Cerebral Venous Thrombosis in Neonates: Two Case Reports

Abstract

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.