Cerebral venous sinus thrombosis in pediatric population – a literature review

• Authors: Alicja Dąbrowska , Jakub Mastalerz , Michał Szyszka

Title variants

PL

Zakrzepica zatok żylnych mózgowia w populacji pediatrycznej – przegląd literatury

Abstracts

PL

Zakrzepica zatok żylnych mózgowia (cerebral venous sinus thrombosis – CVST) to rzadkie, ale poważne schorzenie neurologiczne w populacji pediatrycznej. Występuje u dzieci w każdym wieku, ale noworodki i niemowlęta poniżej trzeciego miesiąca życia stanowią nawet do 43% przypadków. Etiologia tego schorzenia jest wieloczynnikowa, obejmuje wiele różnych predysponujących stanów i chorób. Wczesna i dokładna diagnoza oraz dobrze poprowadzona terapia są kluczowe dla uzyskania lepszych wyników leczenia. Proces diagnostyki może być utrudniony z powodu niespecyficznych objawów. W różnych grupach wiekowych objawy mogą się różnić, co może się przyczyniać do wydłużenia czasu pomiędzy pierwszym kontaktem z lekarzem a zainicjowaniem leczenia. Ponadto nie ma aktualnie żadnego markera, który mógłby zostać użyty w celu postawienia diagnozy. Z powodu tych trudności w diagnostyce zakrzepicy u dzieci w zależności od wieku pacjenta stosuje się odmienne techniki neuroobrazowania, takie jak ultrasonografia przezczaszkowa, rezonans magnetyczny lub wenografia rezonansu magnetycznego. CVST może powodować poważne neurologiczne i kognitywne powikłania. Na szczęście odpowiednio poprowadzone leczenie może obniżyć wskaźnik śmiertelności, a także zapobiec tym powikłaniom. W niniejszej pracy podsumowano aktualną wiedzę na temat CVST u dzieci.

EN

Cerebral venous sinus thrombosis (CVST) is a rare neurological disorder in the pediatric population. It occurs in children of all ages; nevertheless, newborns and infants younger than three months represent up to 43% of cases. The etiology is multifactorial, often encompassing various predisposing conditions. An early and accurate diagnosis and well-chosen treatment are crucial for better outcomes. The process of diagnosis might cause several difficulties as the symptoms tend to be non-specific. In different age groups the neurological signs may vary, and thus elongate the time between the first contact with the doctor and the initiation of treatment. What is more, there is no marker that is suitable in this diagnostic course. Due to such difficulties, different neuroimaging techniques such as cranial ultrasound, magnetic resonance imaging, and magnetic resonance venography should be used. CVST might lead to severe neurological and cognitive complications. Fortunately, appropriate treatment can help lower the mortality rate and prevent those complications. In this paper, we summarize the current knowledge of CVST in children.

Keywords

EN

stroke; pediatrics; anticoagulants; cognitive impairment

PL

udar; pediatria; antykoagulanty; upośledzenie funkcji poznawczych

• Publisher: Śląski Uniwersytet Medyczny w Katowicach
• Journal: Annales Academiae Medicae Silesiensis
• Year: 2024
• Volume: 79
• Pages: 12-16

