Abstract WP411: Anatomical Venous Variants and Physiological Adaptive Changes in Children With Cerebral Sinovenous Thrombosis
Bibliographic record
Abstract
Objective: Cerebral venous vessels a have unique morphology. No information is available regarding the presence of anomalous venous structure and related consequences in children. We aim to describe the frequency of anatomical variants (persistent fetal structures), and physiological changes (collateralization), in children with CSVT. We hypothesize that these variations impact in the re-distribution of venous drainage in the presence of stressors such as anemia or dehydration. Methods: We retrospectively reviewed children (1 month - 18 years), with CSVT over 5 years (Jan 2008 - Dec 2013). We excluded children with arterial ischemic stroke, trauma, compressive intracranial lesions and systemic venous hypertension. We reviewed for symptoms at presentation, risk factors, sinus involved, thrombus location, parenchymal lesions, antithrombotic therapy, outcome using the Paediatric Stroke Outcome Measure (PSOM) and recanalization rate at last follow-up. MRV/CTV reports were evaluated for anatomical variants and physiological changes in the venous systems. Results: Thirty-four children were identified. 17 boys (50%), with mean age at CSVT of 13.5 years (0.2 -17.6 years). 11 had anatomical variations (32%) vs. 23 (68%) with typical anatomy. These included 6 (54%) children with abnormal sinus morphology (hypoplasia/absence of a major dural sinus), 3 (27%) children with persistent fetal structures and 6 (54%) with prominent collateralization. Most of the cases had > 1 anatomical variant together. Signs of increased intracranial pressure were seen more frequently in children with anatomical variants 7(63%) than in those without variants 7(30%), although not statistically significant. 5 children (45%) with anatomical variations had brain parenchymal involvement vs. 5 (22%) with normal anatomy. Mean recanalization rate was the same between the two groups: 10(90%) at mean follow-up of 5.5mo (3 - 9mo) in the variant vs. 22(96%) at 4.2mo (1.5 - 9mo) in the normal anatomy group. Conclusion: The presence of anatomical variants in the cerebral venous structures may be associated with a more severe initial presentation in children with CSVT. Variant venous anatomy may be less efficient in compensating for the obstruction to venous outflow due to thrombosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".