Spotlight on Cerebral venous thrombosis in infants and children

In this article, Dr. Mahendranath Moharir and Dr. Gabrielle deVeber of the University of Toronto discuss cerebral sinovenous thrombosis. The condition is often unrecognized in neonates and children due to nonspecific clinical features and challenges in radiographic diagnosis. Risk factors for cerebral sinovenous thrombosis in neonates are different from those in older children. Treatment with anticoagulants, a well-established practice in adults, is increasingly offered in children and, to a lesser extent, in neonates. The safety of anticoagulants and recanalization outcomes in cerebral sinovenous thrombosis has been established in children as well as in neonates based on consecutive cohort studies; however, its influence on neurologic outcome, particularly in neonates, has not been proven. The clinical outcome from cerebral sinovenous thrombosis remains worse in neonates than in children.

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Spotlight on Cerebral venous thrombosis

Cerebral venous thrombosis is a rare but important cause of stroke that is often missed or delayed in diagnosis. Dr. David Liebeskind of the University of California in Los Angeles provides literature on the topic.

The clinical manifestations are myriad, and a high level of suspicion must be maintained in order to effectively and expeditiously identify this disorder. Infectious and noninfectious processes may cause cerebral venous thrombosis. In adults, about half of cases are associated with pregnancy and the puerperium, but numerous unusual etiologies must be considered in the remainder of patients. Anticoagulation is the mainstay of therapy in the presence of either ischemic or hemorrhagic stroke; in some dire cases, more aggressive approaches such as thrombolysis or mechanical clot disruption may be undertaken.

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Spotlight on Hypercoagulable states and cerebrovascular disease

In this article,Dr. Kathryn Kirchoff-Torres of Albert Einstein College of Medicine discusses advances in understanding the epidemiology, pathophysiology, and management of patients with ischemic stroke and cerebral venous thrombosis associated with genetic and acquired thrombophilia. This article also provides an overview of recently published treatment guidelines for patients with cerebrovascular events and thrombophilias, including the antiphospholipid antibody syndrome.

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