Clinical Analysis Of Cerebral Venous Sinus Thrombosis In Children

OBJECTIVE:To investigate the clinical features of children with cerebral venous sinus thrombosis.METHODS:There are 16 cases of cerebral venous sinus thrombosis(aged1 month to 18 years)were diagnosed and treated in the first affiliated Hospital of Guangxi Medical University from January 2013 to October 2018.The body condition,etiology,clinical manifestation,laboratory examination,imaging examination,treatment plan,outcome and prognosis of the children were collected and recorded.RESULTS:Among the 16 cases,12 cases(75.0%)were male and 4 cases(25.0%)were female.The average age of onset was 13.1 ±5.6 years old.Acute onset was found in 5 cases(31.2%),subacute onset in 8 cases(50.0%)and chronic onset in 3 cases(18.8%).There were 8 cases(50.0%)associated with infection factors,5 cases(31.2%)had non-infection factors,and 3 cases(18.8%)of unknown causes.The average time from admission to diagnosis was5.5 ±4.4 days.Clinical manifestations included headache,vomiting as the main symptoms,few cases with dizziness,epilepsy as initial appearance.All cases were examined by neuroimaging.The results showed that 1 case was single cerebral venous sinus thrombosis,15 cases(93.7%)were multiple cerebralvenous sinus thrombosis,and the most common involved venous sinus was transverse sinus(81.2%),secondly is sigmoid sinus(75%),of which 5 cases were complicated with brain parenchyma injury.In treatment,14 cases were treated with anticoagulant therapy,2 cases were treated with pathogeny and symptomatic treatment only.10cases'(62.5%)condition improved after treatment,neural functional injury in 5 cases(31.2%)and 1 case(6.3%)died.Follow-up and prognosis: 10 cases were followed-up,5 cases were lost.1 case had sequelae of dizziness and headache,1 case had bilateral eyeball abduction is limited,1 case had psychomotor retardation,1 case had secondary epilepsy.CONCLUSION:In this study,the etiology of cerebral venous sinus thrombosis in children is complex and diverse.The main clinical manifestations are intracranial hypertension(headache,vomiting).The elevation of D-dimer is the main change in laboratory.Imaging MRI MRV or DSA is an effective method for the diagnosis of CVST.Anticoagulation is the main treatment in children CVST.