Thrombosis of the Dural Venous Sinuses in Infancy and in Childhood

Abstract

This report was based on the study of fifty instances of thrombosis of the intracranial venous sinuses in infancy and in childhood. We have endeavored to correlate the clinical histories, laboratory data and postmortem studies. An attempt has been made to emphasize a large group of cases to which no definite etiology was assigned. The lesions of the brain consequent to thrombosis of the sinuses and their bearing on neurologic disturbances have been discussed. HISTORICAL DATAOne of the first descriptions of a probable instance of sinus thrombosis was written by Morgagni (1717).1 The first accurate study of the condition has been attributed to Abercrombie.2 In the latter part of the nineteenth century French physicians reported many instances. Bouchut3 observed thirty cases in twenty-three years. He concluded that thrombosis of the dural sinuses was often found in infants who had convulsions for the first time during the course of febrile or other debilitating illnesses, and that thrombi may form even during con¬ valescence. Rilliet and Barthez 4 found that the majority of their cases occurred during the second year of life. They believed that infections of the alimentary tract and lungs were most important predisposing factors, especially if the infants become emaciated. Haushalter, cited by Bertier,5 collected four instances in three hundred autopsies of infants. From the Department of Pediatrics of the Harvard Medical School and the Infants' and Children's hospitals of Boston, and from the Department of Pathology of the Harvard Medical School and the Infants' and Children's hospitals of Boston. 1. Morgagni, J. B.: De Sedibus et causis morborum per anatomen indagatis

Prenatal diagnosis of thrombosis of the dural sinuses with real‐time and color Doppler ultrasound

“…Before 1980, there were no reports of neonatal dural sinus thrombosis, other than in postmortem examination studies of asphyxiated newborns 5 . Early reports emphasized an association with trauma and underlying systemic conditions such as sepsis, meningitis and dehydration 1,6 . More recent studies have also focused upon hypercoagulopathy caused by polycythemia 7,8 or deficiency of physiological anticoagulants (antithrombin, protein C or protein S, factor V Leiden mutation) 9,10 .…”

Cerebral venous thrombosis in a child with iron deficiency anemia and thrombocytosis.

“…The clinical picture of cerebral venous thrombosis may be quite variable since it reflects the site and extent of involvement of thrombus within the venous system, the rapidity of occlusion, and the nature of the primary disease. 9 Thus, the disorder is often not recognized, as documented by both Byers and Hass 9 and more recently by Gates, 31 who reported that cerebral venous thrombosis was not suspected in 15 of 29 fatal cases. Cerebral angiography has traditionally been considered the gold standard in the evaluation of cerebral venous thrombosis.…”

Sonographic Evaluation of the Superior Sinus Sagittalis

“…Early reports of sinus sagittalis thrombosis in newborns emphasized an association with underlying systemic conditions such as sepsis, meningitis and dehydration [9,10] . Other predisposing factors may be asphyxia, and polycythemia [11,12] .…”