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Cerebral Venous Sinus Thrombosis in Pediatric Critical Care

Christina Maratta1,2, Melany Gaetani3,4,5,6, Nicole K McKinnon3,4,5,7

  • 1Division of Pediatric Critical Care, McGill University Health Centre, Montreal, QC, Canada.

Critical Care Explorations
|May 25, 2026
PubMed

Insights

Pediatric cerebral venous sinus thrombosis (CVST) is more common in primary cases and linked to higher mortality. This study highlights the disproportionate impact on marginalized children, urging further investigation.

Area of Science:

  • Pediatric Neurology
  • Critical Care Medicine
  • Epidemiology

Background:

  • Pediatric cerebral venous sinus thrombosis (CVST) is an increasingly recognized condition with significant morbidity and mortality risks.
  • Limited data exists on the epidemiology, management, and outcomes of CVST specifically within the pediatric intensive care unit (PICU) setting.

Purpose of the Study:

  • To characterize the clinical presentation, treatment strategies, and outcomes of critically ill children diagnosed with CVST during their PICU admission.
  • To investigate the incidence of primary versus secondary CVST in this pediatric critical care population.

Main Methods:

  • A retrospective observational cohort study was conducted in a quaternary PICU in Toronto, Canada, from 2018 to 2023.
  • Included were patients aged 18 years or younger with acute primary or secondary CVST, defined by the indication for ICU admission.

Main Results:

  • Thirty pediatric patients were admitted with CVST, with primary CVST (63%) being more frequent than secondary (37%).
  • Associated complications included cerebral infarct (47%) and intracranial hemorrhage (30%).
  • In-hospital mortality was 17% (5/30), with four deaths occurring in the primary CVST group. A disproportionate number of affected children resided in socioeconomically marginalized neighborhoods.

Conclusions:

  • Primary CVST is more prevalent and associated with higher mortality in critically ill children compared to secondary CVST.
  • The overrepresentation of children from marginalized communities underscores the need for increased awareness and research into contributing factors and health disparities.
Abstract

Keywords:
cerebral venous sinus thrombosisoutcomespediatricsstroke

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