Cerebral venous thrombosis: an all or nothing disease?

Stolz, Erwin; Rahimi, Anousha; Gerriets, Tibo; Kraus, Jörg; Kaps, Manfred

doi:10.1016/j.clineuro.2004.06.002

Cited by 88 publications

(91 citation statements)

References 20 publications

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“…Among 186 reported pregnancies, 33 resulted in spontaneous abortion, with a calculated overall crude risk of 17.7% (95% CI, [13][14][15][16][17][18][19][20][21][22][23][24]. We found no case-control studies.…”

Section: Fetal Outcomes In Women With Previous Cvtmentioning

confidence: 44%

“…Additional studies were obtained from manually reviewing references of retrieved articles for full-text evaluation. Finally, we included 13 studies: 8 studies with long-term follow-up of patients with CVT [16][17][18][19][20][21][22][23] and 5 studies evaluating complications during subsequent pregnancies in women with previous cerebrovascular disease. [24][25][26][27][28] The remaining studies were excluded because of lack of information on the course of pregnancies occurring in women with previous CVT or for providing insufficient data for calculation of rates of thrombotic events and abortion.…”

Section: Resultsmentioning

confidence: 99%

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Safety of Pregnancy After Cerebral Venous Thrombosis

Sousa

Canhão

Ferro

2016

Stroke

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Background and Purpose-Pregnancy and puerperium are associated with an increased risk of venous thrombotic events (VTEs), including cerebral venous thrombosis (CVT). We aimed to systematically review, in pregnant woman with previous CVT, (1) the risk of recurrence of CVT or other VTE; (2) the result of pregnancy; and (3) the association of antithrombotic prophylaxis with these outcomes. Methods-We searched MEDLINE, Cochrane Database of Systematic Reviews, clinicaltrials.gov (from inception to July 2015), and reference lists of included studies and review articles. We considered observational studies reporting original data on the frequency of CVT or other VTE associated with pregnancy or puerperium in women with history of CVT. Results-Thirteen studies were included. A simple pooled analysis of individual patient data and meta-analysis of proportions using a random effect model were performed. (1)

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Section: Fetal Outcomes In Women With Previous Cvtmentioning

confidence: 44%

Section: Resultsmentioning

confidence: 99%

Safety of Pregnancy After Cerebral Venous Thrombosis

Sousa

Canhão

Ferro

2016

Stroke

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“…CVT has been postulated to be an “all or nothing disease,”5 with prognosis of complete recovery or death. In the largest study to date, for instance, the ISCVT (International Study on Cerebral Vein and Dural Sinus Thrombosis) reported 6‐month mortality of 7%, complete recovery in 78%, and disability in only 15% 6.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, Endovascular Treatment, and Prognosis of Cerebral Venous Thrombosis: US Center Study of 152 Patients

Salottolo

Wagner

Frei

et al. 2017

JAHA

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BackgroundCerebral venous thrombosis is a rare cause of stroke that poses diagnostic, therapeutic, and prognostic challenges. Mainstay treatment is systemic anticoagulation, but endovascular treatment is increasingly advocated. Our objectives were to describe the epidemiology, treatment, and prognosis of 152 patients with cerebral venous thrombosis.Methods and ResultsThis was a retrospective study of consecutive cerebral venous thrombosis cases from 2006 to 2013 at a comprehensive stroke center through hospital discharge. Predictors of full recovery (modified Rankin Scale scores 0–1) were analyzed with multiple logistic regression and presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The population was young (average age: 42 years), majority female (69%), and commonly presenting with cerebral edema (63%), and 72% were transferred in. All patients received systemic anticoagulation; 49% (n=73) required endovascular treatment. Reasons for requiring endovascular treatment included cerebral edema, herniation, or hemorrhagic infarct (n=38); neurologic decline (n=17); rethrombosis, persistent occlusion, or clot propagation (n=10); extensive clot burden (n=7); and persistent headache despite anticoagulation (n=1). There were 7 (10%) procedural complications. Recanalization was successful (61%), partial (30%), and unsuccessful (9%). Overall, 60% fully recovered. Positive predictors of full recovery included hormonal etiology, particularly for patients who were transferred in (AOR: 7.06 [95% CI, 2.27–21.96], interaction P=0.03) and who had migraine history (AOR: 4.87 [95% CI, 1.01–23.50], P=0.05), whereas negative predictors of full recovery were cerebral edema (AOR: 0.11 [95% CI, 0.04–0.34], P<0.001) and motor weakness (AOR: 0.28 [95% CI, 0.09–0.96], P=0.04).ConclusionsAs one of the largest cohort studies, our findings suggest that cerebral edema, history of migraine, and hormonal etiology were prognostic and that endovascular treatment might be a safe and effective treatment for cerebral venous thrombosis when conventional management is inadequate.

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“…In the past, CVST had been associated with a dismal prognosis and high mortality rate, reaching 30-50%. 5,54 Recent studies, 6,32,37,64,65,68 and especially the ISCVT study, performed in the era of modern neuroimaging, LMWH administration, and endovascular intervention, reported much lower mortality rates (8-14%) and significantly better outcome. A meta-analysis of 19 studies conducted by Dentali et al 22 showed that the mortality rate during the perihospitalization period was about 5.6%, while at the end of the follow-up period, this percentage increased to 9.4%.…”

Section: Outcome and Prognosismentioning

confidence: 99%

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

Filippidis¹,

Kapsalaki

Patramani

et al. 2009

FOC

115

160

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Cerebral venous sinus thrombosis (CVST) is a rare clinicopathological entity. The incidence of CVST in children and neonates has been reported to be as high as 7 cases per million people, whereas in adults the incidence is 3–4 cases per million. The predisposing factors to this condition are mainly genetic and acquired prothrombotic states and infection. The clinical picture of CVST is nonspecific, highly variable, and can mimic several other clinical conditions. Diagnosis of CVST is established with the implementation of neuroimaging studies, especially MR imaging and venography. Identification and elimination of the underlying cause, anticoagulation, proper management of intracranial hypertension, and anticonvulsant prophylaxis constitute cornerstones of CVST treatment. Newer treatment strategies such as endovascular thrombolysis and decompressive craniectomy have been recently used in the treatment of patients with CVST with variable success rates. Further clinical research must be performed to delineate the exact role of these newer treatments in the management of severe cases of CVST. The recent advances in the diagnosis and treatment of patients with CVST have significantly lowered the associated mortality and morbidity and have improved the outcome of these patients.

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Cerebral venous thrombosis: an all or nothing disease?

Cited by 88 publications

References 20 publications

Safety of Pregnancy After Cerebral Venous Thrombosis

Safety of Pregnancy After Cerebral Venous Thrombosis

Epidemiology, Endovascular Treatment, and Prognosis of Cerebral Venous Thrombosis: US Center Study of 152 Patients

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

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