J Korean Child Neurol Soc.  2017 Dec;25(4):234-239. 10.26815/jkcns.2017.25.4.234.

Clinical and Radiologic Features of Pediatric Cerebral Venous Thrombosis in Korea

• Shim Y
• Kim H
• Hwang H
• Chae JH
• Choi J
• Kim KJ
• Lim BC

• KMID: 2403726
• DOI: http://doi.org/10.26815/jkcns.2017.25.4.234

Abstract

PURPOSE
Cerebral venous thrombosis (CVT) is a rare cause of pediatric stroke. Our goal was to describe the clinical CVT features among pediatric patients presenting at a tertiary referral center.
METHODS
Patient data was retrospectively collected from the charts of all pediatric patients (newborn to 18 years old) who were diagnosed with CVT at Seoul National University Children's Hospital between 2000 and 2016. Magnetic resonance imaging or venography was conducted for diagnostic confirmation. Modified Rankin Scale (mRS) was used to evaluate neurologic outcome.
RESULTS
Twenty patients were diagnosed with CVT during the study period (16 male, 4 female). Median age was 4 years. The most common risk factor was systemic infection (6/20, 30.0%). Twelve patients initially presented with headache or vomiting (12/20, 60.0%). Seizure was in only 3 patients within 48 hours of symptom onset; however, as the clinical course progressed, seizure was the symptom that most frequently led to brain imaging (12/20, 60.0%). Thrombosis in the superior sagittal sinus was frequently associated with intracranial hemorrhage (4/11, 36.4%) and clinical seizure (9/11, 81.8%). Anticoagulation and/or antiplatelet agents were used in 16 patients (16/20, 80%). At the 3-month follow-up, 14 patients (14/20, 70%) had an mRS of 0 or 1, showing that most of these patients had no neurologic impairment.
CONCLUSION
Seizure and signs of increased intracranial pressure are the most common manifestation of pediatric CVT. However, clinical features are diverse and include age at symptom onset and underlying risk factors. Despite diagnostic delay, neurologic outcome is favorable in most patients.

Keyword

Cerebral venous thrombosis; Pediatrics; Anticoagulation; Outcome

MeSH Terms

Follow-Up Studies
Headache
Humans
Intracranial Hemorrhages
Intracranial Pressure
Korea*
Magnetic Resonance Imaging
Male
Neuroimaging
Pediatrics
Phlebography
Platelet Aggregation Inhibitors
Retrospective Studies
Risk Factors
Seizures
Seoul
Stroke
Superior Sagittal Sinus
Tertiary Care Centers
Thrombosis
Venous Thrombosis*
Vomiting
Platelet Aggregation Inhibitors