Cerebral venous thrombosis associated with antithrombin III deficiency

Lee, M.K.; Ng, Siew‐Cheok

doi:10.1111/j.1445-5994.1991.tb01388.x

Cited by 9 publications

(3 citation statements)

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“…The major genetic trombophilias as prothrombotic conditions include the following: factor V Leiden (FVL) pathologic variant; [ 17 , 19 , 20 ] G20210 A prothrombin gene pathologic variant; [ 17 , 20 , 21 , 22 ]; hyperhomocysteinemia; [ 23 ] antithrombin deficiency; [ 24 ] and protein C or protein S deficiencies [ 16 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

Jianu

Dan

et al. 2022

Life

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(1) Objective: This review paper aims to discuss multiple aspects of cerebral venous thrombosis (CVT), including epidemiology, etiology, pathophysiology, and clinical presentation. Different neuroimaging methods for diagnosis of CVT, such as computer tomography CT/CT Venography (CTV), and Magnetic Resonance Imaging (MRI)/MR Venography (MRV) will be presented. (2) Methods: A literature analysis using PubMed and the MEDLINE sub-engine was done using the terms: cerebral venous thrombosis, thrombophilia, and imaging. Different studies concerning risk factors, clinical picture, and imaging signs of patients with CVT were examined. (3) Results: At least one risk factor can be identified in 85% of CVT cases. Searching for a thrombophilic state should be realized for patients with CVT who present a high pretest probability of severe thrombophilia. Two pathophysiological mechanisms contribute to their highly variable clinical presentation: augmentation of venular and capillary pressure, and diminution of cerebrospinal fluid absorption. The clinical spectrum of CVT is frequently non-specific and presents a high level of clinical suspicion. Four major syndromes have been described: isolated intracranial hypertension, seizures, focal neurological abnormalities, and encephalopathy. Cavernous sinus thrombosis is the single CVT that presents a characteristic clinical syndrome. Non-enhanced CT (NECT) of the Head is the most frequently performed imaging study in the emergency department. Features of CVT on NECT can be divided into direct signs (demonstration of dense venous clot within a cerebral vein or a cerebral venous sinus), and more frequently indirect signs (such as cerebral edema, or cerebral venous infarct). CVT diagnosis is confirmed with CTV, directly detecting the venous clot as a filling defect, or MRI/MRV, which also realizes a better description of parenchymal abnormalities. (4) Conclusions: CVT is a relatively rare disorder in the general population and is frequently misdiagnosed upon initial examination. The knowledge of wide clinical aspects and imaging signs will be essential in providing a timely diagnosis.

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Section: Resultsmentioning

confidence: 99%

An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

Jianu

Dan

et al. 2022

Life

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“…Najčešći rizični faktori kod osoba starijih od 65 godina su: genetski uvjetovana ili stečena trombofilija, ostali hematološki poremećaji kao, primjerice, policitemija te maligne bolesti. Kod žena u generativnoj dobi najveći rizik predstavlja upotreba oralnih kontraceptiva, a rizik se dodatno povećava ako je prisutna pretilost i/ili jedan od protrombotskih poremećaja [17][18] . Genetski uvjetovana protrombotska stanja su: manjak antitrombina III 19 , manjak proteina C 20 ili proteina S, mutacija gena za faktor V Leiden 21 i G20210 A protrombin 22 .…”

Section: Etiologijaunclassified

Tromboza venskih sinusa

Babić

Vuletić

2019

Med. Flum. (Online)

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Tromboza venskih sinusa je rijedak uzrok moždanog udara. Najčešće se javlja u dobi od 20 do 50 godina. Češće se javlja kod žena nego kod muškaraca. Klinička slika je varijabilna, odnosno, pacijenti se mogu žaliti na glavobolju, slabost jedne polovice tijela ili se mogu prezentirati epileptičkim napadajem ili komatoznim stanjem svijesti. Kod pacijenata kod kojih posumnjamo na trombozu venskih sinusa trebamo učiniti magnetsku rezonanciju (MR) ili kompjutoriziranu tomografiju (CT) mozga odnosno MR venografiju (MRV) ili CT venografiju (CTV). Prognoza pacijenata ovisi o pravovremeno postavljenoj dijagnozi i liječenju uzroka bolesti. Posljednjih nekoliko desetljeća smanjena je smrtnost pacijenata od tromboze venskih sinusa.

