Cerebral venous thrombosis: a retrospective multicentre study of 48 patients

Terazzi, Emanuela; Mittino, Daniela; Rud�, R.; Cerrato, Paolo; Monaco, Francesco; Sciolla, R.; Grasso, E; Leone, Maurizio

doi:10.1007/s10072-004-0363-8

Cited by 56 publications

(39 citation statements)

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“…ISCVT çalışmasında, OKS kullanımı %54,3, hematolojik nedenler %46,1, gebelik ve postpartum dönemde görülme oranı %19 olarak bildirilmiştir (1). Terazzi ve arkadaşları, en sık etyolojik neden olarak %47 ile OKS kullanımını bildirilmiştir (13). Ülkemizde yapılan bir çalışmada, OKS kullanımı %6,9'luk oranla literatüre göre daha düşük olarak bildirilmiştir (14).…”

Section: Discussionunclassified

Cerebral venous sinus thrombosis: Analysis of 27 cases

Duran¹,

Özyurtlu²,

Taşkapılıoğlu³

et al. 2014

Türk Beyin Damar Hast Derg

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ÖZETAMAÇ: Venöz sinus trombozu dural sinus ve serebral venlerin parsiyel yada komplet olarak oklude olduğu serebrovasküler hastalıkların nadir görülen bir alt türüdür. Tipik klinik bulguları başağrısı, görme bozukluğu, papil ödem ve epileptik nöbettir. Gebelik ve özellikle puerperal dönem, oral kontraseptif ve steroid tedavisi ve trombofililer özel risk gruplarını oluşturur. Kranyal BT incelemesi %25 olguda normal bulunduğundan tanıyı kesinleştirmek için kranyal MR ve MR venografiden faydalanmak gerekir. GEREÇ ve YÖNTEM: Çalışmamıza Ocak 2009 -Temmuz 2012 tarihleri arasında hastanemiz nöroloji kliniğinde takip edilmiş, tanısı görüntüleme yöntemleri ile kesinleştirilmiş 27 olgu alınmıştır. Olguların demografik özellikleri, etyolojik faktörleri, klinik ve görüntüleme bulguları, tedavi ve prognozları retrospektif olarak incelenmiştir. Olguların tümünde kranyal BT ve/veya kranyal MR, MR venografi yapıldı. BULGULAR: Hastaların 21'i kadın (%77,8), 6'sı erkek (%22,2) ve yaş ortalaması 34 (19-76) idi. Etyolojik incelemede 5 hastanın (%18.5) gebe veya postpartum dönemde olduğu, 5 hastada (%18.5) vaskülit,4 hastada(%14.9) OKS kullanımı, 3 hastada (%11.1) enfeksiyon, 2 hastada (%7.4) hematolojik nedenler, 2 hastada (%7.4) OKS dışı ilaç kullanımı saptanırken 6 hastada (%22.2) bir neden bulunamamıştır. Kranyal BT ve MR incelemelerinde 7 hastada (%25,9) iskemik enfarkt, 8 hastada (%29,6) kanamalı enfarkt, 3 hastada (%11,1) hematom, 3 hastada (%11,1) ek olarak enfektif bulguya rastlanırken 6 hastada (%22,2) parankim etkilenmesi görülmedi. SONUÇ: Serebral venöz sinüs trombozu tüm yaş guruplarında görülebilen, değişik belirti ve bulgular ortaya çıkaran bir durumdur. Yeni başlayan şiddetli baş ağrısı, fokal nörolojik bulgu ve/ya epileptik nöbet varlığında hızlı şekilde tanıya ulaştıracak tetkikler yapılmalı, tedaviye mümkün olan en erken sürede başlanmalıdır. Anahtar Sözcükler: Venöz sinus trombozu, sinus sagitalis superior, papil ödem, postpartum dönem, antikoagülan tedavi. CEREBRAL VENOUS SINUS THROMBOSIS: ANALYSIS OF 27 CASES ABSTRACTOBJECTIVE: Cerebral venous thrombosis (CVT) is a rare subtype of cerebrovasculer disease which is caused by the partial or complete occlusion of the dural sinuses and cerebral veins. Typical clinical signs include headache, visual problems, papil eodema and seizures.Pregnant women, especially during the puerperium, oral contraceptive pills and steroid treatment, individuals with thrombophilia are a special risk group. must make use of cranial MR imaging and MR venography to confirm the diagnosis; because cranial CT scan is normal of %25 of all cases. MATERIAL and METHODS: The study January 2009 -neurology clinic of our hospital between July 2012 has been finalized 27 cases were diagnosed by imaging methods.Demographic characteristics, etiological factors, clinical and imaging findings, treatment and prognosis were analyzed retrospectively.In all cases, cranial CT and / or cranial MRI, MR venography was performed. RESULTS: 21 female patients (77.8%) and 6 males (22.2%) and the mean age of 34 (19-76...

