Pediatric septic thrombosis of intracranial venous sinuses: from diagnosis to discharge. Twenty years of experience

• Published in: Revista de neurologiá Vol. 73; no. 6; pp. 187 - 193
• Main Authors: Cortés-Ledesma, C, García-Salido, A, Garriga Ferrer-Bergua, L, Cabrero-Hernández, M, Palomino-Pérez, L, de Lama-Caro Patón, G, Jiménez-García, R
• Format: Journal Article
• Language: Spanish; English
• Published: Spain 01.09.2021
• Subjects: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Male; Patient Discharge; Retrospective Studies; Sepsis - complications; Sepsis - diagnosis; Sepsis - therapy; Sinus Thrombosis, Intracranial - diagnosis; Sinus Thrombosis, Intracranial - microbiology; Sinus Thrombosis, Intracranial - therapy; Time Factors
• ISSN: 1576-6578
• DOI: 10.33588/rn.7306.2020586

Septic thrombosis of intracranial venous sinuses (STSV) is a rare and severe complication of cranial infections. The main objective of this paper is to describe the clinical data, diagnostic procedures, treatment and evolution of a series of cases of STSV. In addition, the current literature is reviewed. Observational retrospective study by review of medical histories (January 1995-December 2016). The data collected were: clinical, analytical, epidemiological, microbiological, radiological, management and follow-up. A descriptive and statistical analysis of the data was done. Twelve children were included (86,832 admissions studied). They have a median age of 4.5 years (range 1-13) with a median time of symptoms of 6 days (range 1-25). At admission, the clinical data were: fever (11/12), vomiting (9/12) and headache (8/12). They also showed bad general status 12/12, 7/12 acute otitis media and 5/12 VI cranial nerve paresis. The lumbar puncture was pathological in 4/12. The most frequently microorganism isolated was Streptococcus sp. Prothrombotic mutations were confirmed on 2/12. Cranial computed tomography allowed diagnosis in 9/12; the magnetic resonance imaging achieves that in 12/12. Previous neurological signs or time to diagnosis did not influence the appearance of other image complications. All received antibiotic treatment, heparin 10/12 and 11/12 surgery. There were no sequels. In our series otitis, headache, vomiting and fever were prevalent. Complementary tests allowed the suspect but the definitive diagnosis was obtained by neuroimaging. There were no sequels and the therapies were mainly wide broad-spectrum antibiotics, heparin, and surgical.