Clinical features of pediatric patients with cerebral venous sinus thrombosis after isolated head trauma

J Neurosurg Pediatr. 2024 Jun 28;34(3):286-292. doi: 10.3171/2024.4.PEDS24109. Print 2024 Sep 1.

Abstract

Objective: An association between blunt head trauma and cerebral venous sinus thrombosis (CVST) has been recognized, but its symptoms are nonspecific and the duration of symptoms remains unclear. Anticoagulation therapy is not considered necessary in most cases of traumatic CVST; however, this is controversial. The aim of this study was to describe the clinical characteristics and outcomes of children with CVST after isolated head trauma.

Methods: The records of pediatric patients with isolated head trauma admitted for observation at 3 medical centers between January 2018 and May 2023 were reviewed retrospectively. CVST was diagnosed on MR venography (MRV). Clinical presentation, therapeutic management, and outcomes were evaluated in patients who had follow-up MRV.

Results: Of 260 pediatric patients with head trauma admitted to the 3 hospitals, 26 patients underwent MRV and 8 (30.8%) were diagnosed with CVST. One patient was treated with heparin, while the others received conservative treatment. All patients were discharged home asymptomatic. MRV performed during follow-up displayed complete recanalization in all cases, except for 1 case with partial recanalization. The median hospital stay was longer in patients with CVST than in those without CVST (9.5 vs 3.0 days, p = 0.001).

Conclusions: The length of stay of pediatric patients with traumatic CVST was prolonged compared with those without CVST, but most patients had good outcomes with spontaneous recanalization following conservative treatment.

Keywords: cerebral venous sinus thrombosis; magnetic resonance venography; pediatric brain concussion; pediatric head trauma.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Anticoagulants* / therapeutic use
  • Child
  • Child, Preschool
  • Craniocerebral Trauma* / complications
  • Craniocerebral Trauma* / diagnostic imaging
  • Female
  • Heparin / therapeutic use
  • Humans
  • Infant
  • Length of Stay
  • Magnetic Resonance Angiography
  • Male
  • Phlebography
  • Retrospective Studies
  • Sinus Thrombosis, Intracranial* / diagnostic imaging
  • Sinus Thrombosis, Intracranial* / drug therapy
  • Sinus Thrombosis, Intracranial* / etiology
  • Treatment Outcome

Substances

  • Anticoagulants
  • Heparin