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Section: Discussionunclassified

Cerebral venous sinus thrombosis: Analysis of 27 cases

Duran¹,

Özyurtlu²,

Taşkapılıoğlu³

et al. 2014

Türk Beyin Damar Hast Derg

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“…Oral contraceptives were considered a common predisposing factor for CVST in many studies. 4,5 Hence, the low rates of identifying a pathological process in the Nationwide Inpatients Sample is likely due to the lack of clinical information including medications administered before hospitalization. The hypothesis that hematologic disorders are more common among the nonpyogenic group and central nervous system infection is more common among the pyogenic group was confirmed in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Mortality of Cerebral Venous–Sinus Thrombosis in a Large National Sample

Borhani‐Haghighi

Edgell

Cruz‐Flores

et al. 2012

Stroke

109

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Background and Purpose— The purpose of this study was to evaluate the mortality rates associated with cerebral venous–sinus thrombosis in a large national sample. Methods— A cohort of patients with cerebral venous–sinus thrombosis was identified from the National Inpatient Sample database for the years 2000 to 2007. According to the International Classification of Diseases, 9th Revision, Clinical Modification codes, cerebral venous–sinus thrombosis is categorized into pyogenic and nonpyogenic groups. Multivariate logistic regression analysis was used to assess covariates associated with hospital mortality. Results— Among 3488 patients, the overall mortality rate was 4.39%, which was nonsignificantly higher among the pyogenic group (4.55% versus 3.52%; OR, 0.76; 95% CI, 0.47–1.23). In the pyogenic cerebral venous–sinus thrombosis group, hematologic disorders were the most frequent predisposing condition (16.2%); whereas systemic malignancy followed by hematologic disorders were most common in the nonpyogenic group (14.08% and 10.04%, respectively). Predictors of mortality included age, intracerebral hemorrhage as well as the predisposing conditions of hematologic disorders, systemic malignancy, and central nervous system infection. Conclusions— Compared with arterial stroke, CVST harbors a relatively low mortality rate. Death is determined by age, the presence of intracerebral hemorrhage, and certain predisposing conditions.

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“…CVT 所致的严重视力丧失罕有发生 (2%-4%) [55,193,235 [238][239][240] 。CVT 危险最大的阶段是妊娠晚期和产后最初 4 周 [240] 。在妇女中高达 73% 的 CVT 发生在产褥期 [241] 。剖腹产似乎与经年龄、血管危险因素、感染的存在、医院类型及地点调整后的 CVT 危险增高有关 (OR 3.10, 95% CI 2.26-4.24) [35] 。维生素 K 拮抗剂，包括华法林，与致死性胚胎病和胎儿及新生儿出血有关，因此通常被认为禁用于妊娠期。因此，大多数妇女妊娠期和早期产褥期 CVT 的抗凝治疗为 LMWH [220] 。与 UFH 不同，LMWH 与致畸或胎儿出血危险的增加无关。美国胸科医师学院抗栓指南强调妊娠期和产褥期 DVT 和肺栓塞的预防和治疗，建议 LWMH 优于 UFH [241a] 。他们建议治疗应从妊娠期持续至产后至少 6 周 ( 总的最小疗程为期 6 个月 )。尽管这些建议针对的是系统性静脉血栓，出于若干原因将这些建议应用于 CVT 是符合逻辑的。首先，在致畸和胎儿 / 新生儿 / 母亲出血性并发症方面的安全性应该是相似的；其次，这些建议与非妊娠相关性 CVT 的治疗是一致的。就像对非妊娠妇女一样，溶栓疗法应留给在系统性抗凝治疗下仍有病情恶化的病人，其在妊娠期的应用已有报道 [243] 。未来妊娠和复发与健康个体相比，有既往 VTE 的病人再次发生静脉血栓事件的危险增加 [244,245] 临床结局：预后关于 C V T 的结局和预后有几项研究和综述 [181,256,257] 。这类研究大多数是回顾性的 ( 总的或部分 ) [14,63,66,90,136,175,179,190,194,233,[270][271][272][273][274] 。为数不多的前瞻性研究中，一些研究并没有分析预后因素 [178,193,261] 或仅对这些预测因子做了双变量分析 [275,276] 或仅对特殊病人亚组做了分析 [42,84,89,192] 不能自理 (mRS 评分 ≥ 3 或 Glasgow 预后量表评分 ≥ 3) 的比例是 9.7% [28] 。7 项队列研究 ( 包括资料...…”

Section: 视力丧失unclassified

Diagnosis and Management of Cerebral Venous Thrombosis

Saposnik¹,

Barinagarrementería²,

Brown³

et al. 2011

Stroke

1,637

1,229

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Background— The purpose of this statement is to provide an overview of cerebral venous sinus thrombosis and to provide recommendations for its diagnosis, management, and treatment. The intended audience is physicians and other healthcare providers who are responsible for the diagnosis and management of patients with cerebral venous sinus thrombosis. Methods and Results— Members of the panel were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and represent different areas of expertise. The panel reviewed the relevant literature with an emphasis on reports published since 1966 and used the American Heart Association levels-of-evidence grading algorithm to rate the evidence and to make recommendations. After approval of the statement by the panel, it underwent peer review and approval by the American Heart Association Science Advisory and Coordinating Committee. Conclusions— Evidence-based recommendations are provided for the diagnosis, management, and prevention of recurrence of cerebral venous thrombosis. Recommendations on the evaluation and management of cerebral venous thrombosis during pregnancy and in the pediatric population are provided. Considerations for the management of clinical complications (seizures, hydrocephalus, intracranial hypertension, and neurological deterioration) are also summarized. An algorithm for diagnosis and management of patients with cerebral venous sinus thrombosis is described.

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Cerebral venous thrombosis: a retrospective multicentre study of 48 patients

Cited by 56 publications

References 0 publications

Cerebral venous sinus thrombosis: Analysis of 27 cases

Cerebral venous sinus thrombosis: Analysis of 27 cases

Mortality of Cerebral Venous–Sinus Thrombosis in a Large National Sample

Diagnosis and Management of Cerebral Venous Thrombosis

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