Treatment and outcome of childhood cerebral sinovenous thrombosis.
Journal
Neurology. Clinical practice
ISSN: 2163-0402
Titre abrégé: Neurol Clin Pract
Pays: United States
ID NLM: 101577149
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
11
03
2019
accepted:
26
07
2019
entrez:
10
7
2020
pubmed:
10
7
2020
medline:
10
7
2020
Statut:
ppublish
Résumé
To test our hypothesis that anticoagulation is associated with better neurologic outcomes in childhood cerebral sinovenous thrombosis (CSVT), we analyzed treatment and outcomes in a population of 410 children from the International Pediatric Stroke Study (IPSS). We included patients enrolled in the IPSS registry with a diagnosis of CSVT at age >28 days with radiologic confirmation, in isolation or with concomitant arterial ischemic stroke. The primary outcome was the neurologic status at discharge. We defined unfavorable outcome as severe neurologic impairment or death at discharge. The Pediatric Stroke Outcome Measure was used for long-term outcome in those with follow-up. Predictors of anticoagulation use and outcome were analyzed by logistic regression. Most children (95%) had identifiable risk factors, and 82% received anticoagulation. Shift analysis demonstrated better outcomes at discharge in children who were anticoagulated, and this persisted with longer-term outcomes. In multivariable analysis, anticoagulation was significantly associated with favorable outcomes (adjusted odds ratio [aOR] unfavorable 0.32, Within the IPSS registry, children with risk factors of trauma or intracranial surgery were less likely to receive anticoagulation for CSVT. Anticoagulation was associated with a lower odds of severe neurologic impairment or death at hospital discharge, but this finding is limited and needs further confirmation in randomized, controlled, prospective studies.
Identifiants
pubmed: 32642325
doi: 10.1212/CPJ.0000000000000720
pii: NEURCLINPRACT2019038885
pmc: PMC7292564
doi:
Types de publication
Journal Article
Langues
eng
Pagination
232-244Subventions
Organisme : NINDS NIH HHS
ID : K08 NS097704
Pays : United States
Informations de copyright
© 2019 American Academy of Neurology.
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