TREATMENT AND OUTCOME OF PEDIATRIC CEREBRAL SINOVENOUS THROMBOSIS : A SINGLE CENTER EXPERIENCE
(Abstract release date: 05/19/16)
EHA Library. Aytac S. 06/09/16; 135105; PB2205
Assoc. Prof. Selin Aytac
Contributions
Contributions
Abstract
Abstract: PB2205
Type: Publication Only
Background
Pediatric cerebral sinevenous thrombosis(CVST) is a rare but potentially life threatining condition with a 3-12% reported mortality rate. Clinical findings mostly depend on the initial age at presentation, anatomic localization and extent of thrombosis, presence of infarct and /or symptomps of increased intracranial pressure, intracranial hemorrhage. Moreover, it was reported that most of those children with CVST have diffuse neurologic findings on admission.
Aims
We aim to analyse treatment and prognosis of childhood CVST.
Methods
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital.
Results
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital. There were 14 female and 20 male children with a median age of 7.3 years( 1 month to 17,5 years). When we grouped initial ages 9 (26%) patients were under one year of age and 14(41%) patients were older than 10 years of age on admission. Initial complaints include headage(n=15;44%), seizures(n=5;15%), loss of consciousness (n=4;12%), focal neurological impairment (n=6;%17), diffuse neurological impairment (n=1; 3%) and pseudotumor cerebri (n=3; 9%). Risk factors included underlying disorders (Nephrotic syndrome, Acute leukemia, homocysteinemia, Behçet disorders, etc.) were found to be positive in 59% of the children and 15(44%) of them had hereditary prothrombotic risk factors ( Heterozygous Factor V G1691A mutation (n=4), Homozygous Factor V G1691A mutation(n= 2), Heterozygous Prothrombin G20210A mutation(n=2), homozygous MTHFR C 677T mutation (n=4), PAI 4G/5G mutation(n=2)). Nearly all patients were given anticoagulant treatment and initial treatment were mostly included LMWH(73%) with an median 6 months (1 month to 9 months)of treatment period and 66% of them obtained partial or complete resolution of thrombosis with treatment. Mortality rate was 6%.
Conclusion
This study shows that CVST was more common under 10 years of age (60%)in our group however there was no increased rate of CVST for the neonatal period which was found to be 11% inconsistently lower than the reported rate(57%). Neonatal CVST occured more than half of the patient without a known prothrombotic or underlying risk factors.
Session topic: E-poster
Keyword(s): Children, Prognosis, Thrombosis, Treatment
Type: Publication Only
Background
Pediatric cerebral sinevenous thrombosis(CVST) is a rare but potentially life threatining condition with a 3-12% reported mortality rate. Clinical findings mostly depend on the initial age at presentation, anatomic localization and extent of thrombosis, presence of infarct and /or symptomps of increased intracranial pressure, intracranial hemorrhage. Moreover, it was reported that most of those children with CVST have diffuse neurologic findings on admission.
Aims
We aim to analyse treatment and prognosis of childhood CVST.
Methods
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital.
Results
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital. There were 14 female and 20 male children with a median age of 7.3 years( 1 month to 17,5 years). When we grouped initial ages 9 (26%) patients were under one year of age and 14(41%) patients were older than 10 years of age on admission. Initial complaints include headage(n=15;44%), seizures(n=5;15%), loss of consciousness (n=4;12%), focal neurological impairment (n=6;%17), diffuse neurological impairment (n=1; 3%) and pseudotumor cerebri (n=3; 9%). Risk factors included underlying disorders (Nephrotic syndrome, Acute leukemia, homocysteinemia, Behçet disorders, etc.) were found to be positive in 59% of the children and 15(44%) of them had hereditary prothrombotic risk factors ( Heterozygous Factor V G1691A mutation (n=4), Homozygous Factor V G1691A mutation(n= 2), Heterozygous Prothrombin G20210A mutation(n=2), homozygous MTHFR C 677T mutation (n=4), PAI 4G/5G mutation(n=2)). Nearly all patients were given anticoagulant treatment and initial treatment were mostly included LMWH(73%) with an median 6 months (1 month to 9 months)of treatment period and 66% of them obtained partial or complete resolution of thrombosis with treatment. Mortality rate was 6%.
Conclusion
This study shows that CVST was more common under 10 years of age (60%)in our group however there was no increased rate of CVST for the neonatal period which was found to be 11% inconsistently lower than the reported rate(57%). Neonatal CVST occured more than half of the patient without a known prothrombotic or underlying risk factors.
