Pediatric Cortical Vein Thrombosis Frequency and Association With Venous Infarction
Pediatric Cortical Vein Thrombosis Frequency and Association With Venous Infarction
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DOI：
10.1161/strokeaha.115.011291
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发表时间：
2016-03-01
期刊：
影响因子：
8.3
通讯作者：
Stence, Nicholas V.
中科院分区：
文献类型：
--
作者：
Ritchey, Zak;Hollatz, Amanda L.;Stence, Nicholas V.
背景和目的——皮质静脉血栓（CVT）是脑窦静脉血栓形成的罕见部位。很少有报告描述儿科 CVT，也没有一篇报告区分了其独特的属性。本研究评估了一组脑窦静脉血栓形成儿童的临床特征和影像学结果，将患有 CVT 的儿童与未患有 CVT 的儿童进行比较。方法 - 对诊断为脑窦静脉血栓形成的儿童进行回顾性检查，并根据是否存在皮质静脉受累分为 2 组。结果 - 50 名患者符合纳入标准，其中 12 名患有 CVT。 CVT 组更有可能出现癫痫发作（P=0.0271）、精神状态改变（P=0.0271）和凝血障碍家族史（P=0.0477）。 CVT组的急性影像学更常见地表现为并发上矢状窦血栓形成（P=0.0024）、脑实质出血（P=0.0141）和弥散受限（P<0.0001）。在随访中，CVT 组更常见地表现出头痛、癫痫发作和局灶性神经功能缺损（P=0.0449）和静脉梗死（P=0.0007）。结论 - 在我们的队列中，CVT 与就诊时的癫痫发作、急性影像学上的出血和弥散受限以及随访时的神经功能障碍和静脉梗塞显着相关。皮质静脉参与脑窦静脉血栓形成与儿童梗塞和不良后果风险增加相关。
Background and Purpose-Cortical vein thrombosis (CVT) is an uncommon site of involvement in cerebral sinovenous thrombosis. Few reports have described pediatric CVT, and none has differentiated its unique attributes. This study assessed the clinical features and radiographic outcome of a cohort of children with cerebral sinovenous thrombosis, comparing those with CVT to those without CVT.Methods-Children diagnosed with cerebral sinovenous thrombosis were retrospectively reviewed and separated into 2 groups based on the presence or absence of cortical vein involvement.Results-Fifty patients met inclusion criteria, including 12 with CVT. The CVT group was more likely to present with seizure (P=0.0271), altered mental status (P=0.0271), and a family history of clotting disorder (P=0.0477). Acute imaging of the CVT group more commonly demonstrated concurrent superior sagittal sinus thrombosis (P=0.0024), parenchymal hemorrhage (P=0.0141), and restricted diffusion (P < 0.0001). At follow-up, the CVT group more commonly showed headache, seizure, and focal neurological deficit (P=0.0449), and venous infarction (P=0.0007).Conclusions-In our cohort, CVT was significantly associated with seizures at presentation, hemorrhage and restricted diffusion on acute imaging, as well as neurological disability and venous infarction at follow-up. Involvement of cortical veins in cerebral sinovenous thrombosis is associated with an increased risk of infarction and adverse outcome in children.