Pediatric sinovenous thrombosis.
OBJECTIVE
To determine if anticoagulation therapy is effective for preventing progression of pediatric sinovenous thrombosis, to determine the safety of anticoagulation therapy in the pediatric population, and to outline risk factors and clinical presentation in the authors' population of patients with sinovenous thrombosis.


METHODS
A retrospective chart review was conducted of 17 consecutive pediatric patients with sinovenous thrombosis at the authors' institution regardless of treatment option and outcome.


RESULTS
Fifteen children underwent anticoagulation therapy; two did not. Surgical intervention was undertaken in two patients. None of the children died. None had recurrence after anticoagulation was initiated. Of the patients who had follow-up studies performed, 33% had some resolution of the clot, 60% had complete resolution, and 13% had no change. Both children who did not undergo anticoagulation therapy had resolution of the thrombus. All of the children had improvement of their symptoms at presentation. No patient had worsening of radiologic findings during the follow-up period.


CONCLUSIONS
Anticoagulation therapy did not result in bleeding complications. Fifteen of 17 patients were safely anticoagulated. All children had improvement of their presenting symptoms. There was no worsening of radiologic findings in any patient, and there was improvement in 13 patients. One patient has long-term neurologic sequelae (a learning disability). This patient underwent extensive surgeries for subdural and epidural empyemas.
Johnson
M Cris
MC
Department of Pediatrics, University of Virginia, Charlottesville, Virginia 22908-0386, USA. cj9q@virginia.edu
Parkerson
Nikki
N
Ward
Sarah
S
de Alarcon
Pedro A
PA
D000925:Anticoagulants / Q000627:therapeutic use*; D001925:Brain Damage, Chronic / Q000517:prevention & control; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D004341:Drug Evaluation; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D012640:Seizures / Q000209:etiology; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000601:surgery; D016896:Treatment Outcome; D014768:Virginia / Q000453:epidemiology; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin; D006493:Heparin