Abstract Number: PB0262
Meeting: ISTH 2022 Congress
Background: Cerebral sinovenous thrombosis (CSVT) in children is a rare, often underdiagnosed, serious event.
Aims: To investigate CSVT characteristics in a reference paediatric centre for thrombosis.
Methods: Data were retrospectively collected for children with CSVT, referred between 2010-2021. The categorical variables were described by frequency distributions and compared with x2-test.
Results: Sixty-eight patients (57% males, mean age 6.0±3.9 years) were included. The commonest presenting symptoms were headache (44%), decreased consciousness (32%), vomiting (15%), seizures (16%), diplopia (7%) and torticollis (4%). Papilledema was found in 17 children. Infection (74%) was the main cause with acute otitis media with/without mastoiditis (37% and 18% respectively) being the most frequent one. For diagnostic evaluation MRI/MRV was performed in 68% and CT in 24% of children. Thrombosis was detected in 44% on left side and in 37% on right side. The most frequent site of thrombosis was deep venous system (74%) with multiple localizations in 59% of patients. Sigmoid sinus thrombosis (60%) was predominantly observed, followed by transverse sinus (57%), while extension to ipsilateral jugular vein occurred in 38%. Simultaneous localization in transverse and sigmoid sinuses had an increased probability of papilledema occurrence (p =0.04). One or more prothrombotic risk factors were found in 28% of children. Heterozygosity for FV Leiden and FII20210A mutations were found in 7% and 4% of patients, respectively, and homozygosity for MTHFR-C776T in 15%. All children received anticoagulation (59% coumarin anticoagulants, 41% Low Molecular Weight Heparin) for a mean duration of 8.5 ±4.8 months and 21 ±5.5 months respectively. One third of patients showed complete recanalization after 11± 16 months and another one third partial recanalization in 9± 12 months at MRV. No child died or had persisting neurological sequelae.
Conclusion(s): Physicians should be suspicious of CSVT in children with infections, when referred for neurological signs.
To cite this abstract in AMA style:DETTORAKI A, Michalopoulou A, Gavra M, KAPSIMALI Z, Thymianou S, Vassilopoulou S, Kattamis A, Kanaka-Gantenbein C, PERGANTOU H. Cerebral Sinovenous Thrombosis In Greek Children: A Single Centre Experience [abstract]. https://abstracts.isth.org/abstract/cerebral-sinovenous-thrombosis-in-greek-children-a-single-centre-experience/. Accessed September 26, 2022.
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