhage.
- Intracranial hypertension syndrome was more common in older children.
- Chronic systemic conditions, deep CVT, and brain ischemia predicted functional impairment or mortality (ORs 11.2-15.8).
Conclusions:
- Clinical and radiological characteristics of pediatric CVT are age-dependent.
- Adverse short-term outcomes are predicted by chronic illnesses, deep venous system involvement, and brain ischemia.
Introduction:
Cerebral venous thrombosis (CVT) is an uncommon and poorly studied condition in the pediatric population.
Objectives:
To describe and compare the clinical and radiological features of non-neonatal children with CVT according to age and to analyze their association with functional impairment or mortality at hospital discharge.
Methodology:
An observational cohort study of chil dren older than 30 days with a first CVT diagnosed with imaging/venography by magnetic resonance (IMR/VMR). We measure functionality with the modified Rankin scale defining marked impairment with 3 to 5 points. We used U-Mann-Whitney test to compare ages averages between groups with and without the different studied variables (significance < 0.05). We used logistic regression analyses to estimate the risk of adverse outcome for each variable expressed in Odds Ratios (ORs) and 95% confidence intervals (CI).
Results:
Among 21 patients recruited, 42.8% were girls, median age 6.27 years (Interquartile range: 0.74-10). The average age was lower in children with diagnostic delay > 48 hours (p = 0.041), score < 12 in the Glasgow coma scale (p = 0.013), seizures (p = 0.041), sinus rectus thrombosis (p = 0.011), and intracranial hemorrhage (p = 0.049); while it was significantly higher in children with intracranial hypertension syndrome (p = 0.008). The presence of some chro nic systemic condition (OR = 11.2; CI = 1.04-120.4), deep CVT (OR = 14; CI = 1.3-150.8), and brain ischemia (OR = 15.8; CI = 1.4-174.2) was associated with marked functional impairment or mor tality at discharge.
Conclusions:
Clinical and radiological features of CVT are age-related. Chronic illnesses, deep venous system involvement, and brain ischemia predict adverse short-term outcomes.
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