Retrospective cohort study reveals distinct risk factors and treatment patterns in pediatric and adult CSVT.
Background Cerebral sinus venous thrombosis (CSVT) varies between pediatric and adult patients in presentation and outcomes. This study compared clinical characteristics, risk factors, treatment patterns, and outcomes in these age groups. Methods A retrospective cohort study of patients diagnosed with CSVT (2012–2023) was conducted. Demographic, clinical, and outcome data were analyzed, including recanalization, recurrent thrombosis, and bleeding events. Results From 2012 to 2023, 242 patients were identified (157 adults, 85 children). Children (median age: 2.83 years) predominantly presented with provoked CSVT (85.9% vs. 63.1% in adults, p < 0.001), often due to head and neck infections (34.1% vs. 3.8%, p < 0.0001). Adults (median age: 41.5 years) had higher rates of hormonal (20.4%) and idiopathic cases (36.9% vs. 14.1%, p < 0.001). Headache was the most common symptom in adults (63.1% vs. 30.6% in children, p < 0.0001), while children frequently presented with seizures (31.8% vs. 8.3%, p < 0.0001). Treatment duration was longer in adults, with two‐thirds requiring extended anticoagulation (66.2% vs. 11.76% in children). Pediatric treatment favored low‐molecular‐weight heparin (75.3%), while adults more commonly received warfarin (45.2%) or direct oral anticoagulants (DOACs) (10.2%). Recanalization rates were higher in children (87% vs. 67.5%, p = 0.0009), and recurrent thrombosis was more frequent in adults (5.7% vs. 1.17%). Rates of major bleeding were comparable in both groups (4.7% in children vs. 2.55% in adults, p = 0.457). Conclusion CSVT exhibits age‐specific differences in risk factors, clinical presentation, treatment patterns, and outcomes. Pediatric cases, typically provoked, require shorter treatment durations and show higher recanalization rates.
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Neuman et al. (2025) studied this question.
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