Document Detail


Antithrombotic treatment in neonatal cerebral sinovenous thrombosis: results of the International Pediatric Stroke Study.
MedLine Citation:
PMID:  20149389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify predictors of antithrombotic treatment in neonates with cerebral sinovenous thrombosis (CSVT) in a large multinational study.
STUDY DESIGN: Neonates with CSVT from 10 countries were enrolled in the International Pediatric Stroke Study from 2003 through 2007. Term neonates with CSVT who presented with neurologic symptoms or signs of systemic illness and neuroimaging evidence of thrombus or flow interruption within cerebral venous system were included.
RESULTS: Of 341 neonates enrolled, 84 had isolated CSVT. Neuroimaging findings, available in 67/84 neonates, included venous ischemic infarction in 5, hemorrhagic infarction or other intracranial hemorrhage in 13, both infarction and hemorrhage in 26, and no parenchymal lesions in 23. Treatment data, available in 81/84 neonates, included antithrombotic medications in 52% (n = 43), comprising heparin (n = 14), low molecular weight heparin (n = 34), warfarin (n = 1), and aspirin (n = 2). By univariate logistic regression analysis, deep venous system thrombosis (P = .05) and location in the United States (P = .001) predicted nontreatment. Presence of infarction, hemorrhage, dehydration, systemic illness, and age did not predict treatment or nontreatment. In multivariate analysis only geographic location remained significant.
CONCLUSIONS: In neonatal CSVT, regional antithrombotic treatment practices demonstrate considerable variability and uncertainty about indications for antithrombotic therapy. Additional studies are warranted.
Authors:
Lori C Jordan; Mubeen F Rafay; Sabrina E Smith; Rand Askalan; Khaled M Zamel; Gabrielle deVeber; Stephen Ashwal;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-02-10
Journal Detail:
Title:  The Journal of pediatrics     Volume:  156     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-05-03     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  704-10, 710.e1-710.e2     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aspirin / therapeutic use
Brain / pathology,  radiography
Female
Fibrinolytic Agents / therapeutic use*
Heparin / therapeutic use
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Infant, Newborn
Magnetic Resonance Imaging
Male
Risk Factors
Sinus Thrombosis, Intracranial / complications,  diagnosis,  drug therapy*
Stroke / diagnosis
Tomography, X-Ray Computed
Treatment Outcome
Warfarin / therapeutic use
Grant Support
ID/Acronym/Agency:
K12 NS 049453/NS/NINDS NIH HHS; K12 NS049453-02/NS/NINDS NIH HHS; K23 NS062110/NS/NINDS NIH HHS; K23 NS062110-02/NS/NINDS NIH HHS; K23NS062110/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 5Q7ZVV76EI/Warfarin; 9005-49-6/Heparin; R16CO5Y76E/Aspirin
Investigator
Investigator/Affiliation:
Stephen Ashwal / ; Gabrielle deVeber / ; Donna Ferriero / ; Heather Fullerton / ; Rebecca Ichord / ; Fenella Kirkham / ; John K Lynch / ; Finbar O'Callaghan / ; Steve Pavlakis / ; Guillaume Sebire / ; Andrew Willan / ; Gabrielle deVeber / ; Andrew Willan / ; Adam Kirton / ; Mahendra Moharir / ; Rand Askalan / ; Marianne Sofronas / ; Ulrike Nowak-Gottl / ; Christine Düring / ; Anne Krümpel / ; Michael M Dowling / ; Patricia Plumb / ; Janna Journeycake / ; Katrina van de Bruinhorst / ; Abdalla Abdalla / ; Tonya Phillips / ; Neil Friedman / ; Elie Rizkallah / ; Warren Lo / ; Khaled Zamel / ; Max Wiznitzer / ; Karen Lidsky / ; Marta Isabel Hernandez Chavez / ; Paul Monagle / ; Mark MacKay / ; Chris Barnes / ; Janine Furmedge / ; Anne Gordon / ; Susan L Benedict / ; James F Bale / ; Rebecca Ichord / ; Daniel Licht / ; Sabrina Smith / ; Stephen Ashwal / ; Chalmer McClure / ; Li Kan / ; Robin Smith / ; Joseph Maytal / ; Rosemarrie Sy-Kho / ; Jessica Carpenter / ; Taeun Chang / ; Steven Weinstein / ; Donna Ferriero / ; Heather Fullerton / ; Steve Pavlakis / ; Sharon Goodman / ; Kim Levinson / ; Mubeen Rafay / ; Michael Salman / ; Charuta Joshi / ; Namrata Shah / ; Monica Nash / ; Geoffrey Heyer / ; Vijeya Ganesan / ; Jerome Y Yager / ; Hussain Imam / ; Montri Saengpattrachai / ; Bruce Bjornson / ; Nana Tatishvili / ; E Ann Yeh / ; Peter Humpherys / ; Catherine Amlie-Lefond / ; Harry T Whelan / ; Timothy Bernard / ; Neil Goldenberg / ; Manuel Arriaza Ortiz / ; Anthony Chan / ; Marcel Deray / ; Zaid Khatib / ; Virginia Wong / ; Guillaume Sebire / ; Jill M Cholette / ; Shalu Narang / ; Norma B Lerner / ; Shannon Carpenter / ; Kurt Bischoff /
Comments/Corrections
Comment In:
J Pediatr. 2010 May;156(5):695-6   [PMID:  20236660 ]

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