Abstract
Objective
Current guidelines recommend anticoagulation as the first-line treatment for pediatric cerebral venous sinus thrombosis (CVST), while the application, safety, and standardized regimen of endovascular treatment (EVT) in children remain controversial. This study aimed to evaluate the safety and efficacy of EVT for pediatric CVST and summarize the individualized endovascular strategy of thrombolysis and thrombectomy.Methods
A retrospective analysis was performed on pediatric patients (aged Results
A total of 45 pediatric CVST patients were enrolled, with a mean age of 14.8 years. The main clinical manifestations included headache (82.2%) and impaired consciousness (37.8%), and 88.9% of patients presented with multi-sinus thrombosis, accompanied by parenchymal hemorrhage in 31.1% of cases. The treatment strategies included simple thrombolysis (22.2%), simple thrombectomy (37.8%), and combined therapy (40.0%). The median daily individualized urokinase dose was 13,000 U/kg for 5-7 days. The median AVOIS score decreased from 5 at baseline to 2 at discharge. Two cases of intraoperative venous sinus perforation and one case of symptomatic intracranial hemorrhage were observed. At a median follow-up of 68 months, all patients achieved favorable functional outcomes.Conclusion
Endovascular treatment represents a valuable rescue option for pediatric CVST patients with severe neurological symptoms. The dose of urokinase should be individualized during thrombolysis with or without mechanical thrombectomy.