Session topic: E-poster
Keyword(s): Children, Prognosis, Thrombosis, Treatment
Abstract: PB2205
Type: Publication Only
Background
Pediatric cerebral sinevenous thrombosis(CVST) is a rare but potentially life threatining condition with a 3-12% reported mortality rate. Clinical findings mostly depend on the initial age at presentation, anatomic localization and extent of thrombosis, presence of infarct and /or symptomps of increased intracranial pressure, intracranial hemorrhage. Moreover, it was reported that most of those children with CVST have diffuse neurologic findings on admission.
Aims
We aim to analyse treatment and prognosis of childhood CVST.
Methods
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital.
Results
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital. There were 14 female and 20 male children with a median age of 7.3 years( 1 month to 17,5 years). When we grouped initial ages 9 (26%) patients were under one year of age and 14(41%) patients were older than 10 years of age on admission. Initial complaints include headage(n=15;44%), seizures(n=5;15%), loss of consciousness (n=4;12%), focal neurological impairment (n=6;%17), diffuse neurological impairment (n=1; 3%) and pseudotumor cerebri (n=3; 9%). Risk factors included underlying disorders (Nephrotic syndrome, Acute leukemia, homocysteinemia, Behçet disorders, etc.) were found to be positive in 59% of the children and 15(44%) of them had hereditary prothrombotic risk factors ( Heterozygous Factor V G1691A mutation (n=4), Homozygous Factor V G1691A mutation(n= 2), Heterozygous Prothrombin G20210A mutation(n=2), homozygous MTHFR C 677T mutation (n=4), PAI 4G/5G mutation(n=2)). Nearly all patients were given anticoagulant treatment and initial treatment were mostly included LMWH(73%) with an median 6 months (1 month to 9 months)of treatment period and 66% of them obtained partial or complete resolution of thrombosis with treatment. Mortality rate was 6%.
Conclusion
This study shows that CVST was more common under 10 years of age (60%)in our group however there was no increased rate of CVST for the neonatal period which was found to be 11% inconsistently lower than the reported rate(57%). Neonatal CVST occured more than half of the patient without a known prothrombotic or underlying risk factors.
Session topic: E-poster
Keyword(s): Children, Prognosis, Thrombosis, Treatment
Type: Publication Only
Background
Pediatric cerebral sinevenous thrombosis(CVST) is a rare but potentially life threatining condition with a 3-12% reported mortality rate. Clinical findings mostly depend on the initial age at presentation, anatomic localization and extent of thrombosis, presence of infarct and /or symptomps of increased intracranial pressure, intracranial hemorrhage. Moreover, it was reported that most of those children with CVST have diffuse neurologic findings on admission.
Aims
We aim to analyse treatment and prognosis of childhood CVST.
Methods
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital.
Results
In this study we retrospectively evaluate clinical presentation, underlying disorders, risk factors (genetic and acquired),anticoagulant treatments and prognosis of our 34 patients with CVST diagnosed between January 2009 to June 2015 at Hacettepe University Faculty of Medicine, Ihsan Doğramacı Children’s Hospital. There were 14 female and 20 male children with a median age of 7.3 years( 1 month to 17,5 years). When we grouped initial ages 9 (26%) patients were under one year of age and 14(41%) patients were older than 10 years of age on admission. Initial complaints include headage(n=15;44%), seizures(n=5;15%), loss of consciousness (n=4;12%), focal neurological impairment (n=6;%17), diffuse neurological impairment (n=1; 3%) and pseudotumor cerebri (n=3; 9%). Risk factors included underlying disorders (Nephrotic syndrome, Acute leukemia, homocysteinemia, Behçet disorders, etc.) were found to be positive in 59% of the children and 15(44%) of them had hereditary prothrombotic risk factors ( Heterozygous Factor V G1691A mutation (n=4), Homozygous Factor V G1691A mutation(n= 2), Heterozygous Prothrombin G20210A mutation(n=2), homozygous MTHFR C 677T mutation (n=4), PAI 4G/5G mutation(n=2)). Nearly all patients were given anticoagulant treatment and initial treatment were mostly included LMWH(73%) with an median 6 months (1 month to 9 months)of treatment period and 66% of them obtained partial or complete resolution of thrombosis with treatment. Mortality rate was 6%.
Conclusion
This study shows that CVST was more common under 10 years of age (60%)in our group however there was no increased rate of CVST for the neonatal period which was found to be 11% inconsistently lower than the reported rate(57%). Neonatal CVST occured more than half of the patient without a known prothrombotic or underlying risk factors.
Session topic: E-poster
Keyword(s): Children, Prognosis, Thrombosis, Treatment
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