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Clinical analysis of traumatic cerebral venous sinus thrombosis in children
oleh: ZHAO Xueling, CHENG Yang, LIANG Ping, ZHOU Jianjun
| Format: | Article |
|---|---|
| Diterbitkan: | Editorial Office of Journal of Third Military Medical University 2020-11-01 |
Deskripsi
Objective To investigate the mechanism of formation of traumatic cerebral venous sinus thrombosis (CVST) in children and analyze the clinical manifestations, treatment and prognosis of CVST. Methods We performed a retrospective analysis of 21 children with traumatic CVST treated in our hospital between January 2009 and December 2019. The clinical manifestations, causes of thrombosis, imaging characteristics and the effects of heparin versus non-heparin treatments were analyzed. Results Among the 21 children with CVST, the main clinical symptoms included headache, vomiting, decreased activity, increased intracranial pressure (30.53±5.07 cmH2O), and papilledema (81%). Cranial fractures involving different sinuses or epidural hematoma was common in the children with CVST. The time of first-time hematoma volume reduction was 18.33±6.15 d in these children, and was significantly shorter in children receiving low-molecular-weight heparin (LMWH) treatment than in those without LMWH treatment (15.00±5.13 vs 23.75±2.96 d, P < 0.001). The percentage of residual hematoma was meanly 11% (3.0%, 14.5%) in the cohort, and it was significantly lower in children with LMWH treatment than in those without. The hematoma stabilization time was 31.08±8.81 d and 37.75±5.01 d and the D-dimer stabilization time was 12.92±4.62 d and 14.62±2.82 d in LMWH group and non-LMWH group, respectively, showing no significant differences between the 2 groups (P>0.05). Conclusion CVST in children often occurs following skull fracture across the venous sinuses or epidural hematoma that compresses the venous sinus. Anticoagulation therapy can shorten the time of hematoma volume reduction, reduce the volume of residual hematoma, and accelerate recanalization to improve the short-term outcomes of the patients.