Cerebral Sinovenous Thrombosis in Infants and Children: A Practical Approach to Management

Noa Mandel-Shorer; Christine A Sabapathy; Pradeep Krishnan; Mukta Sharma; Neil A Goldenberg; Leonardo R Brandão; Mahendranath D Moharir

doi:10.1016/j.spen.2022.100993

Cerebral Sinovenous Thrombosis in Infants and Children: A Practical Approach to Management

Semin Pediatr Neurol. 2022 Dec:44:100993. doi: 10.1016/j.spen.2022.100993. Epub 2022 Sep 10.

Authors

Noa Mandel-Shorer¹, Christine A Sabapathy², Pradeep Krishnan³, Mukta Sharma⁴, Neil A Goldenberg⁵, Leonardo R Brandão⁶, Mahendranath D Moharir⁷

Affiliations

¹ Department of Pediatric Hematology-Oncology, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
² Division of Pediatric Hematology-Oncology, Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada.
³ Division of Neuroradiology, Dept. of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
⁴ University of Missouri-Kansas City School of Medicine; Children's Mercy, Kansas City, MO.
⁵ Department of Pediatrics, Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD.
⁶ Division of Paediatric Haematology-Oncology, Dept. of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
⁷ Children's Stroke Program, Division of Paediatric Neurology, Dept. of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada. Electronic address: mahendranath.moharir@sickkids.ca.

PMID: 36456034
DOI: 10.1016/j.spen.2022.100993

Abstract

Cerebral sinovenous thrombosis (CSVT) is a rare, yet potentially devastating disorder, associated with acute complications and long-term neurologic sequelae. Consensus-based international pediatric CSVT treatment guidelines emphasize early clinical-radiologic recognition and prompt consideration for anticoagulation therapy. However, lack of clinical trials has precluded evidence-based patient selection, anticoagulant choice, optimal monitoring parameters and treatment duration. Consequently, uncertainties and controversies persist regarding anticoagulation practices in pediatric CSVT. This review focuses on commonly encountered issues that continue to pose questions and raise debates regarding anticoagulation therapy among pediatric neurologists and hematologists.

Publication types

Review

MeSH terms

Anticoagulants* / therapeutic use
Child
Humans
Infant
Neurologists
Pediatricians
Thrombosis*

Substances

Anticoagulants