Abstract TMP95: Cerebral Sinovenous Thrombosis In Preterm Infants

Introduction: Neonatal cerebral sinovenous thrombosis (CSVT) can lead to brain injury and long-term neurodevelopmental impairments. Previous studies of neonatal CSVT have primarily focused on term infants, and studies of preterm infants are lacking. In this study, we examined the clinical and radiological features, treatment and outcome of CSVT in preterm infants. Methods: This was a retrospective, consecutive cohort study of preterm infants (gestational age <37 weeks) with radiologically confirmed CSVT. All MRI/MRV and CT/CTV scans were re-reviewed to study thrombus characteristics and the pattern of brain injury. Clinical and radiological data were analysed using descriptive statistics, ANOVA and chi-square tests. Outcome was assessed by the validated Pediatric Stroke Outcome Measure (PSOM). Results: A total of 26 preterm infants with CSVT were included. Of these, 65% were late preterm, 27% very preterm and 8% extreme preterm. Most (73%) were symptomatic at presentation with seizures or abnormal exam. Transverse (85%) and superior sagittal (42%) sinus were most common sites of thrombosis. Parenchymal brain injury was predominantly periventricular (35%) and deep white matter (31%) in location. Intraventricular hemorrhage occurred in 46%. Most infants (69%) were treated with anticoagulation. None of the treated infants had hemorrhagic complications. Outcome at follow-up ranged from no impairment (39%), mild impairment (19%) and severe impairment (19%). Conclusions: Preterm infants with CSVT are often symptomatic and have white matter brain lesions at presentation. Anticoagulation treatment of preterm CSVT in this small cohort appeared to be safe. Further larger studies and treatment.