Pediatric Cerebral Venous Sinus Thrombosis: Insights into Risk Profiles, Imaging Features, and Management Outcomes from a Single-Center Cohort

Authors

• Majdah A. Almaghrabi, Department of Pediatric Neurology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi ArabiaFollow
• Faris Althubaiti, Department of Pediatric Neurology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi ArabiaFollow
• Ali H. Algiraigri, Department of Hematology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia AND Hematology Research Unit, King Fahad Medical Research Centre, King Abdulaziz University, Jeddah, Kingdom of Saudi ArabiaFollow
• Rawan M. Hammad, Department of Hematology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia AND Hematology Research Unit, King Fahad Medical Research Centre, King Abdulaziz University, Jeddah, Kingdom of Saudi ArabiaFollow
• Mohammad Khalil, Department of Radiology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi ArabiaFollow

Abstract

Objective: To characterize the clinical presentation, risk factors, neuroimaging findings, management strategies, and outcomes of pediatric cerebral venous sinus thrombosis (CVST).
Methods: We retrospectively reviewed electronic medical records of pediatric patients with imaging-confirmed CVST at a tertiary care center in Jeddah, Kingdom of Saudi Arabia. Demographics, clinical features, risk factors, laboratory and imaging findings, management, and outcomes were analyzed. Descriptive statistics, bivariate analyses, and linear regression were performed.
Results: Seventeen patients were included (mean age 4.6 years, 64% male). Altered level of consciousness (58%), seizures (41%), and headache (35%) were the most common presentations. Infection was the predominant risk factor (71%), including sepsis (35%), meningitis (29%), otitis media (18%), and mastoiditis (18%). Extensive or multiple sinus thrombosis occurred in 58% of patients; isolated right transverse sinus thrombosis was most frequent (24%). Anticoagulation was administered to 88% of patients (primarily low-molecular-weight heparin) with no major bleeding complications. Follow-up imaging (35% of patients) showed complete recanalization in 4 and persistent thrombosis in 2. One patient died (5.9% mortality). Infection was significantly associated with altered consciousness (OR 18.0, p = 0.02). Age did not predict extent of sinus involvement (p = 0.44).
Conclusion: Pediatric CVST in this cohort is strongly linked to infection, which frequently presents with altered mental status. Anticoagulation appears safe and well tolerated. Larger prospective studies are needed to standardize treatment protocols and assess long-term neurodevelopmental outcomes.

Article Type

Original Article

First Page

407

Last Page

414

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Recommended Citation

Almaghrabi, Majdah A.; Althubaiti, Faris; Algiraigri, Ali H.; Hammad, Rawan M.; and Khalil, Mohammad (2026) "Pediatric Cerebral Venous Sinus Thrombosis: Insights into Risk Profiles, Imaging Features, and Management Outcomes from a Single-Center Cohort," Neurosciences: Vol. 31: Iss. 4, Article 8.
DOI: https://doi.org/10.17712/1658-3183.2820