Zhang Yuxuan, Liu Hui, Ding Hongfang
Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying, Shandong, China.
Case Rep Pediatr. 2025 Jul 27;2025:8836176. doi: 10.1155/crpe/8836176. eCollection 2025.
Cerebral venous sinus thrombosis (CVST) is rare in children (0.5%-1.0% of pediatric strokes) and uncommonly associated with closed traumatic brain injury. A 7-year-old girl presented with neurological symptoms following a mild closed craniocerebral injury. Early CT imaging revealed subtle findings that were initially overlooked, leading to delayed diagnosis. Subsequent magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) confirmed the diagnosis of CVST. The patient was successfully treated with enoxaparin bridging followed by rivaroxaban, achieving complete thrombus resolution without bleeding complications. This case highlights the diagnostic challenge of posttraumatic CVST in children, where initial imaging signs may be overlooked. It underscores the importance of vigilant imaging interpretation in pediatric brain trauma with persistent symptoms and demonstrates the efficacy and safety of novel oral anticoagulants (NOACs), specifically rivaroxaban, as a therapeutic option in this population.
脑静脉窦血栓形成（CVST）在儿童中较为罕见（占儿童中风的0.5%-1.0%），且很少与闭合性颅脑损伤相关。一名7岁女孩在轻度闭合性颅脑损伤后出现神经症状。早期CT成像显示有细微发现，但最初被忽视，导致诊断延迟。随后的磁共振成像（MRI）和磁共振静脉造影（MRV）证实了CVST的诊断。患者先接受依诺肝素桥接治疗，随后使用利伐沙班，成功实现血栓完全溶解且无出血并发症。该病例凸显了儿童创伤后CVST的诊断挑战，即初始影像学征象可能被忽视。它强调了对有持续症状的小儿脑外伤进行警惕的影像学解读的重要性，并证明了新型口服抗凝剂（NOACs），特别是利伐沙班，作为该人群治疗选择的有效性和安全性。
