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Child's Nervous System

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01-05-2015 | Original Paper

Neuroimaging findings in pediatric cerebral sinovenous thrombosis

Authors: Matthias W. Wagner, Thangamadhan Bosemani, Alexander Oshmyansky, Andrea Poretti, Thierry A. G. M. Huisman

Published in: Child's Nervous System | Issue 5/2015

Abstract

Purpose

Pediatric cerebral sinovenous thrombosis (CSVT) is a potentially life-threatening condition which is usually diagnosed by MRI. We analyzed the signal changes of the thrombus over time and the role of diffusion-weighted/tensor imaging (DWI/DTI) in the diagnosis of CSVT.

Methods

Clinical histories were reviewed for risk factors for CSVT, neurologic manifestation, and interval from onset of symptoms related to CSVT to the neuroimaging diagnosis. MRI studies were retrospectively evaluated for the appearance of thrombi on T1- and T2-weighted, fluid-attenuated inversion recovery (FLAIR), DWI/DTI, susceptibility-weighted imaging (SWI), and magnetic resonance venography (MRV) images.

Results

Thirty-three children with CSVT were included in this study. Seventy-seven thrombi were found. Seventy-four thrombi could be identified on T1- or T2-weighted images (96 %), 72 thrombi were seen on DWI/DTI (94 %) and 68 on FLAIR (88 %). DWI showed restricted diffusion in 29 thrombi (40 %). Thrombi older than 1 day were more likely to have a T1-hyperintense signal (p = 0.002). No additional correlation between signal intensity and age of the thrombi was found. Intraparenchymal changes secondary to CSVT were seen in 11 children.

Conclusion

MR sequences individually are not sensitive enough to provide the diagnosis. DWI/DTI does not provide complementary diagnostic value. Approximation of the age of the thrombus is difficult because of poor correlation between signal intensity and age of the thrombi.

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deVeber G (2011) Cerebral sinovenous (venous sinus) thrombosis. In: Ganesan V, Kirkham FJ (eds) Stroke and cerebrovascular disease in childhood. Mac Keith Press, London, pp 145–159

Bracken J, Barnacle A, Ditchfield M (2013) Potential pitfalls in imaging of paediatric cerebral sinovenous thrombosis. Pediatr Radiol 43:219–231CrossRefPubMed

Berfelo FJ, Kersbergen KJ, van Ommen CH, Govaert P, van Straaten HL, Poll-The BT, van Wezel-Meijler G, Vermeulen RJ, Groenendaal F, de Vries LS, de Haan TR (2010) Neonatal cerebral sinovenous thrombosis from symptom to outcome. Stroke 41:1382–1388CrossRefPubMed

Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, Ferriero D, Jones BV, Kirkham FJ, Scott RM, Smith ER (2008) Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 39:2644–2691CrossRefPubMed

deVeber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, Camfield CS, David M, Humphreys P, Langevin P, MacDonald EA, Gillett J, Meaney B, Shevell M, Sinclair DB, Yager J (2001) Cerebral sinovenous thrombosis in children. N Engl J Med 345:417–423CrossRefPubMed

Sze G, Simmons B, Krol G, Walker R, Zimmerman RD, Deck MD (1988) Dural sinus thrombosis: verification with spin-echo techniques. AJNR Am J Neuroradiol 9:679–686PubMed

Macchi PJ, Grossman RI, Gomori JM, Goldberg HI, Zimmerman RA, Bilaniuk LT (1986) High field MR imaging of cerebral venous thrombosis. J Comput Assist Tomogr 10:10–15CrossRefPubMed

Leach JL, Fortuna RB, Jones BV, Gaskill-Shipley MF (2006) Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radiographics 26(Suppl 1):S19–S41, discussion S42-13CrossRefPubMed

Bianchi D, Maeder P, Bogousslavsky J, Schnyder P, Meuli RA (1998) Diagnosis of cerebral venous thrombosis with routine magnetic resonance: an update. Eur Neurol 40:179–190CrossRefPubMed

10.

Dormont D, Anxionnat R, Evrard S, Louaille C, Chiras J, Marsault C (1994) MRI in cerebral venous thrombosis. J Neuroradiol 21:81–99PubMed

11.

Hedlund GL (2013) Cerebral sinovenous thrombosis in pediatric practice. Pediatr Radiol 43:173–188CrossRefPubMed

12.

Poon CS, Chang JK, Swarnkar A, Johnson MH, Wasenko J (2007) Radiologic diagnosis of cerebral venous thrombosis: pictorial review. AJR Am J Roentgenol 189:S64–S75CrossRefPubMed

13.

Isensee C, Reul J, Thron A (1994) Magnetic resonance imaging of thrombosed dural sinuses. Stroke 25:29–34CrossRefPubMed

14.

Lafitte F, Boukobza M, Guichard JP, Hoeffel C, Reizine D, Ille O, Woimant F, Merland JJ (1997) MRI and MRA for diagnosis and follow-up of cerebral venous thrombosis (CVT). Clin Radiol 52:672–679CrossRefPubMed

15.

Favrole P, Guichard JP, Crassard I, Bousser MG, Chabriat H (2004) Diffusion-weighted imaging of intravascular clots in cerebral venous thrombosis. Stroke 35:99–103CrossRefPubMed

16.

Lovblad KO, Bassetti C, Schneider J, Guzman R, El-Koussy M, Remonda L, Schroth G (2001) Diffusion-weighted mr in cerebral venous thrombosis. Cerebrovasc Dis 11:169–176CrossRefPubMed

17.

Idbaih A, Boukobza M, Crassard I, Porcher R, Bousser MG, Chabriat H (2006) MRI of clot in cerebral venous thrombosis: high diagnostic value of susceptibility-weighted images. Stroke 37:991–995CrossRefPubMed

Title: Neuroimaging findings in pediatric cerebral sinovenous thrombosis
Authors: Matthias W. Wagner
Thangamadhan Bosemani
Alexander Oshmyansky
Andrea Poretti
Thierry A. G. M. Huisman
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 5/2015
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-015-2662-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Neuroimaging findings in pediatric cerebral sinovenous thrombosis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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