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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

LOPEZ-ESPEJO, M.; HERNANDEZ-CHAVEZ, M.  y  HUETE, I.. Clinical and radiological features of cerebral venous thrombosis in a children cohort. Rev. chil. pediatr. [online]. 2018, vol.89, n.5, pp.621-629. ISSN 0370-4106.  http://dx.doi.org/10.4067/S0370-41062018005000805.

Introduction:

Cerebral venous thrombosis (CVT) is an uncommon and poorly studied condition in the pediatric population.

Objectives:

To describe and compare the clinical and radiological features of non-neonatal children with CVT according to age and to analyze their association with functional impairment or mortality at hospital discharge.

Methodology:

An observational cohort study of chil dren older than 30 days with a first CVT diagnosed with imaging/venography by magnetic resonance (IMR/VMR). We measure functionality with the modified Rankin scale defining marked impairment with 3 to 5 points. We used U-Mann-Whitney test to compare ages averages between groups with and without the different studied variables (significance < 0.05). We used logistic regression analyses to estimate the risk of adverse outcome for each variable expressed in Odds Ratios (ORs) and 95% confidence intervals (CI).

Results:

Among 21 patients recruited, 42.8% were girls, median age 6.27 years (Interquartile range: 0.74-10). The average age was lower in children with diagnostic delay > 48 hours (p = 0.041), score < 12 in the Glasgow coma scale (p = 0.013), seizures (p = 0.041), sinus rectus thrombosis (p = 0.011), and intracranial hemorrhage (p = 0.049); while it was significantly higher in children with intracranial hypertension syndrome (p = 0.008). The presence of some chro nic systemic condition (OR = 11.2; CI = 1.04-120.4), deep CVT (OR = 14; CI = 1.3-150.8), and brain ischemia (OR = 15.8; CI = 1.4-174.2) was associated with marked functional impairment or mor tality at discharge.

Conclusions:

Clinical and radiological features of CVT are age-related. Chronic illnesses, deep venous system involvement, and brain ischemia predict adverse short-term outcomes.

Palabras clave : Dural sinus thrombosis; brain infarction; intracranial hemorrhage; pediatric stroke; functional evaluation.

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