The University of Southampton
University of Southampton Institutional Repository

Paediatric cerebral sinovenous thrombosis: findings of the International Paediatric Stroke Study

Paediatric cerebral sinovenous thrombosis: findings of the International Paediatric Stroke Study
Paediatric cerebral sinovenous thrombosis: findings of the International Paediatric Stroke Study

OBJECTIVES: We evaluated clinical features, treatment practices and early outcome in a multicentre cohort of children with cerebral sinovenous thrombosis (CSVT).

METHODS: Children with CSVT from 10 countries were enrolled from January 2003 to July 2007 in the International Paediatric Stroke Study. We analysed clinical symptoms, underlying conditions, antithrombotic treatment and neurological outcome at hospital discharge in 170 children.

RESULTS: Of 170 children enrolled, 60% were male; median age 7.2 years (IQR 2.9-12.4). Headache, altered consciousness, focal deficits and seizures were common presenting clinical features. Infarction affected 37% and intracranial haemorrhage 31%. Risk factors included chronic disease in 50%; acute systemic illness or head/neck disorders 41%; prothrombotic state 20% and other haematological abnormality 19%. Discharge neurological status was normal in 48%, abnormal in 43% and unknown in 5%. Antithrombotic therapy was common, most often low molecular weight heparin was common, with significant regional variation in treatment practices. Mortality was low (4%) and was associated with no anticoagulation but not underlying chronic disease, anatomic extent of thrombosis or intracranial haemorrhage. Abnormal neurological status at discharge or death was associated with decreased level of consciousness at presentation and the presence of an identified prothrombotic state.

CONCLUSIONS: Our study extends the observations of previously published smaller studies in children with CSVT that this is a morbid disease with diverse underlying causes and risk factors. Divergent treatment practices among highly specialised centres as well as limited data on treatment efficacy and safety suggest that further study of this condition is warranted.

Child, Child, Preschool, Female, Fibrinolytic Agents, Humans, Intracranial Thrombosis, Male, Risk Factors, Stroke, Treatment Outcome, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
0003-9888
174-179
Ichord, R.N.
d3cb64eb-0dab-4e05-bbb6-f0ff9bbdcea8
Benedict, S.L.
2fc88a9d-3f13-4458-a9fa-d5207b01f776
Chan, A.K.
0d7bc0b4-b955-4bd5-bfda-ff541a4e69fa
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Nowak-Göttl, U.
7f2e4b9a-3d08-4bf1-8207-6bc7603f7e10
International Paediatric Stroke Study Group
Ichord, R.N.
d3cb64eb-0dab-4e05-bbb6-f0ff9bbdcea8
Benedict, S.L.
2fc88a9d-3f13-4458-a9fa-d5207b01f776
Chan, A.K.
0d7bc0b4-b955-4bd5-bfda-ff541a4e69fa
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Nowak-Göttl, U.
7f2e4b9a-3d08-4bf1-8207-6bc7603f7e10

Ichord, R.N., Benedict, S.L., Chan, A.K., Kirkham, F.J. and Nowak-Göttl, U. , International Paediatric Stroke Study Group (2015) Paediatric cerebral sinovenous thrombosis: findings of the International Paediatric Stroke Study. Archives of Disease in Childhood, 100 (2), 174-179. (doi:10.1136/archdischild-2014-306382).

Record type: Article

Abstract

OBJECTIVES: We evaluated clinical features, treatment practices and early outcome in a multicentre cohort of children with cerebral sinovenous thrombosis (CSVT).

METHODS: Children with CSVT from 10 countries were enrolled from January 2003 to July 2007 in the International Paediatric Stroke Study. We analysed clinical symptoms, underlying conditions, antithrombotic treatment and neurological outcome at hospital discharge in 170 children.

RESULTS: Of 170 children enrolled, 60% were male; median age 7.2 years (IQR 2.9-12.4). Headache, altered consciousness, focal deficits and seizures were common presenting clinical features. Infarction affected 37% and intracranial haemorrhage 31%. Risk factors included chronic disease in 50%; acute systemic illness or head/neck disorders 41%; prothrombotic state 20% and other haematological abnormality 19%. Discharge neurological status was normal in 48%, abnormal in 43% and unknown in 5%. Antithrombotic therapy was common, most often low molecular weight heparin was common, with significant regional variation in treatment practices. Mortality was low (4%) and was associated with no anticoagulation but not underlying chronic disease, anatomic extent of thrombosis or intracranial haemorrhage. Abnormal neurological status at discharge or death was associated with decreased level of consciousness at presentation and the presence of an identified prothrombotic state.

CONCLUSIONS: Our study extends the observations of previously published smaller studies in children with CSVT that this is a morbid disease with diverse underlying causes and risk factors. Divergent treatment practices among highly specialised centres as well as limited data on treatment efficacy and safety suggest that further study of this condition is warranted.

Full text not available from this repository.

More information

e-pub ahead of print date: 20 January 2015
Published date: February 2015
Additional Information: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Keywords: Child, Child, Preschool, Female, Fibrinolytic Agents, Humans, Intracranial Thrombosis, Male, Risk Factors, Stroke, Treatment Outcome, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't

Identifiers

Local EPrints ID: 420597
URI: https://eprints.soton.ac.uk/id/eprint/420597
ISSN: 0003-9888
PURE UUID: d4430b1e-1b65-4003-9c01-8e91554c5618

Catalogue record

Date deposited: 10 May 2018 16:30
Last modified: 05 Oct 2018 11:54

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×