Pediatric Cerebral Venous Sinus Thrombosis: More Questions than Answers

Abstract

Pediatric cerebral venous sinus thrombosis (PCVST) is a rare type of stroke with reported incidence of 0.5–0.7 per 100,000 children and 2.6 per 100,000 neonates. Several genetic and environmental risk factors have been identified and varies with age. As children grow, they appear to have more traditional risk factors for PCVST. Clinically, PCVST patients can have headaches, seizures, various focal neurological deficits, and coma. The most commonly used imaging modalities for diagnosing PCVST include CT/CT venogram or MR/MR venogram. Transfontanel Power Doppler Ultrasonography is another alternative tool for the noninvasive diagnosis and monitoring of neonatal PCVST. Treatment strategies include supportive care, seizure control and anticoagulation. However, although safe, anticoagulation has not demonstrated an overwhelming benefit on neurologic outcome especially in neonates.