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Pediatric Posttraumatic Cerebral Venous Sinus Thrombosis: Successful Resolution With Rivaroxaban

Yuxuan Zhang1, Hui Liu1, Hongfang Ding1

  • 1Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying, Shandong, China.

Case Reports in Pediatrics
|August 4, 2025
PubMed

Insights

Cerebral venous sinus thrombosis (CVST) is rare in children, often missed on initial CT scans after head trauma. Prompt MRI/MRV and anticoagulation with novel oral anticoagulants like rivaroxaban led to successful recovery.

Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Vascular Neurology

Background:

  • Cerebral venous sinus thrombosis (CVST) is an infrequent cause of stroke in children, accounting for 0.5%-1.0% of pediatric strokes.
  • CVST is rarely associated with closed traumatic brain injury, presenting diagnostic challenges.

Observation:

  • A 7-year-old girl experienced neurological symptoms post-mild closed head injury.
  • Initial CT scans showed subtle findings, delaying CVST diagnosis.
  • Magnetic resonance imaging (MRI) and venography (MRV) confirmed CVST.

Findings:

  • The patient received enoxaparin followed by rivaroxaban, achieving complete thrombus resolution.
  • Treatment with novel oral anticoagulants (NOACs) was successful without bleeding complications.

Implications:

  • This case underscores the importance of vigilant imaging interpretation in pediatric head trauma with persistent symptoms.
  • It highlights the diagnostic difficulty of posttraumatic CVST in children.
  • Novel oral anticoagulants (NOACs), such as rivaroxaban, show promise as a safe and effective treatment for pediatric CVST.

Keywords:
cerebral venous sinus thrombosischildtraumatic brain injury

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