Cerebral venous thrombosis in children

Cerebral venous thrombosis is an important cause of stroke in children. Und erstanding the natural history of the disease is essential for rational app lication of new interventions. We retrospectively identified 31 children wi th cerebral venous thrombosis confirmed by head computed tomography (4 pati ents) or by magnetic resonance imaging (27 patients). Risk factors, clinica l and radiographic features, and neurologic outcomes were analyzed. There w ere 21 males and 10 females aged 1 day to 13 years (median 14 days). Ninete en (61%) were neonates. The most common risk factors included mastoiditis, persistent pulmonary hypertension, cardiac malformation, and dehydration. T he chief clinical features were seizures, fever, respiratory distress, and lethargy. Fifteen patients had infarctions (8 hemorrhagic, 7 ischemic). Pro tein C and antithrombin III deficiency were the most common coagulopathies among 14 tested patients. On discharge, 11 patients were normal, 17 had res idual deficits, and 2 patients died. Twenty-seven patients were followed fr om 1 month to 12 years (mean 22 months). At follow-up, 11 patients were nor mal, and 13 patients had development delay. One had residual hemiparesis an d cortical visual impairment. Two had other deficits. Neonatal cerebral ven ous thrombosis is probably more common than previously thought, and outcome s are worse in this group. All children with cerebral venous thrombosis sho uld be tested for coagulation disorders.