Cerebral sinodural thrombosis following minor head injury in children

Stylianos Pikis, Samuel Moscovici, Eyal Itshayek, José E. Cohen*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Cerebral sinodural thrombosis (CSDT) is a rare complication of minor head trauma in children. Despite recommendations, anticoagulation is frequently withheld. We aimed to evaluate the etiology, clinical presentation, risk factors, diagnosis, treatment, and outcome of pediatric CSDT following minor head trauma, and specifically to evaluate factors associated with anticoagulation use following minor head trauma in pediatric patients with CSDT. A literature search from 1990 to 2012 identified manuscripts discussing epidemiology, risk factors, clinical presentation, management, and outcome in pediatric patients with CSDT subsequent to minor head trauma. One pediatric patient diagnosed with CSDT following minor head trauma in our institution was also included in the study. There were 18 pediatric patients with CSDT following minor trauma, including the current patient. Mean patient age was 7.8 years (range 23 months-15 years). There was a strong female predominance (2.4:1). Vomiting and headache were the most common symptoms. Five patients had pre-existing risk factors (gastroenteritis, protein S deficiency, estroprogestenic medication, elevated antiphospholipid antibodies, malnutrition). Anticoagulation was administered to six patients with additional risk factors, severe symptoms, or deterioration. There was no mortality, 12 patients recovered fully, and four patients improved with residual symptoms. One patient required lumboperitoneal shunt placement. Pediatric CSDT is a rare complication of minor head trauma, with variable presentation. Anticoagulation has generally been reserved for patients suffering from severe symptoms, for those who deteriorate neurologically during observation, and for those who suffer from a concomitant prothrombotic disorder.

Original languageEnglish
Pages (from-to)481-484
Number of pages4
JournalJournal of Clinical Neuroscience
Volume20
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

Keywords

  • Cerebral sinus thrombosis
  • Minor head injury
  • Sinus thrombosis

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