Abstract Details

Title Retrospective Cohort Analysis in Neonatal Cerebral Sinus Venous Thrombosis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-053

Objective To describe clinical/neuroimaging characteristics, risk factors, presenting clinical features, treatment and long-term neurological outcomes in neonates with cerebral sinus venous thrombosis (CSVT).

Background

Neonatal CSVT is an extremely rare neurovascular condition. The clinical and radiological characteristics, and long-term outcome are rarely reported.

Design/Methods This is a retrospective, observational study conducted at a single tertiary referral center in neonates with CSVT between 2000 and 2017.

Results 62 neonates diagnosed with CSVT using computed tomography (CT)/magnetic resonance imaging (MRI) and brain venograms (CTV/MRV) were included. Average follow-up duration was 3.6 years (range 3 days to 16 years). Of the 62 patients, 44 (71%) were male. Cardiac diseases were the most common underlying risk factor (24%) followed by meningitis (16%), systemic febrile illness (16%), hypoxia (16%), and dehydration (11%). Common presenting features included seizure (53%), fever (14%), lethargy (11%) and dehydration (11%). Neuroimaging findings (available in 61 subjects) include ischemic infarction (19%), both infarction and hemorrhage (30%), other intracranial hemorrhage (17%), and no parenchymal lesions (30%). Common sites of thrombosis included left transverse sinus in 56%, followed by right transverse sinus in 53% and superior sagittal sinus (44%). Treatment data was available in 59 patients. Thirty five out of 59 subjects were treated with supportive care only (no anticoagulation or antiplatelet). Other treatment options included low molecular weight heparin (30%), unfractionated heparin (16%) and aspirin (4%). Follow up neurological status (data available in 61 subjects) was normal in 50%, abnormal in 30%, and death was reported in 17%.

Conclusions In our study, the most common presenting clinical feature in neonates with CSVT was seizure. Treatment of neonatal CSVT must be aggressive as it could be associated with significant morbidity and neurological disability on long term follow up.

Authors/Disclosures
Cemal Karakas, MD (Norton Children's Hospital, University of Louisville) PRESENTER	Dr. Karakas has nothing to disclose.
Danielle Takacs, MD (Baylor College of Medicine/Texas Children's Hospital)	Dr. Takacs has received publishing royalties from a publication relating to health care.
Ethan Edmondson, MD	Dr. Edmondson has nothing to disclose.
Kristen Fisher, DO (Baylor College of Medicine)	Dr. Fisher has nothing to disclose.
Nikita Shukla, MD (BCM)	The institution of Dr. Shukla has received research support from Roche.
Gary D. Clark, MD (Baylor College of Medicine)	The institution of Dr. Clark has received research support from Greewich pharmaceuticals. The institution of Dr. Clark has received research support from Novartis.
Davut Pehlivan, MD	Dr. Pehlivan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ionis Pharmaceuticals.

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