Work

Early Enoxaparin Treatment in a Newborn with Cerebral Venous Sinus Thrombosis and Acute Cerebellar Hemorrhage

Year: 2025

Type: article

Abstract: Objective: To evaluate the management of anticoagulant therapy in neonates with cerebral sinus venous thrombosis (CSVT), focusing on potential benefits and risks. Study Design: We report the case of a full-term neonate diagnosed with CSVT, highlighting the rationale for early anticoagulation with unfractionated heparin. A brief literature review supports our clinical decision-making, considering current evidence and expert consensus despite limited neonatal-specific guidelines. Results: Heparin therapy was started shortly after diagnosis, without hemorrhagic complications. Neuroimaging showed complete thrombus resolution. The neonate had a normal neurological examination at discharge. Follow-up confirmed overall good clinical condition and showed mild axial hypotonia and convergent strabismus suggestive of cortical visual impairment. Conclusion: Management of CSVT in neonates remains debated. While heparin may carry a risk of bleeding, delaying treatment can lead to thrombus progression. Our case supports the potential safety and efficacy of early heparin use in selected patients. Tailored, risk-based decisions may improve outcomes, though further studies are needed to establish standardized protocols.

Source: American Journal of Perinatology Reports

DOI: 10.1055/a-2566-3952