Paediatric cerebral sinus vein thrombosis

Gili Kenet; Dalia Waldman; Aharon Lubetsky; Nurit Kornbrut; Abdalla Khalil; Ariel Koren; Baruch Wolach; Aviva Fattal; Joseph Kapelushnik; Hannah Tamary; Joanne Yacobovitch; Eyal Raveh; Shoshana Revel-Vilk; Amos Toren; Benjamin Brenner

doi:10.1160/TH04-03-0182

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2004; 92(04): 713-718
DOI: 10.1160/TH04-03-0182

Theme Issue Article

Schattauer GmbH

Paediatric cerebral sinus vein thrombosis

A multi-center, case-controlled study

Gili Kenet

¹The Paediatric Coagulation Service, Sheba Medical Center, Tel-Hashomer

²Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel-Hashomer

,

Dalia Waldman

¹The Paediatric Coagulation Service, Sheba Medical Center, Tel-Hashomer

³Institute of Paediatric Hemato-Oncology, Sheba Medical Center, Tel-Hashomer

,

Aharon Lubetsky

²Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel-Hashomer

,

Nurit Kornbrut

²Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel-Hashomer

,

Abdalla Khalil

⁴The Thrombosis and Hemostasis Unit, Rambam Medical Center

,

Ariel Koren

⁵The Paediatric Departments and the Paediatric Hematology and Neurology Units of Haemek Hospital

,

Baruch Wolach

⁶Meir Medical Center, Paediatric Hematology and Neurology Units of Haemek Hospital

,

Aviva Fattal

⁷Dana Hospital-Souraski Medical Center, Paediatric Hematology and Neurology Units of Haemek Hospital

,

Joseph Kapelushnik

⁸Soroka Medical Center, Paediatric Hematology and Neurology Units of Haemek Hospital

,

Hannah Tamary

⁹Schneider Medical Center, Paediatric Hematology and Neurology Units of Haemek Hospital

,

Joanne Yacobovitch

⁹Schneider Medical Center, Paediatric Hematology and Neurology Units of Haemek Hospital

,

Eyal Raveh

⁹Schneider Medical Center, Paediatric Hematology and Neurology Units of Haemek Hospital

,

Shoshana Revel-Vilk

¹⁰Hadassah Medical Center, Israel, Paediatric Hematology and Neurology Units of Haemek Hospital

,

Amos Toren

³Institute of Paediatric Hemato-Oncology, Sheba Medical Center, Tel-Hashomer

,

Benjamin Brenner

⁴The Thrombosis and Hemostasis Unit, Rambam Medical Center

› Author Affiliations

Abstract

Summary

The etiology and pathophysiology of cerebral sinus venous thrombosis (CSVT) in the paediatric population is still poorly understood, and the role of thrombophilic risk factors remains to be elucidated. In our multi-center case-controlled study we studied 46 patients with CSVT diagnosed from April 1996 to December 2003, consecutively referred for thrombophilia work-up. The results of thrombophilia screen were compared to 112 healthy paediatric controls. Anticoagulant therapy was applied according to treating physicians’ decisions, and all cases were prospectively followed for a median of 4.1 years. Of 46 children, 8 had CSVT diagnosed in the neonatal period and therefore were analyzed separately. The prevalence of single thrombophilia markers and combinations of thrombophilic risk factors were similar among cases and controls. Among children with CSVT co-morbid systemic illness was present in most patients at diagnosis. Seven out of 8 children with idiopathic CSVT had thrombophilic risk factors as compared to 31/38 patients with co-morbid conditions. Anticoagulation was initiated in most patients, 11/46 patients continued therapy for a total of one year or more post event. Neither clinical presentation nor initial treatment decisions were affected by presence of thrombophilic risk factors in our study group. Thrombophilia prevalence was not increased in children with CSVT as compared to controls, however thrombophilia was more frequent among children with idiopathic CSVT. Thus, those selected patients would benefit most from thrombophilia work-up, required for long-term therapy considerations.

Keywords

Cerebral sinus vein thrombosis - thrombophilia - paediatric

Full Text

References

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