Aims and objectives
Cerebral sinovenous thrombosis (CSVT) is a rare disorder increasingly diagnosed,
especially in paediatric population where it has an incidence of 1:100.000 and represents almost approximately 20% of cerebral vascular diseases.
Most symptoms are nonspecific,
so neuroimaging techniques,
especially magnetic resonance imaging (MRI),
are essential for its management.
Across all pediatric age groups,
seizures remain the most common presentation of CSVT.
Apart from seizures,
irritability and hypotonia are especially observed in neonates and headache and motor symptoms predominate in the non-neonatal patients.
The location of the...
Methods and materials
Retrospective study performed in a tertiary-level healthcare hospital (Hospital Vall d'Hebron,
Barcelona,
Spain) from 2010 to 2018,
which includes 35 patients diagnosed with CSVT confirmed by CT,
MRI with or without magnetic resonance venography (MRV) or transfontanel power Doppler ultrasonography.
Demographic and clinical characteristics of the patients were recorded,
including age at the time of presentation,
sex,
neurologic manifestations and risk factors associated with CSVT,
along with treatment and neurologic outcome.
CSVT was classified as superficial or deep and data regarding cortical vein involvement and...
Results
A total of 35 children diagnosed with CSVT were included in the study.
Mean age at diagnosis was 4.5 ± 2.1 years-old (range from 3 days to 15.9 years) (Table 1),
with a male-to-female ratio was 1.9:1.
Predisposal factors were identified in most patients (91.4%) and were different according to age (Table 1).
Acute systemic illnesses were present in 80% of neonates,
including perinatal complications and dehydration.
Head and neck infections were more common in are also important risk factors for CSVT non-neonates,
especially mastoiditis...
Conclusion
Radiologists play an important role in the early detection of paediatric CSVT,
since symptoms are often non-specific.
MRI is modality of choice for its diagnosis,
although CT may be used in the emergency room.
Most frequent etiologies in paediatric population are neonatal dehydration and infectious spread of otomastoiditis.
Procoagulant drugs are important source of CSVT in patients with hematological disorders,
especially leukemia.
Clinical manifestations of CSVT in neonates were seizures whereas a decreased level of consciousness,
headache and focal neurologic signs were more common in...
Personal information
José Miguel Escudero-Fernández
Department of pediatric radiology
Hospital Universitari Materno-Infantil Vall d’Hebron,
Institut català de la Salut.
Passeig de la Vall d’Hebron 119-129 08035 Barcelona Spain
Email:
[email protected]
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