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Cerebral venous thrombosis in children
1Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
|November 1, 1995
Summary
Cerebral venous thrombosis (CVT) in infants has a worse prognosis than in older children, often linked to severe initial insults. Early diagnosis and consideration of CVT are crucial for infants with intractable seizures.
Area of Science:
- Neurology
- Pediatric Neurology
- Diagnostic Imaging
Background:
- Cerebral venous thrombosis (CVT) is a rare but serious condition affecting all age groups.
- Infants and children present unique diagnostic and prognostic challenges in CVT.
- Understanding risk factors and outcomes is vital for early intervention.
Purpose of the Study:
- To retrospectively review pediatric cases of cerebral venous thrombosis.
- To compare clinical presentation, diagnostic methods, and outcomes between infants and older children.
- To identify factors influencing prognosis in pediatric CVT.
Main Methods:
- Retrospective chart review of 16 pediatric patients diagnosed with CVT between May 1984 and April 1995.
- Diagnostic modalities included computed tomography (CT), conventional cerebral angiography, magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA).
- Analysis of presenting symptoms, associated illnesses, and long-term follow-up outcomes.
Main Results:
- Infants (under 1 year) predominantly presented with mental changes and seizures, often associated with head injury or dehydration, leading to motor handicaps.
- Older children more frequently showed headache or consciousness changes, often linked to sepsis or infections, with variable outcomes (complete recovery, death, vegetative state).
- Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) demonstrated superior diagnostic accuracy compared to CT.
Conclusions:
- Prognosis for CVT in infants is generally worse than in older children, heavily influenced by the severity of initial insults.
- Widespread sinus thrombosis and severe initial insults correlate with poor outcomes.
- Cerebral venous thrombosis should be considered in infants with intractable seizures, especially when difficult to control.