Iatrogenic cerebral sinovenous thrombosis - well known but yet under reported


  • Sandeep Karanam Department of Pediatrics, Bapuji Child Health and Research Institute, Davangere, Karnataka
  • Ramesh H. Department of Pediatrics, Bapuji Child Health and Research Institute, Davangere, Karnataka
  • C. R. Banapurmath Department of Pediatrics, Bapuji Child Health and Research Institute, Davangere, Karnataka




CSVT, Oral contraceptives


Cerebral sinus venous thrombosis (CSVT) although rare, there is concern that cases of this potentially treatable condition are missed. The clinical manifestations can be life-threatening and cause long-term neurological deficits. As the symptoms and signs are non-specific, diagnosis is often delayed and may be missed, hence the onus lies on clinician to request for appropriate investigations. Oral contraceptives by inducing hypercoaguable state found to have strong causal association with CSVT.


deVeber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, et al. Cerebral Sinovenous Thrombosis in Children. N Engl J Med. 2001;345:417-23.

Kenet G, Kirkham F, Niederstadt T, Heinecke A, Saunders D, Stoll M, et al. European Thromboses Study Group. Risk factors for recurrent venous thromboembolism in the European collaborative paediatric database on cerebral venous thrombosis: A multicentre cohort study. Lancet Neurol. 2007;6:595-603.

Carvalho KS, Bodensteiner JB, Connolly PJ, Garg BP. Cerebral venous thrombosis in children. J Child Neurol. 2001;16:574-80.

Heller C, Heinecke A, Junker R, Knofler R, Kosch A, Kurnik K, et al. Cerebral venous thrombosis in children: a multifactorial origin. Circulation. 2003;108(11):1362-7.

Sheerani M. Oral Contraceptives and Cerebral Venous Thrombosis: case report and a brief review of literature. JPMA. 2006;56(11).

Mallick AA, Sharples PM, Calvert SE, et al. Cerebral venous sinus thrombosis: a case series including thrombolysis. Arch Dis Child. 2009;94:790-4.

Wasay M, Dai AI, Ansari M. Cerebral venous sinus thrombosis in children: a multicenter cohort from the United States. J Child Neurol. 2008;23:26-31.

Crassard I, Bousser MG. Cerebral venous thrombosis. J Neuroophthalmol. 2004;24:156-63.

Renowden S. Cerebral venous sinus thrombosis. Eur Radiol. 2004;14:215-26.

Roach ES, Golomb MR, Adams R. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 2008;39:2644-91.

Monagle P, Chalmers E, Chan A. Antithrombotic therapy in neonates and children: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:887S-968S.

deVeber GA, MacGregor D, Curtis R. Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis. J Child Neurol. 2000;15:316-24.