Pediatric blood & cancer · 2025
Age-Specific Differences in Cerebral Sinus Venous Thrombosis: A Retrospective Cohort Study From a Tertiary Care Center.
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Neuman Yarden Peley, Sawaid Kasem, Cohen Omri, Lalezari Shadan, Barg Assaf Arie, Radinsky Liat Waldman, Kenet Gili, Lubetzky Aharon, Levy-Mendelovich Sarina
Аннотация
BACKGROUND: Cerebral sinus venous thrombosis (CSVT) varies between pediatric and adult patients in presentation and outcomes. This study compared clinical characteristics, risk factors, treatment patterns, and outcomes in these age groups.
METHODS: A retrospective cohort study of patients diagnosed with CSVT (2012-2023) was conducted. Demographic, clinical, and outcome data were analyzed, including recanalization, recurrent thrombosis, and bleeding events.
RESULTS: From 2012 to 2023, 242 patients were identified (157 adults, 85 children). Children (median age: 2.83 years) predominantly presented with provoked CSVT (85.9% vs. 63.1% in adults, p < 0.001), often due to head and neck infections (34.1% vs. 3.8%, p < 0.0001). Adults (median age: 41.5 years) had higher rates of hormonal (20.4%) and idiopathic cases (36.9% vs. 14.1%, p < 0.001). Headache was the most common symptom in adults (63.1% vs. 30.6% in children, p < 0.0001), while children frequently presented with seizures (31.8% vs. 8.3%, p < 0.0001). Treatment duration was longer in adults, with two-thirds requiring extended anticoagulation (66.2% vs. 11.76% in children). Pediatric treatment favored low-molecular-weight heparin (75.3%), while adults more commonly received warfarin (45.2%) or direct oral anticoagulants (DOACs) (10.2%). Recanalization rates were higher in children (87% vs. 67.5%, p = 0.0009), and recurrent thrombosis was more frequent in adults (5.7% vs. 1.17%). Rates of major bleeding were comparable in both groups (4.7% in children vs. 2.55% in adults, p = 0.457).
CONCLUSION: CSVT exhibits age-specific differences in risk factors, clinical presentation, treatment patterns, and outcomes. Pediatric cases, typically provoked, require shorter treatment durations and show higher recanalization rates.
METHODS: A retrospective cohort study of patients diagnosed with CSVT (2012-2023) was conducted. Demographic, clinical, and outcome data were analyzed, including recanalization, recurrent thrombosis, and bleeding events.
RESULTS: From 2012 to 2023, 242 patients were identified (157 adults, 85 children). Children (median age: 2.83 years) predominantly presented with provoked CSVT (85.9% vs. 63.1% in adults, p < 0.001), often due to head and neck infections (34.1% vs. 3.8%, p < 0.0001). Adults (median age: 41.5 years) had higher rates of hormonal (20.4%) and idiopathic cases (36.9% vs. 14.1%, p < 0.001). Headache was the most common symptom in adults (63.1% vs. 30.6% in children, p < 0.0001), while children frequently presented with seizures (31.8% vs. 8.3%, p < 0.0001). Treatment duration was longer in adults, with two-thirds requiring extended anticoagulation (66.2% vs. 11.76% in children). Pediatric treatment favored low-molecular-weight heparin (75.3%), while adults more commonly received warfarin (45.2%) or direct oral anticoagulants (DOACs) (10.2%). Recanalization rates were higher in children (87% vs. 67.5%, p = 0.0009), and recurrent thrombosis was more frequent in adults (5.7% vs. 1.17%). Rates of major bleeding were comparable in both groups (4.7% in children vs. 2.55% in adults, p = 0.457).
CONCLUSION: CSVT exhibits age-specific differences in risk factors, clinical presentation, treatment patterns, and outcomes. Pediatric cases, typically provoked, require shorter treatment durations and show higher recanalization rates.