Cerebral Venous Sinus Thrombosis Pediatric Case Report.

Abstract

A cerebral venous sinus thrombosis (CVST) is an obstruction of the dural venous sinuses caused by a thrombus. The dural sinuses drain into the brain, and when there is a blockage, it can increase the risk of cerebral ischemia or hemorrhage. CVST is very rare in the pediatric population, with only seven cases per million reported each year. This case describes a 2-year-old male who was transferred from a referral hospital with a possible diagnosis of anemia and worsening clinical status. After multiple tests revealed no probable cause for the patient's declining clinical status, a magnetic resonance imaging (MRI) and computed tomography (CT) scan were performed. These studies revealed a sinus venous thrombosis. The patient was transferred to the pediatric intensive care unit and a high-dose heparin infusion was initiated. CVST presents with vague symptoms, which can often delay the diagnosis. Patients may present with a variety of symptoms including seizures, decreased level of consciousness, nausea and vomiting, headache, ataxia, speech impairment, cranial nerve palsies, and hemiparesis. CVST is typically diagnosed using MRI and CT scan. CVST is acutely treated with an anticoagulant such as unfractionated heparin or low molecular weight heparin and in severe cases a mechanical thrombectomy might be necessary. CVST has a significant morbidity and mortality rate, so prompt diagnosis is crucial to the patient's overall outcome. In this case, the patient's CVST was due to iron deficiency anemia, which is rare, and the patient made a full recovery without requiring surgical intervention.