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“…M 2 Thrombotic and thromboembolic events may occur anywhere in the body in these patients, and the prevalence of thromboses in these individuals is as high as 26%. I3 About half of these events are spontaneous; the remainder are related to precipitants such as trauma, major surgery, infections, pregnancy, the postpartum period 14 and the use of oral contraceptives.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Vein Thrombosis due to Hereditary Antithrombin III Deficiency

Tuite

Ahmad

Grant

et al. 1993

Can. j. neurol. sci.

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Cerebral vein thrombosis, also called superior sagittal sinus thrombosis, is a well recognized clinical and radiologic entity associated with a variety of medical disorders. We report a patient with fatal cerebral vein thrombosis following myelography, in whom the cause was familial antithrombin III (AT3) deficiency. Unsuspected AT3 deficiency should be considered in cases of unexplained cerebral venous thromboses. RESUME: Thrombose veineuse cerebrale due a une deficience hereditaire en antithrombine III. La thrombose veineuse cerebrale, egalement appelee thrombose du sinus sagittal superieur, est une entite associee a des affections medicales variees et bien reconnue au point de vue clinique et radiologique. Nous rapportons le cas d'un patient qui a presente, suite a une myelographie, une thrombose veineuse cerebrale causee par un deficit familial en antithrombine III (AT3). Un deficit insoupconne en AT3 devrait etre envisage dans les cas de thrombose cerebrale veineuse inexpliquee.Can. J. Neurol. Sci. 1993; 20:158-161 Cerebral vein thrombosis consists of thrombosis of the superior sagittal sinus, other cortical veins, and sometimes deep cerebral veins. The use of the previous term "superior sagittal sinus thrombosis" is to be discouraged, because the involved veins usually extend beyond the superior sagittal sinus. Neurologic symptoms and signs usually include those of raised intracranial pressure, seizures, and focal neurological deficits. Cerebral vein thrombosis was initially described in association with skull trauma and pyogenic infections of the scalp, sinuses and meninges, but since then an extensive list of other causes or associated medical disorders has accumulated (see Table l). 1 5 A variety of coagulation abnormalities occur in some of these disorders. However we are aware of only one case report linking antithrombin III (AT3) deficiency with cerebral vein thrombosis. Ambruso et al. described a 15-year-old boy with prior history of a calf deep venous thrombosis which was initially treated with heparin, then warfarin. 6 Three months after warfarin was discontinued the patient developed cerebral sinus thrombosis and testing revealed AT3 deficiency. AT3 is a heparin cofactor that blocks the coagulation cascade by inhibiting activated coagulation factors (Figure 1). AT3 deficiency can be familial or acquired and these patients are at risk for thrombotic events. 7 CASE REPORTA 24-year-old man was admitted to hospital because of seizures and headache. He had previously been well except for chronic low back pain for which he had been electively admitted to another hospital for investigation three days earlier. A myelogram had been performed (Isovue non-ionic contrast medium, Squibb, Princeton, NJ) and was normal. The following day he complained of headache, neck pain, photophobia, nausea and vomiting. The headache worsened and he then had a right arm focal motor seizure. This recurred five times over the next 24 hours. He was treated with intravenous phenytoin and transferred to our hospita...

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Cerebral venous thrombosis associated with antithrombin III deficiency

Cited by 9 publications

References 6 publications

An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

Tromboza venskih sinusa

Cerebral Vein Thrombosis due to Hereditary Antithrombin III Deficiency

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