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Hamostaseologie 2023; 43(03): 188-195
DOI: 10.1055/a-1848-3649
Original Article

Laboratory Findings, Medical Imaging, and Clinical Outcome in Children with Cerebral Sinus Venous Thrombosis

Hannah Glonnegger   *
1   Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Medical Centre - University of Freiburg, Baden-Württemberg, Germany
,
Nicole Glatthaar   *
1   Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Medical Centre - University of Freiburg, Baden-Württemberg, Germany
,
Matthias Eckenweiler
1   Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Medical Centre - University of Freiburg, Baden-Württemberg, Germany
,
Michael Barth
1   Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Medical Centre - University of Freiburg, Baden-Württemberg, Germany
,
Markus Uhl
1   Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Medical Centre - University of Freiburg, Baden-Württemberg, Germany
,
Martin Büchsel
2   Institute of Clinical Chemistry and Laboratory Medicine, Faculty of Medicine, Medical Centre - University of Freiburg, Baden-Württemberg, Germany
,
Barbara Zieger
1   Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Medical Centre - University of Freiburg, Baden-Württemberg, Germany
› Author Affiliations Funding No funding was received for conducting this study.
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Abstract

Introduction Cerebral sinus venous thrombosis (CSVT) is a rare disease, especially in children. Therefore, thrombophilia markers, risk factors, treatment strategy, and MRI, as well as clinical outcome need further investigation to support future diagnostic and therapeutic guidelines for children.

Methods We retrospectively identified all children with CSVT treated in our center between January 1, 2000, and December 31, 2015. Risk factors and laboratory findings were investigated. Furthermore, outcome and treatment satisfaction were evaluated using magnetic resonance imaging (MRI) analyses and a modified questionnaire.

Results All 43 patients, who agreed to participate, were treated with therapeutic levels of heparin; 86% of children had an increased risk for thromboembolic events upon onset of CSVT (acute disease: 58.1%, perinatal risk factors: 9.3%, medical intervention/immobility: 14%, chronic disease: 16.3%). Thrombophilia markers showed positive results (e.g., reduced values for protein C/S, factor-V–Leiden mutation) in 58% of children at the time of CSVT diagnosis but dropping to 20.9% over the course of the disease. Forty-two of 43 patients received MRI follow-ups and the outcome showed complete recanalization in 69% of the patients and partial recanalization in 31%. At the onset of CSVT, 88% of patients reported restrictions in everyday life due to CSVT; at follow-up this percentage declined to 18%. Satisfaction with the outcome among parents/patients according to the questionnaire was high with 1.7 (German school grades from 1 to 6).

Conclusions All 42 children with MRI follow-up demonstrated complete or partial recanalization under anticoagulation. This positive result underlines the need for future studies on anticoagulation to optimize therapy regimens of pediatric CSVT.

Keywords

cerebral sinus venous thrombosis - anticoagulation - prothrombotic risk marker - outcome

Author Contributions

N.G. and B.Z. initiated and developed the design of the study. N.G., B.Z., and all other authors were involved in writing and reading the manuscript. M.B. performed the laboratory testing and contributed to writing the manuscript. H.G. performed the final revision.

All authors finally approved the final manuscript.


Ethics Approval

Ethical approval was received from the local Ethics Committee of Freiburg.


Consent to Participate

Informed consent was obtained from all participants or legal guardians included in the study.


Consent for Publication

All participants or legal guardians were informed in written form about publication of anonymized data.


* Shared authorship.


Supplementary Material



Publication History

Received: 27 November 2021

Accepted: 22 August 2022

Article published online:
10 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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