A case series of septic infants with cerebral venous sinus thrombosis: novelty neonatal thromboembolism risk stratification model in the Grodno region

Abstract

Neonatal thromboembolism, especially cerebral venous sinus thrombosis (CVST), is a significantly recognized complication in critically ill infants. Early detection protocols remained challenging due to variable clinical presentation and lack of standard predictive models. This study aims to develop a novelty risk stratification model composed of detailed analysis from four cases. A retrospective case series evaluation was conducted on four individual cases of neonates with severe sepsis complicated by transverse sinus thrombosis confirmed radiologically. Clinical characteristics, complete blood count (CBC), coagulation parameters, biochemical markers, and inflammatory biomarkers were longitudinally assessed. A novelty neonatal thromboembolism risk score (NTRS) was derived based on persistent laboratory findings. All four patients exhibited a specific prothrombotic profile characterized by leukemoid reaction (>50×10⁹/l), thrombocytopenia (<150×10⁹/l), significantly increased D-dimer (>10,000 ng/ml), hypofibrinogenemia (<1.5 g/l), increased inflammatory markers (procalcitonin >5 ng/ml, CRP >20 mg/l), and evidence showing multiorgan dysfunction. The developed novelty NTRS (range 0–16) successfully graded all four cases into one low, two high and one critical risk categories before the confirmation of thrombosis was found. This novelty NTRS model characterizes a practical, laboratory-driven approach for early identification of neonates at risk for thromboembolism. Prospective larger cohorts are necessary to validate these findings.