Case Report

Cerebral Venous Thrombosis in Neonates: Two Case Reports


Cerebral venous thrombosis is an uncommon disorder in children however it can be associated with serious clinical consequences. As it is a rare condition without any specific clinical presentation, it is usually undiagnosed. Clinical manifestation of cerebral thrombosis in children is relatively different from adult because of age-related differences in the vascular and neurologic systems. We present a case of a twenty days boy with a history of one-week lethargy and poor feeding and grand mal seizure. He had hypernatremia and severe dehydration. Non-contrast CT scan of the brain revealed superior sagittal and both transverse and sigmoid sinus thrombosis. The patient was treated in neonatal ICU with a favorable clinical response. We also present a fourteen days girl who presented with three days of fever, poor feeding, tachycardia, respiratory distress, and grand mal seizure. She had hypernatremia and severe dehydration. Non-contrast CT scan of the brain revealed superior sagittal sinus thrombosis and right temporal lobe infarction. She was also treated in neonatal ICU with noticeable improvement in symptoms. These cases demonstrate the importance of dehydration in neonatal and clinical suspicion of cerebral venous thrombosis (CVT). We present these two cases to enhance the awareness of clinical practitioners. CVT is an unusual and serious condition in neonates and due to its nonspecific clinical presentation often remains unrecognized. Early neuroimaging, including transfontanel doppler ultra-sonography, and non-contrast CT scan in all neonates with neonatal seizures will improve detection.

Terés NL, Koyfman A, Runyon MS, Cerebral venous thrombosis. A real issue for the emergency department. Emergencias 2007;19:99-103.

Lau KY, Au-Yeung M, Tsoi TH, Roebuck DJ, Tan LTH. Acute Dural Sinus Thrombosis Computed Tomography and Magnetic Resonance Imaging Features J HK Coll Radiol 2002;5:29-34.

Williams LS, Garg BP, Carvalho KS, Golomb MR. Cerebral sinovenous thrombosis in the neonate. Arch Neurol 2006;63:405-9.

deVeber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, et al. Cerebral sinovenous thrombosis in children. N Engl J Med 2001;345:417-23.

Dlamini N, Billinghurst L, Kirkham FJ. Cerebral venous sinus (sinovenous) thrombosis in children. Neurosurg Clin N Am 2010;21:511-27.

Azin H, Ashjazadeh N. Cerebral venous sinus thrombosis--clinical features, predisposing and prognostic factors. Acta Neurol Taiwan 2008;17:82-7.

Dzialo AF, Black-Schaffer RM. Cerebral venous thrombosis in young adults: 2 Case reports. Arch Phys Med Rehabil 2001;82:683-8.

Berfelo FJ, Kersbergen KJ, van Ommen CH, Govaert P, van Straaten HL, Poll-The BT, et al. Neonatal cerebral sinovenous thrombosis from symptom to outcome. Stroke 2010;41:1382-8.

Stolz EP. Role of ultrasound in diagnosis and management of cerebral vein and sinus thrombosis. Front Neurol Neurosci 2008;23:112-21.

Bezinque SL, Slovis TL, Touchette AS, Schave DM, Jarski RW, Bedard MP, et al. Characterization of superior sagittal sinus blood flow velocity using color flow Doppler in neonates and infants. Pediatr Radiol 1995;25:175-9.

Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, et al. 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 2008;39:2644-91.

Kersbergen KJ, Groenendaal F, Benders MJ, de Vries LS. et al. Neonatal cerebral sinovenous thrombosis: neuroimaging and long-term follow-up. J Child Neurol 2011;26:1111-20.

deVeber G, Chan A, Monagle P, Marzinotto V, Armstrong D, Massicotte P, et al. Anticoagulation therapy in pediatric patients with sinovenous thrombosis: a cohort study. Arch Neurol 1998;55:1533-7.

IssueVol 56, No 6 (2018) QRcode
SectionCase Report(s)
Cerebral thrombosis Brain infarction Venous Neonate

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Maghsoudi M, Babapour B, Shahbazzadegan B, Maghsoudi S. Cerebral Venous Thrombosis in Neonates: Two Case Reports. Acta Med Iran. 2018;56(6):410-414.