Clinical Profile and Long-term Outcome in Neonatal Cerebral Sinus Venous Thrombosis

Abstract Introduction Neonatal cerebral sinus venous thrombosis (CSVT) causes high morbidity and mortality. Factors associated with either favorable or unfavorable long-term outcomes have not been clearly established. This study aimed to determine the factors involved in long-term neurological outcomes in neonatal CSVT patients. Methods This was a retrospective cohort study of neonatal CSVT patients at a single institution. Clinical factors associated with long-term neurological outcomes were examined. Results A total of 67 patients met study inclusion criteria for radiologically-confirmed neonatal CSVT. The mean patient follow-up duration was four years (range one week to 16 years, median six years). We observed a favorable neurological outcome defined by a pediatric stroke outcome measures (PSOM) score of 0-0.5 in 26 (53%) of surviving patients at follow-up. An unfavorable neurological outcome as defined by PSOM score >0.5 was observed in 23 survivors (47%). Death was reported in 18 (27%) patients, of which 10 patients died due to direct complications of CSVT. Congential heart disease and genetic disease were associated with a significantly increased odds for all cause death. Cardiorespiratory failure and altered mental status during the initial neurological exam were significantly associated with increased odds of death due to CSVT. Among surviving patients, higher PSOM scores were associated with preature birth (i.e., gestational age Conclusions This study aimed to identify factors associated with long-term neurological outcomes in neonatal CSVT patients, distinguishing between all cause death, death specifically due to CSVT, and PSOM scores in CSVT survivors. These results can help guide further studies in neonatal CSVT aiming to decrease morbidity and mortality with the goal of improving long-term neurological outcomes.