Antithrombotic Treatment in Neonatal Cerebral Sinovenous Thrombosis: Results of the International Pediatric Stroke Study - 07/03/14
for the International Pediatric Stroke Study Group
Reprint requests: Stephen Ashwal, MD, Department of Pediatrics, Loma Linda University School of Medicine, 111785 Campus St, Loma Linda, CA 92350.Abstract |
Objective |
To identify predictors of antithrombotic treatment in neonates with cerebral sinovenous thrombosis (CSVT) in a large multinational study.
Study design |
Neonates with CSVT from 10 countries were enrolled in the International Pediatric Stroke Study from 2003 through 2007. Term neonates with CSVT who presented with neurologic symptoms or signs of systemic illness and neuroimaging evidence of thrombus or flow interruption within cerebral venous system were included.
Results |
Of 341 neonates enrolled, 84 had isolated CSVT. Neuroimaging findings, available in 67/84 neonates, included venous ischemic infarction in 5, hemorrhagic infarction or other intracranial hemorrhage in 13, both infarction and hemorrhage in 26, and no parenchymal lesions in 23. Treatment data, available in 81/84 neonates, included antithrombotic medications in 52% (n = 43), comprising heparin (n = 14), low molecular weight heparin (n = 34), warfarin (n = 1), and aspirin (n = 2). By univariate logistic regression analysis, deep venous system thrombosis (P = .05) and location in the United States (P = .001) predicted nontreatment. Presence of infarction, hemorrhage, dehydration, systemic illness, and age did not predict treatment or nontreatment. In multivariate analysis only geographic location remained significant.
Conclusions |
In neonatal CSVT, regional antithrombotic treatment practices demonstrate considerable variability and uncertainty about indications for antithrombotic therapy. Additional studies are warranted.
Le texte complet de cet article est disponible en PDF.Mots-clés : AIS, CSVT, CT, CTV, IPSS, LMWH, MRI, MRV, UFH
Plan
| Supported by K23NS062110 (L.C.J.), K12 NS 049453 (S.E.S.), Manitoba Institute of Health research grant for IPSS (M.F.R.), Child Neurology Society and Foundation (multicenter clinical research grant), Canadian Stroke Network, and Auxilium Children’s Foundation (G.d.V.). The authors declare no conflicts of interest. |
Vol 156 - N° 5
P. 704 - mai 2010 Retour au numéro
Article précédent
- Vitamin D and the Magic Mountain: The Anti-Infectious Role of the Vitamin
- Russell W. Chesney
- 50 Years Ago in The Journal of Pediatrics : Interrelationships in the Urinary Excretion of Creatine, Creatinine, Free Alpha Amino Acid Nitrogen, and Total Nitrogen in Premature Infants
- Patti J. Thureen, William W. Hay
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?