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[Clinical analysis of cerebral venous sinus thrombosis in six children]
1Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Insights
Infection is a primary risk factor for childhood cerebral venous sinus thrombosis (CVST). Early diagnosis with brain MRI and MRV, followed by treatment, can improve outcomes for pediatric patients with CVST.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Medical Imaging
Background:
- Cerebral venous sinus thrombosis (CVST) is a rare but serious condition in children.
- Understanding its clinical features and risk factors is crucial for timely diagnosis and management.
- This study focuses on a small cohort to add to the existing knowledge base.
Purpose of the Study:
- To summarize the clinical characteristics of pediatric cerebral venous sinus thrombosis (CVST).
- To enhance the understanding of CVST in the pediatric population.
- To identify key risk factors and diagnostic findings.
Main Methods:
- Retrospective analysis of 6 pediatric CVST cases (January 2012 - December 2017).
- Review of risk factors, clinical presentations, laboratory findings, and imaging (MRI/MRV).
- Evaluation of treatment responses and patient outcomes.
Main Results:
- Infection was the most common risk factor (3/6 cases), followed by chemotherapy and corticosteroid use.
- Headache was universal; other symptoms included vomiting, convulsions, and focal neurological deficits.
- MRI/MRV revealed intracranial hemorrhage, cerebral infarction, and venous sinus abnormalities; superior sagittal and transverse sinuses were most affected.
- Anticoagulation led to symptom improvement and venous recanalization in all cases, though two cases had persistent deficits.
Conclusions:
- Infection is a significant risk factor for pediatric CVST.
- Headache is a common presenting symptom prompting medical consultation.
- Brain MRI and MRV are vital for diagnosis, and prompt treatment improves prognosis.
Abstract:
Objective: To summarize the clinical features of cerebral venous sinus thrombosis (CVST) in 6 children, and to improve the understanding of CVST in children. Methods: The risk factors, clinical presentations, laboratory findings, imaging manifestations, treatments and outcomes of 6 children (3 males, 3 females) with CVST admitted to the Department of Pediatrics, First Affiliated Hospital of Zhengzhou University from January 2012 to December 2017 were analyzed retrospectively. Results: The risk factors of disease were found in 5 cases, including 3 cases of infection, 1 case of L-asparaginase and dexamethasone chemotherapy and 1 case of oral prednisone alone. No definite risk factor was found in 1 case. The clinical presentations were headache in all cases, vomiting in 3 cases, convulsion in 2 cases, hemiplegia, photophobia, phonophobia and limitation of eyeball abduction in 1 case respectively. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed 2 cases of intracranial hemorrhage, 2 cases of cerebral parenchymal infarction and 2 cases of abnormal signal in venous sinus. Thrombus located in superior sagittal sinus in 4 cases, transverse sinus in 4 cases, sigmoid sinus in 3 cases and straight sinus in 1 case. After anticoagulation treatment, headache and vomiting were alleviated, and veins were recanalized in 6 cases. Two cases were diagnosed with eyeball abduction limitation and hemiplegia but did not improve in the short term after treatment. Conclusions: Infection is the main risk factor of CVST in children and headache is often the cause of medical consultation. Brain MRI and MRV are helpful in diagnosis and timely treatment can improve prognosis.
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