Risk factors for pediatric cerebral sinovenous thrombosis: A case-control study with case validation

Sellers, Austin; Meoded, Avner; Quintana, Javier F.; Jallo, George I.; Amankwah, Ernest K.; Nguyen, Anh Thy; Betensky, Marisol; Mills, Katie; Goldenberg, Neil A.; Shimony, Nir

doi:10.1016/j.thromres.2020.06.013

Cited by 11 publications

(7 citation statements)

References 38 publications

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“…Regarding risk factors, acute head and neck infections in previously healthy children were the dominant predisposing factors for CVT, as seen in previous studies. [28][29][30] The most frequent permanent risk factor in our cohort was a history of malignancy. This may be justified by the fact that our hospital is a reference center for oncology pediatric patients.…”

Section: Risk Factorsmentioning

confidence: 95%

Cerebral Venous Thrombosis in Pediatric Age: Risk Factors and Prognosis

Pais-Cunha,

Almeida,

Curval

et al. 2023

Neuropediatrics

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Introduction: Cerebral venous thrombosis (CVT) is a rare but potentially fatal disease in pediatric age with an important morbimortality. In adults several factors have been associated with worse outcomes, however there are still few studies in children. This study aims to identify risk factors associated with clinical manifestations and long-term sequelae in pediatric CVT. Methodsː Retrospective analysis of pediatric inpatients admitted to a tertiary-care hospital due to CVT between 2008 and 2020. Resultsː 54 children were included, 56% male, median age of 6.5 years-old (9 months - 17.3 years-old). Permanent risk factors were identified in 13 patients (malignancy – 8; hematologic condition – 5) and transient risk factors in 47, including head and neck infections (57%) and head trauma (15%). Multiple venous sinuses involvement was present in 65% and the deep venous system was affected in four patients. 17% had intracranial hemorrhage and 9% cerebral infarction. 64% of patients with multiple venous sinuses involvement presented with severe clinical manifestations: impaired consciousness; intracranial hypertension; acute symptomatic seizures or focal deficits. Regarding long-term prognosis, 6 patients had major sequelae: epilepsy (n=3); sensor-motor deficits (n=2) and cognitive impairment (n=3). Permanent risk factors were associated with severe clinical manifestations (p=0.043). Cerebral infarction and intracranial hemorrhage were associated with major sequelae (p=0.006 and p=0.03, respectively, adjusted for age and sex).

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Section: Risk Factorsmentioning

confidence: 95%

Cerebral Venous Thrombosis in Pediatric Age: Risk Factors and Prognosis

Pais-Cunha,

Almeida,

Curval

et al. 2023

Neuropediatrics

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“…In children, like within the adult population, the superficial sinuses are most frequently involved, with the transverse sinuses being more frequently involved in children older than two years of life [18]. In the study conducted by Sellers et al, the independent risk factors for CSVT in children are head and neck trauma and infection, as well as mechanical ventilation [19]. Furthermore, hematological conditions, malignancy, congenital heart disease, and inflammatory bowel disease are described as predisposing factors to CSVT [20].…”

Section: Cerebral Sinovenous Thrombosis In Childrenmentioning

confidence: 99%

The Genetic Basis of Strokes in Pediatric Populations and Insight into New Therapeutic Options

Janković

Petrović²,

Novaković

et al. 2022

IJMS

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Strokes within pediatric populations are considered to be the 10th leading cause of death in the United States of America, with over half of such events occurring in children younger than one year of life. The multifactorial etiopathology that has an influence on stroke development and occurrence signify the importance of the timely recognition of both modifiable and non-modifiable factors for adequate diagnostic and treatment approaches. The early recognition of a stroke and stroke risk in children has the potential to advance the application of neuroprotective, thrombolytic, and antithrombotic interventions and rehabilitation strategies to the earliest possible timepoints after the onset of a stroke, improving the outcomes and quality of life for affected children and their families. The recent development of molecular genetic methods has greatly facilitated the analysis and diagnosis of single-gene disorders. In this review, the most significant single gene disorders associated with pediatric stroke are presented, along with specific therapeutic options whenever they exist. Besides monogenic disorders that may present with stroke as a first symptom, genetic polymorphisms may contribute to the risk of pediatric and perinatal stroke. The most frequently studied genetic risk factors are several common polymorphisms in genes associated with thrombophilia; these genes code for proteins that are part of the coagulation cascade, fibrolysis, homocystein metabolism, lipid metabolism, or platelets. Single polymorphism frequencies may not be sufficient to completely explain the stroke causality and an analysis of several genotype combinations is a more promising approach. The recent steps forward in our understanding of the disorders underlying strokes has given us a next generation of therapeutics and therapeutic targets by which to improve stroke survival, protect or rebuild neuronal connections in the brain, and enhance neural function. Advances in DNA sequencing and the development of new tools to correct human gene mutations have brought genetic analysis and gene therapy into the focus of investigations for new therapeutic options for stroke patients.

