PB0262 - Cerebral Sinovenous Thrombosis In Greek Children: A Single Centre Experience

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

ATHINA DETTORAKI, MD, MSc, PhD

PAEDIATRICIAN
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece

Co-Author(s)

AM

AIKATERINI MICHALOPOULOU

PAEDIATRICIAN
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
MG

Maria Gavra

Radiologist
Department of CT and MRI, AGHIA SOPHIA CHILDREN'S HOSPITAL
ATHENS, Attiki, Greece
ZK

ZOEY KAPSIMALI

BIOCHEMIST
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
ST

Sotiria Thymianou

BIOLOGIST
Haemophilia Centre/Haemostasis and Thrombosis Unit, AGHIA SOPHIA CHILDREN'S HOSPITAL
ATHENS, Attiki, Greece
SV

Sofia Vassilopoulou

Neurologist
EGINITION HOSPITAL, NATIONAL AND KAPODISTRIAN UNIVERSITY OF ATHENS Department of Neurology, Stroke Unit
ATHENS, Attiki, Greece
AK

Antonis Kattamis

PAEDIATRICIAN
Hospital, First Department of Pediatrics, National and Kapodistrian University of Athens, AGHIA SOPHIA CHILDREN'S HOSPITAL
ATHENS, Attiki, Greece
CK

CHRISTINA KANAKA-GANTENBEIN

PROFESSOR OF PEDIATRICS- PEDIATRIC ENDOCRINOLOGY
Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
HP

Helen Pergantou

PAEDIATRICIAN, DIRECTOR OF HAEMOPHILIA CENTRE/HEAMOSTASIS AND THROMBOSIS UNIT
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
Athens, Argolis, Greece

Background: Cerebral sinovenous thrombosis (CSVT) in children is a rare, often underdiagnosed, serious event.

Aims: To investigate CSVT characteristics in a reference paediatric centre for thrombosis.

Methods: Data were retrospectively collected for children with CSVT, referred between 2010-2021. The categorical variables were described by frequency distributions and compared with x2-test.

Results: Sixty-eight patients (57% males, mean age 6.0±3.9 years) were included. The commonest presenting symptoms were headache (44%), decreased consciousness (32%), vomiting (15%), seizures (16%), diplopia (7%) and torticollis (4%). Papilledema was found in 17 children. Infection (74%) was the main cause with acute otitis media with/without mastoiditis (37% and 18% respectively) being the most frequent one. For diagnostic evaluation MRI/MRV was performed in 68% and CT in 24% of children. Thrombosis was detected in 44% on left side and in 37% on right side. The most frequent site of thrombosis was deep venous system (74%) with multiple localizations in 59% of patients. Sigmoid sinus thrombosis (60%) was predominantly observed, followed by transverse sinus (57%), while extension to ipsilateral jugular vein occurred in 38%. Simultaneous localization in transverse and sigmoid sinuses had an increased probability of papilledema occurrence (p =0.04). One or more prothrombotic risk factors were found in 28% of children. Heterozygosity for FV Leiden and FII20210A mutations were found in 7% and 4% of patients, respectively, and homozygosity for MTHFR-C776T in 15%. All children received anticoagulation (59% coumarin anticoagulants, 41% Low Molecular Weight Heparin) for a mean duration of 8.5 ±4.8 months and 21 ±5.5 months respectively. One third of patients showed complete recanalization after 11± 16 months and another one third partial recanalization in 9± 12 months at MRV. No child died or had persisting neurological sequelae.

Conclusion(s): Physicians should be suspicious of CSVT in children with infections, when referred for neurological signs.