Cerebral sinovenous thrombosis in pediatric practice

Abstract

Cerebral sinovenous thrombosis (CSVT) in the pediatric population is a relatively uncommon yet under-appreciated and potentially life-threatening neurological condition. Early symptoms and signs are often vague and the clinician requesting a cranial imaging study might not even suspect sinovenous thrombosis. If left undiagnosed, or if the diagnosis of CSVT is delayed, progressive neurological deterioration, coma and death can follow. The purpose of this review is to highlight pertinent development of the cerebral venous system, discuss the causal factors of cerebral sinovenous thrombosis in the pediatric population, review practical imaging strategies using cranial sonography augmented with color and pulsed Doppler, unenhanced brain CT, CT venography, cerebral MRI, and MR venography (MRV). Finally, this review will illustrate the imaging features of sinovenous thrombosis, including a discussion of the common causes of false-positive and false-negative CT and MRI studies.

Venous injury in abusive head trauma

“…The neuroimaging features of cortical sinus and venous thrombosis have also been described in multiple studies [4][5][6][7][8]. An obvious feature is absence of the normal veins or sinus on MRI or MR venography, but equally important is the demonstration of a thrombus within the vessel lumen on MRI.…”

“…Identification of cortical sinus and venous thrombosis can be a challenge because of the anatomical variations in venous anatomy and limitations of noninvasive neuroimaging techniques such as MR venography and CT venography. However, several previous studies have defined the clinical and neuroimaging findings in children with cortical sinus and venous thrombosis [4][5][6][7][8].…”

Alternate theories of causation in abusive head trauma: What the science tells us

“…In rare cases this has been reported in adults with severe underlying illnesses [24][25][26][27][28]. Newborn infants are known to be more susceptible to venous sinus thrombosis and often are found to have coexisting subdural hematoma, as well [29]. Clinical examples of welldocumented subdural hematoma in infants resulting from venous sinus thrombus (in the absence of trauma) have not been reported after the post-natal period.…”

Inferior Petrosal Sinus Thrombosis in a Child due to Malposition of Central Venous Catheter: A Case Report

“…infection, pneumothorax, hematoma, and thrombosis have been described [1]. Furthermore, one of the most serious mechanical complications of CVC is malpositioning [1].…”

“…Furthermore, one of the most serious mechanical complications of CVC is malpositioning [1]. Cerebral sinovenous thrombosis is a relatively rare event in the pediatric population, with an estimated incidence of approximately 1/100,000 [2].…”