Journal of Pediatric Neurology 2017; 15(06): 328-331
DOI: 10.1055/s-0037-1603558
Case Report
Georg Thieme Verlag KG Stuttgart · New York

External Ventricular Drainage in Acute Cerebral Venous Thrombosis with Bilateral Thalamic Infarcts

Alexandre Simonin
1   Division of Neurosurgery, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
,
Alexandra Lipp
2   Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
,
Mahmoud Messerer
1   Division of Neurosurgery, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
,
Roy Thomas Daniel
1   Division of Neurosurgery, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
› Author Affiliations
Further Information

Publication History

25 January 2017

24 April 2017

Publication Date:
02 June 2017 (online)

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Abstract

Cerebral venous thrombosis (CVT) is an uncommon type of stroke with a considerable risk of mortality and morbidity (around 15% overall death or dependency rate in recent meta-analysis). We present the case of a 20-month-old girl who presented with an altered level of consciousness and motor impairment. Imaging studies showed deep CVT with bilateral thalamic edema, resulting in obstructive hydrocephalus due to third ventricle compression. An external ventricular drain was placed, along with intracranial pressure (ICP) monitoring. Evolution was favorable with near-complete neurological recovery. Anticoagulation is the mainstay of treatment of CVT. However, there are very few studies addressing shunting procedures in the management of associated intracranial hypertension. We believe that for patients presenting with bilateral thalamic edema and obstructive hydrocephalus, early shunting and ICP monitoring should be considered.

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