Cerebral Venous and Sinus Thrombosis in Women

Coutinho, Jonathan M.; Ferro, José M.; Canhão, Patrı́cia; Barinagarrementería, Fernando; Cantú, Carlos; Bousser, Marie‐Germaine; Stam, Jan

doi:10.1161/strokeaha.108.543884

Cited by 344 publications

(312 citation statements)

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“…Most studies reported female sex preference in patients affected with CSVT, with no gender difference in children and elderly based on gender specific risk factors. [4][5] Kalita et al, Koopman et al and stated that CVST was more frequently associated with oral contraceptive use, pregnancy, or puerperium. 6,7 In present study male gender (73.3%) was predominantly affected with CSVT than females.…”

Section: Discussionmentioning

confidence: 99%

Cerebral sinus venous thrombosis

Manorenj

Barla

2016

Int J Res Med Sci

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INTRODUCTIONRibes et al first discovered CSVT in 1825 on autopsy cases. CSVT affects predominantly younger people with female gender predominance.1 CSVT is considered to be a multifactorial condition associated with inherited and acquired risk factors. Inherited risk factors include hyperhomocystenemia, factor V Leiden mutation, protein C, protein S and antithrombin III deficiency and positive anti-cardiolipin and antiphospholipid antibodies. 1,2Acquired risk factors include central nervous system infections, head trauma, brain tumor, systemic vasculitis, hematological conditions, nephrotic syndrome, pregnancy and puerperium and dehydration. The purpose of present study is to investigate the prevalence, pattern and risk ABSTRACT Background: Intracranial Sino venous occlusive disease is an infrequent condition and accounts only 0.5-1% of all strokes. Objective of the study was to know the prevalence, pattern and risk factors involved in patients of cerebral sinus venous thrombosis (CSVT). Methods: Hospital databases were searched retrospectively and patients diagnosed with CSVT from December 2014 to February 2016 were identified. Data on clinical presentation, risk factor, cerebral sinus involved, hospital stay and outcome were analyzed. Results: Fifteen patients (3.4%) were identified as CSVT out of a total acute stroke case of 430. Mean age of patients was 31 years and 11 (73.3%) were males. The presenting symptoms included headache (n=14), altered sensorium (n=1) and seizures (n=5); signs included hemi paresis (n=4), papilledema (n=8) and bilateral VI nerve palsy (n=3). Majority had aseptic CSVT (n=14), and one patient had septic CSVT associated with tuberculous meningitis (TBM). Radiological findings included brain parenchyma involvement (n=8), subdural hematoma (SDH) (n=1), subarachnoid haemorrhage (SAH) (n=1) and normal brain parenchyma (n=5). Multiple cerebral sinuses were involved in seven patients. Most common site of CSVT was observed in sigmoid sinus. Risk factors included hyperhomocystenemia (n=3), protein S deficiency (n=8), protein C deficiency (n=6) and antithrombin III deficiency (n=3) as primary hypercoagulable state. ANA positive was observed in one patient and four had history of alcohol use. All fifteen patients received low molecular weight heparin (LMWH) for 1 week along with bridging oral anticoagulant. None of the patients required intrasinus thrombolysis and decompression surgery. Average hospital stay was 9 days. All had modified Rankin scale (MRS) ≤ 2 at 6 months follow up. Conclusions: Prevalence of CSVT is higher than that reported from Asian studies. Younger age and male predominance was observed. Protein S deficiency was the major risk factor for CSVT.

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Section: Discussionmentioning

confidence: 99%

Cerebral sinus venous thrombosis

Manorenj

Barla

2016

Int J Res Med Sci

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“…Since female sex factors are one of the major predisposing factors triggering the underlying mechanism of thrombosis, female gender is one of the major risk factors with a frequency rate of 3 to 1, when compared with men 9 . Suggesting our cases that have no other identifiable risk factor for thrombosis other than female gender and puerperium, previous reports demonstrated a 65% of identifiable causes of CSVT in women are related to pregnancy, puerperium, oral contraceptive use, or hormonal therapies which are unique to women 5,9 .…”

Section: Discussionmentioning

confidence: 99%

Cerebral sinus venous thrombosis in puerperium: Review of the literature in the light of two cases

Değirmenci¹,

Kececi²,

Şeker³

2015

Cumhuriyet Med J

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SUMMARYCerebral venous sinus thrombosis (CSVT) is the presence of thrombosis in the dural vein, resulting with a variety of symptoms including seizure, loss of consciousness, focal neurological deficits, stroke and intracranial hypertension. Headache is the most common symptom of intracranial hypertension with or without vision loss, cranial nerve palsies. Since CSVT is more common in women regarding to the predisposing risk factors such as sex hormones, pregnancy, puerperium, which are unique to women, we reported these cases in order to emphasize the importance of considering this life-threatening, neurological emergency in women with headache complaint.

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“…A meta-analysis of 17 clinical studies showed that oral contraceptive use, Leiden mutation of Factor V, and hyperHcy were recognized as statistically significant risk factors 8). A multinational (21 countries), multicenter (89 centers) prospective observational study entitled the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) [9][10][11][12][13] examined 624 cases of CVT and reported that the prevalence of hyper-Hcy is 4.5%. However, Boncoraglio et al reported from Italy that 10 of 26 patients (38.5%) with CVT had hyper-Hcy7).…”

Section: Archivos De Medicina Issn 1698-9465 Journal Of Neurology Andmentioning

confidence: 99%