Child Neurology: Radiologic Evolution and Developmental Correlates in Fetal Cerebral Sinovenous Thrombosis

Fetal cerebral sinovenous thrombosis (CSVT) is a rare cerebrovascular disorder. We report the neuroimaging evolution and clinical trajectory of 2 children with CSVT detected on fetal MRI. Serial imaging demonstrated that cerebrovascular pathology identified in utero evolved including changes in thrombus burden, venous drainage patterns, and parenchymal sequelae highlighting the importance of structured neuroimaging follow-up. Neurodevelopmental outcomes were associated with the extent of parenchymal injury rather than with persistent sinus occlusion alone. Antenatal identification of CSVT allows for anticipatory counselling, multidisciplinary care planning, early developmental surveillance, and intervention.