Clinical Profile and Long-Term Outcome in Neonatal Cerebral Sinus Venous Thrombosis

Herman, Isabella; Karakas, Cemal; Webber, Troy A.; Kralik, Stephen F.; Takacs, Danielle; Fisher, Kristen; Edmondson, Ethan; Riviello, James J.; Clark, Gary D.; Pehlivan, Davut

doi:10.1016/j.pediatrneurol.2021.05.001

Cited by 9 publications

(11 citation statements)

References 35 publications

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“…Neonatal CSVT has abnormal neurological outcomes in 40 to 80% of cases, as seen in the index case. 5 Cardiorespiratory failure or altered mental status at the time of initial neurological examination were associated with increased mortality in a follow-up study. 5 Poor outcomes are reported frequently with prematurity, traumatic birth, straight or internal cerebral vein thrombosis, and hemorrhagic infarct.…”

Section: Discussionmentioning

confidence: 96%

“…5 Cardiorespiratory failure or altered mental status at the time of initial neurological examination were associated with increased mortality in a follow-up study. 5 Poor outcomes are reported frequently with prematurity, traumatic birth, straight or internal cerebral vein thrombosis, and hemorrhagic infarct. 2 Presence of thalamic hemorrhage has been associated with long-term neuromorbidities such as cerebral palsy, electrical status epilepticus, focal epilepsy, cortical visual impairment, and cognitive delay.…”

Section: Discussionmentioning

confidence: 96%

“…4 A follow-up study found many long-term sequelae at 4 years of age including epilepsy, developmental delay, cerebral palsy, speech delay, visual impairment, and learning disabilities. 5…”

Section: Introductionmentioning

confidence: 99%

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Neonatal Cerebral Sinovenous Thrombosis Post–Therapeutic Hypothermia in Perinatal Asphyxia: A Case Report

Goyal

Mascarenhas

et al. 2022

Journal of Pediatric Neurology

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Cerebral sinovenous thrombosis (CSVT) is an uncommon condition in neonates and often leads to adverse neurodevelopmental outcomes. A high index of suspicion for CSVT is mandated for asphyxiated infants, especially following therapeutic hypothermia (TH). Magnetic resonance venography can assist in the early detection of CSVT in suspected cases. Timely initiation of anticoagulation therapy prevents thrombus propagation and allows recanalization at around 6 to 12 weeks. Long-term follow-up is essential as cognitive impairment, motor dysfunctions, and epilepsy are common complications. Herein, we describe the clinical course of a term infant who developed CSVT in the first week of life following TH for perinatal asphyxia, its management strategies, and short-term follow-up till infancy.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

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Neonatal Cerebral Sinovenous Thrombosis Post–Therapeutic Hypothermia in Perinatal Asphyxia: A Case Report

Goyal

Mascarenhas

et al. 2022

Journal of Pediatric Neurology

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“…4,10,11,43,44 Factors that have been shown to be associated with worse outcomes include lower gestational age, traumatic birth, congenital heart disease, and location and type of brain injury. 44 In our study, most preterm infants had parenchymal brain injury, which can be associated with poor neurodevelopmental outcomes. However, it is important to note that morbidity in our sample of preterm infants with CVST may have been compounded by sequelae of prematurity.…”

Section: Discussionmentioning

confidence: 99%

“…The neurodevelopmental outcomes in our sample are similar to outcomes of term neonates with CVST. 4,10,11,43,44 Factors that have been shown to be associated with worse outcomes include lower gestational age, traumatic birth, congenital heart disease, and location and type of brain injury. 44 In our study, most preterm infants had parenchymal brain injury, which can be associated with poor neurodevelopmental outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis in Preterm Infants

Christensen

Krishnan

deVeber

et al. 2022

Stroke

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BACKGROUND: Neonatal cerebral venous sinus thrombosis (CVST) can lead to brain injury and neurodevelopmental impairments. Previous studies of neonatal CVST have focused on term infants, and studies of preterm infants are lacking. In this study, we examined the clinical and radiological features, treatment and outcome of CVST in preterm infants. METHODS: This was a retrospective, consecutive cohort study of preterm infants (gestational age <37 weeks) with radiologically confirmed CVST. All magnetic resonance imaging/MRV and CT/CTV scans were re-reviewed to study thrombus characteristics and pattern of brain injury. Outcome was assessed by the validated pediatric stroke outcome measure at the most recent clinic visit. RESULTS: Twenty-six preterm infants with CVST were studied. Of these, 65% were moderate-late preterm (32–37 weeks), 27% very preterm (28–32 weeks), and 8% extreme preterm (<28 weeks). Most (73%) were symptomatic at presentation with seizures or abnormal exam. Transverse (85%) and superior sagittal (42%) sinuses were common sites of thrombosis. Parenchymal brain injury was predominantly periventricular (35%) and deep white matter (31%) in location. Intraventricular hemorrhage occurred in 46%. Most infants (69%) were treated with anticoagulation. No treated infant (including eleven with pretreatment hemorrhage) had new or worsening post-treatment hemorrhage. Outcomes ranged from no deficits (50%), mild-moderate (25%), and severe (25%) impairment. CONCLUSIONS: In our sample of preterm infants with CVST, more than one-quarter were asymptomatic. White matter brain lesions predominated and one-half had neurological deficits at follow-up. Anticoagulation of preterm CVST in this small cohort appeared to be safe. Larger studies of preterm CVST are needed.

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A Comprehensive Examination of Clinical Characteristics and Determinants of Long-Term Outcomes in Pediatric Cerebral Sinus Venous Thrombosis

Karakas,

Herman,

Kralik

et al. 2024

Pediatric Neurology

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Clinical Profile and Long-Term Outcome in Neonatal Cerebral Sinus Venous Thrombosis

Cited by 9 publications

References 35 publications

Neonatal Cerebral Sinovenous Thrombosis Post–Therapeutic Hypothermia in Perinatal Asphyxia: A Case Report

Neonatal Cerebral Sinovenous Thrombosis Post–Therapeutic Hypothermia in Perinatal Asphyxia: A Case Report

Cerebral Venous Sinus Thrombosis in Preterm Infants

A Comprehensive Examination of Clinical Characteristics and Determinants of Long-Term Outcomes in Pediatric Cerebral Sinus Venous Thrombosis

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