Long‐term prognosis of cerebral venous sinus thrombosis in childhood

Abstract

Cerebral venous sinus thrombosis (CVST) is a rare but potentially serious disorder in children. There is no literature on the long‐term neuropsychological and emotional sequelae and implications for quality of life. We studied 17 children who had CVST after the neonatal period, aged between 1 month and 16 years at the time of CVST (mean age at CVST was 6 years, median 4 years 8 months). Five children died during follow‐up. The cause of death was related to CVST in one child. Twelve children participated in a clinical follow‐up assessment. Mean follow‐up was 2 years 8 months. One child had physical sequelae with impairment of skilled movement. All children had average or high intelligence scores. Two children with CVST due to an uncomplicated mastoiditis had mild cognitive deficits: one child had difficulty with written language; the other had diminished cognitive efficiency with concentration and attention problems associated with decreased psychosocial functioning. Decreased physical well‐being was reported in three of 12 children. We conclude that children who had survived CVST had a fair prognosis. Most had normal cognitive and physical development, although mild cognitive deficits or decreased physical and psychosocial well‐being can occur.

Cerebral venous sinus thrombosis: a case series including thrombolysis

“…Cognitive difficulties have been found to occur in almost 40% of children with CVST,1 while other studies have found fewer or no cognitive difficulties 18 19. In our series the most frequently occurring adverse outcome was chronic intracranial hypertension.…”

Cerebral Venous Thrombosis in the Mediterranean Area in Children

“…Other predictors of poor neurologic outcome were coagulation abnormalities, multiple sinus thrombosis, seizures at presentation, and venous infarction 49–50. Notably, CSVT prognosis was found to be better when compared to arterial ischemic stroke 51–52. Nearly 50% of CSVT patients do not have infarcts and may suffer fewer motor deficits or no permanent damage 53…”

Evaluation of cases with cerebral thrombosis in children

“…On brain MRI performed in the third month in this patient, encephalomalacia was found, but neurological examination was found to be normal. In the pediatric age group, the mortality rate related with cerebral sinovenous thrombosis is below 10%, but neurological defects may be observed at the time of discharge or during the follow-up in 17-79% of the patients; long-term rehabilitation may be needed because of motor and cognitive sequelae (2,10,18,(32)(33)(34). Young age, coma, seizure and focal neurological findings have been found to be related with poor prognosis (2).…”