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“…Risk factors for CVST differ between neonates and older children [1,[5][6][7]. Neonatal thrombosis can be caused by maternal factors (eg, hypertension, diabetes, inflammation of the membranes), congenital infections, birth defects, and perinatal hypoxia [5].…”

Section: Introductionmentioning

confidence: 99%

“…Neonatal thrombosis can be caused by maternal factors (eg, hypertension, diabetes, inflammation of the membranes), congenital infections, birth defects, and perinatal hypoxia [ 5 ]. In turn, in infants and older children, the most important risk factors for CVST can be divided into several groups: general causes (dehydration, fever), head/neck infections, other pathologies of head and neck area (eg, injuries, treatment with radiant energy, proliferative processes, neurosurgical procedure), congenital heart defects, disorders of the hematopoietic system, kidney diseases, certain medications (corticosteroids), thrombophilia, and complicated delivery [ 2 , 3 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Study of 52 Pediatric Patients Who Required 78 Hospital Admissions for Cerebral Venous Sinus Thrombosis from 2013 to 2020 Using Data from the Polish National Health Fund Registry

et al. 2023

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The paper was prepared under the project entitled "Maps of Health Needs-Database of Systematic and Implementation Analysis" which was co-financed by the European Union from the European Social Fund as part of the Operational Program Knowledge Education Development. The study was also a part of the "Integrated Analytical Platform", which was a project co-financed by the European Union from the European Social Fund as part of the Digital Poland Project Centre (CPPC). The open access publication costs were funded by the Centre of Postgraduate Medical Education (Warsaw, Poland) Conflict of interest:None declared Background:Cerebral venous sinus thrombosis (CVST) in children is a rare disease with a complex, multifactorial etiopathogenesis. The Polish National Health Fund (NHF) Registry [Narodowy Fundusz Zdrowia (NFZ)], contains health insurance data from all 16 national provinces, or voivodeships. This study used data from the Polish NHF Registry to evaluate 52 pediatric patients who required 78 hospital admissions for CVST from 2013 to 2020. Material/Methods:The data in the Polish NHF Registry were acquired based on the disease code I67.6 from the International Classification of Diseases, Tenth Revision (ICD-10), and the patients' age (up to 18 years old). Results:We identified 78 hospitalizations of 52 pediatric patients due to CVST in Poland from 2013 to 2020 (63.5% boys and 36.5% girls, mean age 9.7±5.8 years old). The mean duration of hospitalization was 10.5±11.7 days, the mean cost of hospitalization was 3273±2191 Polish zloty (PLN). The most common age subgroup was adolescents (27%). Ten percent of patients were hospitalized in a region other than their region of residence. The duration and cost of hospitalization were positively correlated with each other (r=0.512, P<0.001). The most common type of admission was an emergency (51%), and the most common discharge was referral for further outpatient treatment (50%). Conclusions:Polish registry data showed that from 2013 to 2020, CVST was more commonly diagnosed in male adolescents from 15 to 18 years of age who presented as emergency hospital admissions. There were regional differences in incidence and duration of hospital stay and healthcare costs between patients.

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Risk factors for pediatric cerebral sinovenous thrombosis: A case-control study with case validation

Cited by 11 publications

References 38 publications

Cerebral Venous Thrombosis in Pediatric Age: Risk Factors and Prognosis

Cerebral Venous Thrombosis in Pediatric Age: Risk Factors and Prognosis

The Genetic Basis of Strokes in Pediatric Populations and Insight into New Therapeutic Options

Study of 52 Pediatric Patients Who Required 78 Hospital Admissions for Cerebral Venous Sinus Thrombosis from 2013 to 2020 Using Data from the Polish National Health Fund Registry

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