AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on August 7, 2008
doi: 10.3174/ajnr.A1246
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American Journal of Neuroradiology 29:1961-1965, November-December 2008
© 2008 American Society of Neuroradiology

PEDIATRICS

Frequency and Topographic Distribution of Brain Lesions in Pediatric Cerebral Venous Thrombosis

M. Teksama,b, M. Moharirc, G. deVeberc and M. Shroffb

a Department of Radiology, Fatih University Medical School, Ankara, Turkey
b Department of Diagnostic Imaging, The Hospital For Sick Children, Toronto, Ontario, Canada
c Department of Neurology, The Hospital For Sick Children, Toronto, Ontario, Canada

Please address correspondence to Mehmet Teksam, MD, Fatih University Medical School, Department of Radiology, Alparslan Türkes Cad. No:57, Emek, Ankara 06510, Turkey; e-mail: mteksam{at}fatih.edu.tr

BACKGROUND AND PURPOSE: Cerebral sinovenous thrombosis (CSVT) is increasingly encountered in children, including neonates. The purpose of this study was to assess the frequency and topographic distribution of parenchymal brain lesions associated with CSVT in children and to compare these with the known anatomic venous drainage pathways.

MATERIALS AND METHODS: Brain CT/CT venograms and/or MR imaging/MR venograms of 71 consecutive patients with CSVT were reviewed retrospectively. The patients were grouped into neonates, infants, and older children. The site of CSVT, the location and size of the brain lesions, and the presence of hemorrhage were documented. The frequency of the brain lesions was calculated.

RESULTS: There were 34 neonates, 10 infants, and 27 older children with CSVT who were included. The most common sites of CSVT were the transverse sinuses, the superior sagittal sinus, and the straight sinus. Overall, 37 of 71 children with CSVT had parenchymal brain lesions. There were 21 of 34 neonates, 4 of 10 infants, and 12 of 27 older children who had brain lesions. The most common locations were in the frontal and parietal lobes. The topographic distribution of lesions correlated with the corresponding venous drainage territory in 16 of 21 neonates, all infants, and all older children. The neonates had smaller-sized lesions. Brain lesions were hemorrhagic in 76% of neonates, 75% of infants, and 33% of older children.

CONCLUSION: The topographic distribution of brain lesions associated with CSVT correlates with the known drainage territories of the dural venous sinus in children.




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Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X