Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

Wang, Xinhua; Zhang, Linmei; Chai, Ying; Ji, Wang; Yu, Lingfeng; Zhou, Shuizhen

doi:10.3389/fped.2019.00364

Cited by 18 publications

(33 citation statements)

References 18 publications

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“…5,20 Reports have shown that 23% to 30% of patients with pediatric CVST are dehydrated. 4,5,11 A review described inherited thrombophilia (protein C, S, anti-thrombin III deficiencies, factor V Leiden mutation) in 20% to 62% and anti-phospholipid syndrome in 17% of patients having pediatric CVST. 3 Other common risk factors include chronic diseases that lead to a prothrombotic state such as systemic lupus erythematosus, nephrotic syndrome, nephritis, head trauma and malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…Dehydration which is often associated with infections in pediatric patients is also a risk factor for CVST. 5,20 Reports have shown that 23% to 30% of patients with pediatric CVST are dehydrated. 4,5,11…”

Section: Discussionmentioning

confidence: 99%

“…4 The diagnosis of CVST is primarily made using neuroimaging. Unenhanced CT scan as the first-line imaging technique 3 is limited by its low sensitivity of 30%, 3,5 and decreased specificity in neonates because of their slower blood flow, high hematocrit levels, and the relative low density of the surrounding non-myelinated brain tissue also increased risk of radiation exposure. 6 Contrast-CT may show the classic “empty delta” sign of CVST which may be delayed for several days after the onset of symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…6 Contrast-CT may show the classic “empty delta” sign of CVST which may be delayed for several days after the onset of symptoms. 3,7 A combination of MRI and MRV is now being accepted as the “gold standard” for diagnosis of CVST 5 while transfontanellar Doppler ultrasound which is a readily available and non-invasive modality is another choice for diagnosis in neonates especially in the low middle income (LMIC) country setting. 3…”

Section: Introductionmentioning

confidence: 99%

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Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

Moiz

Ukrani

Arif

et al. 2021

Clin Appl Thromb Hemost

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Pediatric cerebral venous sinus thrombosis (CVST) is rare but a potentially fatal disease requiring its understanding in local setting. In this study, we observed the clinical course, management, and outcome of pediatric patients with sinus thrombosis in a tertiary care center at Pakistan. Patients between age 0 to 18 years of both genders diagnosed with sinus thrombosis during 2011 to 2020 were included. Data was collected through in-house computerized system and SPSS version 19 was used for analysis. Of 143492 pediatric admissions, 32 (21 males and 11 females) patients with a median (IQR) age of 4.5 years (0-16) had CVST. This is equivalent to 18.5 CVST events per million pediatric admissions. Adolescents were mostly affected, and the overall mortality was 7%. Primary underlying disorders were infections (59%), hematological neoplasms (12.5%), thrombotic thrombocytopenic purpura (3%) and antiphospholipid syndrome (3%). Activated protein C resistance (44%) was the most common inherited thrombophilia. Twenty-one (66%) patients were anemic with a mean (±SD) hemoglobin of 9.0 g/dL (±2.3). Regression analysis showed a positive association of anemia with multiple sinus involvement ( P-value 0.009) but not with duration of symptoms ( P-value 0.344), hospital stay ( P-value 0.466), age ( P-value 0.863) or gender ( P-value 0.542) of the patients. SARS-COV2 was negative in patients during 2020. Adolescents were primarily affected by sinus thrombosis and infections was the predominant risk factor for all age groups, with a low all-cause mortality. A high index of clinical suspicion is required for prompt diagnosis and intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

Moiz

Ukrani

Arif

et al. 2021

Clin Appl Thromb Hemost

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“…Because of the great variability in clinical manifestations and vague clinical symptoms, CSVT is extremely difficult to be diagnosed in children based on clinical manifestations alone, making it a relatively underrecognized condition 3,9 …”

Section: Discussionmentioning

confidence: 99%

Jak2 mutation expands the thrombophilic panel in children

Forest

Gallo

Fumarola

et al. 2020

Journal of Thrombosis and Haemostasis

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Cerebral sinus venous thrombosis (CSVT) is a cause of vascular accidents with an estimated incidence of 6 to 7 per million children younger than age 18. 1,2 Conditions that increase the risk of CSVT in children are infectious processes of the head and neck region, hypercoagulable states, and dehydration. 3,4 The diagnosis of the underlying disease allows appropriate and timely management of the modifiable risk factors. This often requires drug administration, sometimes for the entire life, with implications for the long-term outcome. Unfortunately, even after thorough investigations, the etiology remains unknown in 20%-25% of the cases, making it difficult to choose the best long-term therapy. 3 Here, we report the case of a girl affected by CSVT where the extensive initial diagnostic workup could not identify the underlying etiology. Eventually, the diagnosis was achieved expanding the standard thrombophilia panel test.

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Clinical features of patients with cerebral venous sinus thrombosis at plateau areas

Yang¹,

Cheng²,

Peng³

et al. 2023

Brain and Behavior

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Objective: Cerebral venous sinus thrombosis (CVST) is believed to be associated with high-altitude exposure and has worse clinical prognosis in plateau areas than in plain areas, although this needs to be further verified. This retrospective study aims to compare the clinical differences of patients with CVST in plateau and plain areas and further ascertain the role of high-altitude exposure in the etiology of aggravating predisposition toward CVST.Methods: Twenty-four symptomatic CVST patients occurring at plateau areas (altitude ≥ 4000 m), in corresponding with 24 CVST patients occurring at plain areas (altitude ≤ 1000 m), were recruited according to the inclusion and exclusion criteria from June 2020 to December 2021. The collected data and compared parameters include clinical features, neuroimaging findings, hematology profile, lipid profile, and coagulation profile within 24 h of hospital admission, as well as the treatment method and final outcome.Results: There were no obvious differences of demographic characteristics, including gender, age, height, and weight between patients with CVST in plateau and plain areas, as well as medical history, neuroimaging findings, treatment protocols, and clinical outcome (all p > .05). Compared to patients with CVST at plain areas, time before hospital admission was longer and heartbeat was slower in patients with CVST at plateau areas (all p < .05). More importantly, elevated red blood cells counts, hemoglobin level, and altered coagulation function were found in patients with CVST at plateau areas (all p < .05). Conclusion:CVST patients in plateau areas presented with altered clinical characteristics, altered coagulation function, and aggravated predisposition toward venous thromboembolism compared with CVST patients in plain areas. Future prospective studies will be needed to further elucidate the influences of a high altitude on the pathogenesis of CVST.

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Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

Cited by 18 publications

References 18 publications

Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

Jak2 mutation expands the thrombophilic panel in children

Clinical features of patients with cerebral venous sinus thrombosis at plateau areas

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