Cornelius Leema P, Elango Neeraj, Jeyaram Venkateswaran Kuttava
Department of Paediatric Neurology, Institute of Child Health and Hospital for Children, Madras Medical College, Chennai, Tamil Nadu, India.
Ann Indian Acad Neurol. 2021 Nov-Dec;24(6):901-907. doi: 10.4103/aian.AIAN_221_21. Epub 2021 Dec 17.
Cerebral venous sinus thrombosis (CVST) is rare in children, increasingly being recognized of late due to advances in neuroimaging. The aim of the study was to describe the clinical, etiological, and imaging characteristics of CVST and its outcome in children.
A retrospective chart review of children with CVST in a tertiary hospital from January 2011 to December 2020.
Of the 35 patients enrolled, 26 (74.3%) patients were males. The mean age was 5.03 years with a range of 0.17-12 years. The common presenting symptoms were seizures in 18 (51.4%) followed by headache in 17 (48.6%), fever in 16 (45.7%), and vomiting in 15 (42.9%) children. Superior sagittal sinus was the commonest site of thrombus occlusion in 20 (57%), followed by transverse sinus in 18 (51.4%) patients. Multiple sinus involvement was noticed in one-half of the patients. The risk factors associated with CVST were head and neck infections in 15 (42.9%) children, inherited thrombophilia in 4 (11.6%), head trauma, iron deficiency anemia, leukemia with l-asparaginase therapy, acquired thrombophilia in 3 (8.6%) each, dehydration in 2 (5.7%), and dural arteriovenous fistula in one child. Two children (5.7%) died and one-third of the cohort had a poor outcome.
Head and neck infections continue to be the common cause of CVST in children. Though mortality is low, CVST is associated with significant morbidity in children.
儿童脑静脉窦血栓形成（CVST）较为罕见，近年来随着神经影像学的发展，其发病率逐渐得到更多认识。本研究旨在描述儿童CVST的临床、病因及影像学特征及其预后情况。
对一家三级医院2011年1月至2020年12月期间患有CVST的儿童进行回顾性病历审查。
在纳入的35例患者中，26例（74.3%）为男性。平均年龄为5.03岁，范围为0.17至12岁。常见的首发症状为癫痫发作，共18例（51.4%），其次是头痛17例（48.6%）、发热16例（45.7%）、呕吐15例（42.9%）。上矢状窦是最常见的血栓阻塞部位，共20例（57%），其次是横窦18例（51.4%）。一半的患者存在多个静脉窦受累情况。与CVST相关的危险因素包括15例（42.9%）儿童的头颈部感染、4例（11.6%）的遗传性易栓症、头部外伤、缺铁性贫血、接受L-天冬酰胺酶治疗的白血病、各3例（8.6%）的获得性易栓症、2例（5.7%）的脱水以及1例儿童的硬脑膜动静脉瘘。2例（5.7%）儿童死亡，三分之一的队列预后不良。
头颈部感染仍是儿童CVST的常见原因。尽管死亡率较低，但CVST与儿童的显著发病率相关。
