Cerebral Venous Thrombosis Treatment in Children

Once it is confirmed that the child’s symptoms stem from a blood clot, medications such as intravenous heparin and/or aspirin are used to prevent the clot from growing and give the body the chance to break the clot down. It may be necessary to keep taking these medications (or related medications, such as Coumadin [warfarin]) for several months.

If a child is critically ill and medications are not enough to clear the blood clot, physicians in Boston Children’s Cerebrovascular Surgery and Interventions Program sometimes perform endovascular thrombolysis. This emergency treatment, performed under general anesthesia during a cerebral angiogram, guides a very small catheter into the cerebral venous sinus (a main channel in the skull that collects venous blood) to introduce balloons, suction devices or other tools to break up the clot or even extract it from the vessel. In some cases, clot-dissolving drugs such as tissue plasminogen activator (tPA) are delivered through the catheter, right at the blockage.

Once any immediate danger has passed, we closely monitor all children to prevent potential complications of the venous thrombosis, such as hydrocephalus (“water on the brain”), excessive venous pressure in the brain and seizures.