Cerebral Venous Thrombosis in Neonates and Children (Age < 18 Years)
Cerebral venous thrombosis (CVT) in patients younger than 18 years — from neonates through older children — presents distinct management considerations. This protocol addresses the pediatric age group specifically.
Clinical Population
This protocol applies to neonates and children under 18 years diagnosed with CVT. In this age group, parenteral anticoagulation is the foundation of acute management, typically followed by an extended course of oral or subcutaneous therapy.
Escalation Considerations
In cases of clinical deterioration — particularly worsening level of consciousness — more invasive procedural approaches, including endovascular techniques, may be considered as a potentially lifesaving measure. The complete protocol defines the specific criteria and structured sequence for when and how escalation applies.
References
DOI: 10.1161/STR.0000000000000456
The management of acute CVT in children typically involves LMWH or unfractionated heparin.
Parenteral anticoagulation is also the first-line treatment, followed by LMWH, VKA, or rivaroxaban for at least 6 weeks.
As for adults, if there is deterioration in level of consciousness, more invasive procedures should be considered and may potentially be lifesaving (Figure 4).