Clinical analysis of traumatic cerebral venous sinus thrombosis in children

Xueling ZHAO; Yang CHENG; Ping LIANG; Jianjun ZHOU

doi:10.16016/j.1000-5404.202006151

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Clinical analysis of traumatic cerebral venous sinus thrombosis in children

Pediatric Clinical reseach | 更新时间：2026-01-09

- Clinical analysis of traumatic cerebral venous sinus thrombosis in children
- Journal of Third Military Medical University Vol. 42, Issue 22, Pages: 2190-2194(2020)
- 作者机构：
  
  重庆 400014，重庆医科大学附属儿童医院神经外科，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室
- 作者简介：
- 基金信息：
  
  the Key Project of National Clinical Key-discipline Construction of China(国卫办医函544)
- DOI：10.16016/j.1000-5404.202006151
  CLC： R181.32;R726.511;R743.32
- Received：17 June 2020，
  
  Revised：2020-09-11，
  
  Published：30 November 2020
- 稿件说明：
移动端阅览
Xueling ZHAO, Yang CHENG, Ping LIANG, et al. Clinical analysis of traumatic cerebral venous sinus thrombosis in children[J]. Journal of Third Military Medical University, 2020, 42(22): 2190-2194.
DOI：

Xueling ZHAO, Yang CHENG, Ping LIANG, et al. Clinical analysis of traumatic cerebral venous sinus thrombosis in children[J]. Journal of Third Military Medical University, 2020, 42(22): 2190-2194. DOI： 10.16016/j.1000-5404.202006151.

摘要

目的

探讨儿童创伤性颅内静脉窦血栓的形成机制、临床表现、治疗方案及预后。

方法

回顾性分析我院2009年1月至2019年12月收治创伤性颅内静脉窦血栓患儿临床资料，总结其临床表现、形成机制、影像学特点，对比肝素与非肝素治疗效果。

结果

本组患儿共21例，主要临床症状为头痛、呕吐及活动量减少，颅内压增高，视乳头水肿发生率高(81%)。血栓形成部位多伴有跨窦的颅骨骨折或硬膜外血肿；血栓初次减少的时间为(18.33±6.15) d，肝素组显著短于非肝素组，血栓残余平均比率为11%(3.0%

14.5%)，肝素组血栓残余比率为5%(2%，13%)，显著低于非肝素组。两组间的血栓稳定时间及D-二聚体减少时间差异无统计学意义(

0.05)。

结论

儿童创伤性颅内静脉窦血栓常见于跨静脉窦的颅骨骨折及压迫静脉窦的硬膜外血肿，抗凝治疗可使血栓初次减少时间缩短，血栓残余比缩小，加速血栓再通，再通效果更佳，短期预后较好。

Abstract

Objective

To investigate the mechanism of formation of traumatic cerebral venous sinus thrombosis (CVST) in children and analyze the clinical manifestations

treatment and prognosis of CVST.

Methods

We performed a retrospective analysis of 21 children with traumatic CVST treated in our hospital between January 2009 and December 2019. The clinical manifestations

causes of thrombosis

imaging characteristics and the effects of heparin versus non-heparin treatments were analyzed.

Results

Among the 21 children with CVST

the main clinical symptoms included headache

vomiting

decreased activity

creased intracranial pressure (30.53±5.07 cmH

and papilledema (81%). Cranial fractures involving different sinuses or epidural hematoma was common in the children with CVST. The time of first-time hematoma volume reduction was 18.33±6.15 d in these children

and was significantly shorter in children receiving low-molecular-weight heparin (LMWH) treatment than in those without LMWH treatment (15.00±5.13

23.75±2.96 d

0.001). The percentage of residual hematoma was meanly 11% (3.0%

14.5%) in the cohort

and it was significantly lower in children with LMWH treatment than in those without. The hematoma stabilization time was 31.08±8.81 d and 37.75±5.01 d and the D-dimer stabilization time was 12.92±4.62 d and 14.62±2.82 d in LMWH group and non-LMWH group

respectively

showing no significant differences between the 2 groups (

0.05).

Conclusion

CVST in children often occurs following skull fracture across the venous sinuses or epidural hematoma that compresses the venous sinus. Anticoagulation therapy can shorten the time of hematoma volume reduction

reduce the volume of residual hematoma

and accelerate recanalization to improve the short-term outcomes of the patients.

关键词

Keywords

references

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Department of Nutrition, Nutrition and Food Safety Research Center， Chongqing Medical Nutrition Research Center， Chongqing Key Laboratory of Nutrition and Health， Faculty of Military Preventive Medicine， Army Medical University （Third Military Medical University）

Department of Cardiovascular Surgery， Second Affiliated Hospital， Army Medical University （Third Military Medical University）， Chongqing, Nutrition and Food Safety Research Center， Chongqing Medical Nutrition Research Center， Chongqing Key Laboratory of Nutrition and Health， Faculty of Military Preventive Medicine， Army Medical University （Third Military Medical University）

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Department of Anesthesiology Children’s Hospital of Chongqing Medical University， National Clinical Research Center for Child Health and Disorders， Ministry of Education Key Laboratory of Child Development and Disorders， Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders

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