Eloy Juliette, Hochart Audrey, Soto-Ares Gustavo, Lagree Marion, Kuchcinski Grégory, Karnoub Mélodie-Anne, Maltezeanu Alix, Leteurtre Stéphane, Dubos François
CHU Lille, Paediatric Emergency Unit and Infectious Diseases, Lille, France.
CHU Lille, Department of Haemostasis and Transfusion, Lille, France.
Acta Paediatr. 2025 Feb;114(2):378-387. doi: 10.1111/apa.17439. Epub 2024 Oct 2.
Cerebral venous thrombosis (CVT) is a rare complication of ear, nose and throat (ENT) infections. Although recent guidelines recommend the systematic use of anti-coagulation therapy (ACT) in the treatment of these CVT, literature data are scarce. The present study's objective was to determine the value of ACT in achieving recanalisation after thrombosis and its effect on patient outcomes.
All paediatric patients with CVT and a concomitant ENT infection who attended Lille University Hospital (Lille, France) between January 2012 and December 2021 were retrospectively included.
We included 43 children (63% boys), with a mean age of 4 years. The most frequent infection was mastoiditis (54%). ACT was initiated in 23 patients (53%), one of whom had an intracranial haemorrhage. Partial or full recanalisation was observed in 33 (80%) of the 41 survivors. In patients with no neurological signs and symptoms on admission and in patients with mastoiditis-related CVT, the clinical and radiological outcomes were favourable and did not differ according to the administration of ACT. Likewise, ACT did not appear to influence the recanalisation rate or sequelae.
ACT was not necessary for all patients with mastoiditis-related CVT and those with no neurological signs and symptoms on admission.
脑静脉血栓形成（CVT）是耳鼻喉（ENT）感染的一种罕见并发症。尽管最近的指南推荐在这些CVT的治疗中系统使用抗凝治疗（ACT），但文献数据稀缺。本研究的目的是确定ACT在血栓形成后实现再通的价值及其对患者预后的影响。
回顾性纳入2012年1月至2021年12月期间在法国里尔大学医院就诊的所有患有CVT并伴有ENT感染的儿科患者。
我们纳入了43名儿童（63%为男孩），平均年龄为4岁。最常见的感染是乳突炎（54%）。23名患者（53%）开始使用ACT，其中1人发生颅内出血。在41名幸存者中的33名（80%）观察到部分或完全再通。在入院时无神经体征和症状的患者以及与乳突炎相关的CVT患者中，临床和影像学结果良好，且根据ACT的使用情况没有差异。同样，ACT似乎也不影响再通率或后遗症。
对于所有与乳突炎相关的CVT患者以及入院时无神经体征和症状的患者，ACT并非必要。