Dates

published

2025

Contributors

author

Alicja Dąbrowska

• Faculty of Medicine, Medical University of Wrocław, Poland

• https://orcid.org/000000018610107X

author

Jakub Mastalerz

• Faculty of Medicine, Medical University of Wrocław, Poland

author

Michał Szyszka

• Faculty of Medicine, Medical University of Wrocław, Poland

References

• Mora R., Ibarra L., Olivera V., Rosas M., Cibils L., Baltar F. et al. Ve-nous and cerebral sinus thrombosis in newborns and children. [Article in Spanish]. Medicina 2023; 83 Suppl 4: 95–101.
• deVeber G., Andrew M., Adams C., Bjornson B., Booth F., Buckley D.J. et al. Cerebral sinovenous thrombosis in children. N. Engl. J. Med. 2001; 345(6): 417–423, doi: 10.1056/NEJM200108093450604.
• He J., Montanez N.A., Fraser S., Barnett A., Silos C., Smith K. et al. Increased neonatal mortality and increasing rate of cerebral venous sinus thrombosis in hospitalized children: A pediatric health information system database study. Blood 2023; 142(Supplement 1): 133.
• Klaassen I.L.M., Lauw M.N., Fiocco M., van der Sluis I.M., Pieters R., Middeldorp S. et al. Venous thromboembolism in a large cohort of children with acute lymphoblastic leukemia: Risk factors and effect on prognosis. Res. Pract. Thromb. Haemost. 2019; 3(2): 234–241, doi: 10.1002/rth2.12182.
• Kersbergen K.J., Groenendaal F., Benders M.J.N.L., de Vries L.S. Neonatal cerebral sinovenous thrombosis: neuroimaging and long-term follow-up. J. Child Neurol. 2011; 26(9): 1111–1120, doi: 10.1177/0883073811408090.
• Filip C., Zonda G.I., Vasilache I.A., Scripcariu I.S., Vicoveanu P., Dima V. et al. Neonatal cerebral sinovenous thrombosis and the main perinatal risk factors – A retrospective unicentric study. Children 2022; 9(8): 1182, doi: 10.3390/children9081182.
• Hashmi M., Wasay M. Caring for cerebral venous sinus thrombosis in children. J. Emerg. Trauma Shock 2011; 4(3): 389–394, doi: 10.4103/0974-2700.83870.
• Moiz B., Altaf S., Devi Ukrani R., Arif A., Akbar I. et al. Low hemoglo-bin as a biomarker for paediatric sinus thrombosis [abstract LPB0124]. Res. Pract. Thromb. Haemost. 2021; 5(Suppl 2, e12589): 582, doi: 10.1002/rth2.12589.
• Gandhi J., Mages K., Kucine N., Chien K. Venous thromboembolism in pediatric inflammatory bowel disease: A scoping review. J. Pediatr. Gastroenterol. Nutr. 2023; 77(4): 491–498, doi: 10.1097/MPG.0000000000003889.
• Cornelius L.P., Elango N., Jeyaram V.K. Clinico-etiological factors, neuroimaging characteristics and outcome in pediatric cerebral venous sinus thrombosis. Ann. Indian Acad. Neurol. 2021; 24(6): 901–907, doi: 10.4103/aian.AIAN_221_21.
• Kotani S., Fujiwara G., Fuji K., Maekawa T., Ogita S., Goto Y. et al. Clinical features of pediatric patients with cerebral venous sinus thrombosis after isolated head trauma. J. Neurosurg. Pediatr. 2024; 34(3): 286–292, doi: 10.3171/2024.4.PEDS24109.
• Alghamdi S., AlMayahi J., Bagais A., AlOraimi L., Al.-Rashidi Q., Al-Saadi T. Cerebral venous sinus thrombosis in pediatrics with closed head injury: A systematic review and meta-analysis. Indian J. Neurotrauma 2024; 21(2): 118–124, doi: 10.1055/s-0044-1778730.
• Romano A., Rossi-Espagnet M.C., Pasquini L., Di Napoli A., Dellepiane F., Butera G. et al. Cerebral venous thrombosis: a challenging diagnosis; A new nonenhanced computed tomography standardized semi-quantitative method. Tomography 2022; 8(1): 1–9, doi: 10.3390/tomography8010001.
• Christensen R., Krishnan P., deVeber G., Dlamini N., MacGregor D., Pulcine E. et al. Cerebral venous sinus thrombosis in preterm infants. Stroke 2022; 53(7): 2241–2248, doi: 10.1161/STROKEAHA.121.037621.
• Sun J.A., Estrela T., Gise R. Clinical course and visual outcomes of papilledema in pediatric cerebral venous sinus thrombosis. Am. J. Ophthalmol. 2024; 263: 126–132, doi: 10.1016/j.ajo.2024.02.001.
• Zhang X., Qiu D., He J., Gao Z., Zheng L., Yan Q. et al. Clinical characteristics and anticoagulation effects of cerebral venous sinus thrombosis in children. Chin. J. Neurosurg. 2023; 39(10): 1015–1019, doi: 10.3760/cma.j.cn112050-20221108-00517.
• Fung A., Hudson G., Anil S. (1497) Endovascular treatment of cerebral venous sinus thrombosis in children: a scoping review. Arch. Dis. Child. 2021; 106(Suppl 1): A394.
• Felling R.J., Hassanein S.M.A., Armstrong J., Aversa L., Billinghurst L., Goldenberg N.A. et al. Treatment and outcome of childhood cerebral sinovenous thrombosis. Neurol. Clin. Pract. 2020; 10(3): 232–244, doi: 10.1212/CPJ.0000000000000720.
• Sutter P.A., Anderson M.G., Sahyouni R., Plonsker J., Ravindra V.M., Gonda D.D. et al. Anticoagulation for the treatment of septic cerebral venous sinus thrombosis in the setting of pediatric sinogenic and otogenic intracranial infections. Neurosurg. Focus 2023; 55(4): E8, doi: 10.3171/2023.7.FOCUS23374.
• Proaño J.S., Martinez P.A., Sendi P., Totapally B.R. Characteristics and outcomes of children with cerebral sinus venous thrombosis. Neurocrit. Care 2023; 39(2): 331–338, doi: 10.1007/s12028-023-01765-7.
• Teksam M., Moharir M., deVeber G., Shroff M. Frequency and topographic distribution of brain lesions in pediatric cerebral venous thrombosis. Am. J. Neuroradiol. 2008; 29(10): 1961–1965, doi: 10.3174/ajnr.A1246.
• Sébire G., Tabarki B., Saunders D.E., Leroy I., Liesner R., Saint-Martin C. et al. Cerebral venous sinus thrombosis in children: risk factors, presentation, diagnosis and outcome. Brain 2005; 128(Pt 3): 477–489, doi: 10.1093/brain/awh412.
• Mallick A.A., Sharples P.M., Calvert S.E., Jones R.W.A., Leary M., Lux A.L. et al. Cerebral venous sinus thrombosis: a case series including thrombolysis. Arch. Dis. Child. 2009; 94(10): 790–794, doi: 10.1136/adc.2008.154708.
• Mineyko A., Kirton A., Billinghurst L., Tatishvili N.N., Wintermark M., deVeber G. et al. Seizures and outcome one year after neonatal and childho-od cerebral sinovenous thrombosis. Pediatr. Neurol. 2020; 105: 21–26, doi: 10.1016/j.pediatrneurol.2019.08.012.
• De Schryver E.L., Blom I., Braun K.P., Kappelle L.J., Rinkel G.J., Peters A.C. et al. Long-term prognosis of cerebral venous sinus thrombosis in childhood. Dev. Med. Child Neurol. 2004; 46(8): 514–519, doi: 10.1017/s0012162204000866.
• Hetherington R., Tuff L., Anderson P., Miles B., deVeber G. Short-term intellectual outcome after arterial ischemic stroke and sinovenous thrombosis in childhood and infancy. J. Child Neurol. 2005; 20(7): 553–559, doi: 10.1177/08830738050200070201.

Identifiers

DOI

10.18794/aams/196969

Biblioteka Nauki

56640777