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Cerebral sinovenous thrombosis in children: A single-center experience
İpek Dokurel Çetin1, Cenk Eraslan2, Erdem Şimşek1
1Department of Child Health and Diseases, Department of Child Neurology, Ege University School of Medicine, İzmir, Turkey.
Insights
Cerebral sinovenous thrombosis (CSVT) in children is often linked to infections and genetic factors. Early diagnosis and prompt anticoagulant therapy are crucial for favorable outcomes, as no mortality was observed in this study.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
Background:
- Cerebral sinovenous thrombosis (CSVT) is a rare but serious condition in children.
- Understanding its clinical presentation, causes, and outcomes is vital for timely management.
Purpose of the Study:
- To comprehensively evaluate pediatric patients diagnosed with CSVT.
- To analyze clinical findings, etiology, risk factors, imaging characteristics, treatment, and long-term prognosis.
Main Methods:
- Retrospective evaluation of medical records of 19 pediatric patients (0-17 years) with confirmed CSVT.
- Data collected included clinical presentation, etiology, genetic factors, imaging findings, treatment, and follow-up outcomes.
Main Results:
- Headache and papilledema were the most common presenting symptoms and signs.
- Identified etiologies included infections (otitis, sinusitis), catheter use, and Behçet's disease; MTHFR mutation was a common genetic factor.
- The transverse sinus was the most frequently affected site (68.4%).
- Sequelae included hemiparesis (15.7%) and epilepsy (26.3%) after a median follow-up of 12 months; no mortality occurred.
Conclusions:
- Prompt neurological imaging is recommended for infants and children with altered consciousness, especially those with infections or chronic conditions.
- Funduscopic examination for papilledema is essential in children presenting with headache.
- Immediate initiation of anticoagulant therapy is critical upon diagnosis of CSVT.
Objective:
The study aimed to evaluate the patients with a diagnosis of cerebral sinovenous thrombosis in terms of clinical findings, etiology and underlying risk factors, imaging findings, treatment, and prognosis in the long term.
Materials And Methods:
Medical records of 19 patients whose ages ranged between 0 days and 17 years with clinical and radiological cerebral sinovenous thrombosis in Ege University Department of Child Neurology were retrospectively evaluated.
Results:
Nine of nineteen cases were female (47.3%). The median age was 84 months (0-201 months). The most common complaint at the presentation was headache (n=12) and the most common physical examination finding was papilledema (n=11). In etiology, otitis/mastoiditis in three cases, iron deficiency anemia in three cases, sinusitis in two cases, catheter use in four cases, Behçet's disease in three cases were determined. The most common observed genetic factors causing thrombosis was methylenetetrahydrofolate reductase mutation. The transverse sinus (68.4%) is the sinus where thrombosis is most frequently observed. As a result of an average follow-up of 12 months (2-72 months), hemiparesis (n=3/19, 15.7%) and epilepsy (n=5/19, 26.3%) were recorded as sequelae findings, and no mortality was observed.
Conclusion:
In cases presenting with headache, evaluation of papilledema on funduscopic examination should not be skipped. Neurological imaging should be performed in the change of consciousness of poor feeding infants and children with infections in the head and neck area or underlying chronic diseases. When cerebral sinovenous thrombosis is detected, anticoagulant therapy should be started immediately.
