Clinical Spectrum and Outcome of Cerebral Venous Sinus Thrombosis in Children.

Abstract

To determine clinical spectrum, neuroimaging finding and outcome of cerebral venous sinus thrombosis (CVST) in children. Descriptive and cross-sectional study. Department of Paediatric Neurology, Children's Hospital and Institute of Child Health, Lahore, from 2015 to 2016. Data was collected in a predesigned proforma by non-probability purposive sampling technique from all enrolled 32 patients fulfilling the inclusion criteria. We analysed descriptively the clinical presentation, neuroimaging findings, associated risk factors and outcome. Chi-square test was used to check the association between demographic variables and findings at five percent level of significance. Out of 32 patients enrolled, 75% (24) patients were male; median age was 2.5 years. Fever was found the most common presentation followed by headache and lethargy. Neuroimaging showed superior sagital sinus thrombosis in all (100%), while 25% (8) have additional thrombosis of internal cerebral veins. Ischemic infarction was found in 11 (35%), while hemorrhagic infarction was found in 9 (29%) patients. Death occurred in 6.25% of children. Infections were the common cause of CVST in children followed by anemia and dehydration. Mortality trend was low with earlier diagnosis and aggressive treatment. Anticoagulant treatment along with adequate hydration, antibiotics and correction of anemia can lead to a better outcome. A large local and regional prospective multicenter studies for pediatric cerebral venous sinus thrombosis is suggested to evaluate the risk factors and plan guidelines for managing this condition in children.