title: Pediatric Cortical Vein Thrombosis: Frequency and Association With Venous Infarction.
abstract: OBJECTIVE
  Cortical vein thrombosis (CVT) is an uncommon site of involvement in cerebral sinovenous thrombosis. Few reports have described pediatric CVT, and none has differentiated its unique attributes. This study assessed the clinical features and radiographic outcome of a cohort of children with cerebral sinovenous thrombosis, comparing those with CVT to those without CVT.
  
  
  METHODS
  Children diagnosed with cerebral sinovenous thrombosis were retrospectively reviewed and separated into 2 groups based on the presence or absence of cortical vein involvement.
  
  
  RESULTS
  Fifty patients met inclusion criteria, including 12 with CVT. The CVT group was more likely to present with seizure (P=0.0271), altered mental status (P=0.0271), and a family history of clotting disorder (P=0.0477). Acute imaging of the CVT group more commonly demonstrated concurrent superior sagittal sinus thrombosis (P=0.0024), parenchymal hemorrhage (P=0.0141), and restricted diffusion (P<0.0001). At follow-up, the CVT group more commonly showed headache, seizure, and focal neurological deficit (P=0.0449), and venous infarction (P=0.0007).
  
  
  CONCLUSIONS
  In our cohort, CVT was significantly associated with seizures at presentation, hemorrhage and restricted diffusion on acute imaging, as well as neurological disability and venous infarction at follow-up. Involvement of cortical veins in cerebral sinovenous thrombosis is associated with an increased risk of infarction and adverse outcome in children.
authors.affiliation: From the Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora (Z.R., A.L.H., T.J.B.); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora (D.W.); Department of Radiology, Children's Hospital Colorado, Aurora (L.Z.F., N.V.S.); and Departments of Pediatrics and Pediatric Neurology, Children's Hospital Colorado, Aurora (E.C.M., T.J.B.).
authors.forename: Zak
authors.initials: Z
authors.lastname: Ritchey
authors.affiliation: From the Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora (Z.R., A.L.H., T.J.B.); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora (D.W.); Department of Radiology, Children's Hospital Colorado, Aurora (L.Z.F., N.V.S.); and Departments of Pediatrics and Pediatric Neurology, Children's Hospital Colorado, Aurora (E.C.M., T.J.B.).
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Hollatz
authors.affiliation: From the Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora (Z.R., A.L.H., T.J.B.); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora (D.W.); Department of Radiology, Children's Hospital Colorado, Aurora (L.Z.F., N.V.S.); and Departments of Pediatrics and Pediatric Neurology, Children's Hospital Colorado, Aurora (E.C.M., T.J.B.).
authors.forename: David
authors.initials: D
authors.lastname: Weitzenkamp
authors.affiliation: From the Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora (Z.R., A.L.H., T.J.B.); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora (D.W.); Department of Radiology, Children's Hospital Colorado, Aurora (L.Z.F., N.V.S.); and Departments of Pediatrics and Pediatric Neurology, Children's Hospital Colorado, Aurora (E.C.M., T.J.B.).
authors.forename: Laura Z
authors.initials: LZ
authors.lastname: Fenton
authors.affiliation: From the Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora (Z.R., A.L.H., T.J.B.); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora (D.W.); Department of Radiology, Children's Hospital Colorado, Aurora (L.Z.F., N.V.S.); and Departments of Pediatrics and Pediatric Neurology, Children's Hospital Colorado, Aurora (E.C.M., T.J.B.).
authors.forename: Emily C
authors.initials: EC
authors.lastname: Maxwell
authors.affiliation: From the Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora (Z.R., A.L.H., T.J.B.); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora (D.W.); Department of Radiology, Children's Hospital Colorado, Aurora (L.Z.F., N.V.S.); and Departments of Pediatrics and Pediatric Neurology, Children's Hospital Colorado, Aurora (E.C.M., T.J.B.).
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bernard
authors.affiliation: From the Mountain States Regional Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora (Z.R., A.L.H., T.J.B.); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora (D.W.); Department of Radiology, Children's Hospital Colorado, Aurora (L.Z.F., N.V.S.); and Departments of Pediatrics and Pediatric Neurology, Children's Hospital Colorado, Aurora (E.C.M., T.J.B.). nicholas.stence@childrenscolorado.org.
authors.forename: Nicholas V
authors.initials: NV
authors.lastname: Stence
mesh_terms: D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology
keywords: brain infarction; cerebral venous thrombosis; hemorrhage; pediatric stroke; stroke