Cerebral venous thrombosis in Argentina: clinical presentation, predisposing factors, outcomes and  literature review

Alet, Matías; Ciardi, Celina; Alemán, Alberto; Bandeo, Lucrecia; Bonardo, Pablo; Cea, Clarisa; Cirio, Juan; Cossio, Jerónimo; Cuculic, María; Esnaola, María Martha; García-Pérez, Fernando; Giner, Federico; Gómez-Schneider, Maia; Isaac, Cristian; Lepera, Sandra; Martínez, Carlos; Martínez-Lorenzín, Román; Montes, Mariana; Orzuza, Gabriela; Persi, Gabriel; Povedano, Guillermo; Pujol-Lereis, Virginia; Quiroga-Narváez, Julieta; Romano, Marina; Sabio, Rodrigo; Viglione, Juan Pablo; Zurrú, María Cristina; Saposnik, Gustavo; Stroke, Argentinian

doi:10.1016/j.jstrokecerebrovasdis.2020.105145

Cited by 21 publications

(44 citation statements)

References 32 publications

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“…Among the combination of various venous sinuses involved in our study, the most common was found to be combination of Sagittal, Transverse and Sigmoid sinuses which were involved in 13 patients (28.8%) followed by combination of Sagittal and Transverse sinuses in 6 patients (13.3 %). 15,16 Altered sensorium was most commonly seen in cortical vein thrombosis (42.3% i.e; 11 out of 26 patients with cortical vein involvement) followed by superior sagittal sinus thrombosis (36.1% i.e; 13 out of 36 patients with superior sagittal sinus thrombosis). Only 27.5% patients with transverse sinus involvement had altered sensorium at onset.…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiological profile of patients with cerebral venous and sinus thrombosis in a tertiary care hospital

et al. 2021

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Background: Cerebral venous and sinus thrombosis (CVT) is one of the common causes of stroke in young people. It is a relatively uncommon neurologic disorder that is potentially reversible with prompt diagnosis and appropriate medical care. The purpose of this study is to identify the clinical and radiological features aiding diagnosis of cortical vein thrombosisMethods: A cross-sectional study was conducted from November 2015 to May 2017 in tertiary care centre in Manipal after institutional ethical clearance. A total of 46 patients diagnosed with CVT were included in the study. Clinical symptoms and signs at admission and radiological features were documented.Results: A total of 46 subjects were included. Males (53.3%) were more affected than females (46.7%), mostly in the 3rd decade. The most common risk factors were polycythaemia (31.1%) and oral contraceptive pill intake (17.7%). Headache was the most common symptom followed by paralysis and seizures. Multiple sinuses were involved in two-thirds of the patients. Superior sagital sinus thrombosis was the most common sinus involved followed by transverse sinus thrombosisConclusions: The most common clinical feature is headache followed by paresis and seizures. Superior saggital sinus thrombosis is more common than transverse and sigmoid sinus thrombosis in Indian population. Normal CT scan of brain doesn’t rule out cerebral venous sinus thrombosis.

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Section: Discussionmentioning

confidence: 99%

Clinical and radiological profile of patients with cerebral venous and sinus thrombosis in a tertiary care hospital

et al. 2021

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“…[3][4][5][6]8 Á Íslandi voru konur í miklum meirihluta, um 70%, sem er sambaerilegt við aðrar rannsóknir (68-85%). [9][10][11][12] Meðalaldurinn þýðisins var 34,3 ár sem er heldur laegra en í rannsóknum frá Argentínu, Túnis, Noregi og tveimur staerstu rannsóknum sem gerðar hafa verið á stokkasega -ISCVT-og VENOST-rannsóknunum (37,3-43,2 ár). [9][10][11]13,14 Ekki var marktaekur munur á meðalaldri milli kynja (p=0,3).…”

Section: Umraeðaunclassified

“…Hlutfallið samraemist erlendum rannsóknum (71-94%). [9][10][11][12][13][14]22,23 Allar greiningar á stokkasega voru staðfestar með myndgreiningu: tölvusneiðmynd, segulómun eða baeði. Í þessari rannsókn voru heldur fleiri (55%) greindir með baeði tölvusneiðmynd og segulómun, miðað við erlendar rannsóknir (9-14%).…”

Section: Umraeðaunclassified

“…39% sjúklinga sýndu merki um heiladrep við myndgreiningu en 52% sýndu merki um heilablaeðingu. Hlutfall einstaklinga með heiladrep er heldur haerra en í erlendum rannsóknum (11-33%) 9,10,13,14 en hlutfall sjúklinga með heilablaeðingu er töluvert haerra en í öðrum rannsóknum (3,8-10%). 10,14 Við skoðun sjúkraskráa kom í ljós að maeling D-dímers í blóði var lítið sem ekkert notuð til greiningar á stokkasega.…”

Section: Umraeðaunclassified

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The incidence of sinus thrombosis in Iceland 2008-2020

Asgeirsdottir

Ólafsson²,

Sveinsson

2022

LBL

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BACKGROUND: Cerebral venous sinus thrombosis (CSVT) is the cause of 0.5%-1% of all strokes. CSVT can cause haemorrhage, cerebral infarction and increased intracranial pressure. Due to a variety of symptoms, CSVT can be difficult to diagnose. The purpose of this study was to examine the incidence of CSVT in Iceland 2008-2020, risk factors, symptoms, treatment and outcome. METHODS: A retrospective reviewing of medical records of those diagnosed with CSVT from 1. January 2008 to 31. December 2020, was performed. Sex, age at diagnosis, symptoms, known risk factors, imaging results, treatment and outcome were studied. Statistical processing was performed with Excel and Rstudio. RESULTS: Overall, 31 patients were diagnosed with CSVT (22 women). The mean incidence was 0.72/100.00 per year. The mean age was 34.3 years (14-63 years). The most common symptom was headache (87%), other symptoms included focal symptoms and seizures. The most common risk factor was the use of oral contraceptives (73%). Four patients had no risk factor. The most commonly affected sinus was the transverse-sinus (74%). All patients were treated with anticoagulants. Most received heparin or low-molecular-weight heparin then succeeded by warfarin or NOACs. Three months after diagnosis, 87% of the patients scored 0-2 on the modified Rankin Scale. One patient died as a result of CSVT. DISCUSSION: The incidence of CSVT in Iceland is in accordance with other studies. Headache was the most common symptom and oral contraceptives the most common risk factor among women. Most patients made a good recovery, which suggests a timely diagnosis and appropriate treatment for CSVT in Iceland.

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“…CVST is rare, accounting for less than 1% of strokes ( 26 ). Non-VITT CVST is reported in the relatively younger patients, with 70% younger than 50 years old and more common in females ( 27 ). Further studies of VITT pathogenesis may help in a better understanding of CVST occurrence.…”

Section: Pathophysiologymentioning

confidence: 99%

Recognizing Vaccine-Induced Immune Thrombotic Thrombocytopenia

Iba

Levy

Warkentin

2021

Critical Care Medicine

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OBJECTIVES: Vaccine-induced immune thrombotic thrombocytopenia is an unexpected consequence of the coronavirus disease 2019 pandemic era. We reviewed the pathogenesis, clinical presentation, diagnosis, and treatment of this rare side effect. DATA SOURCES: Online search of published medical literature through PubMed, Scopus, Web of Science, and Google Scholar using the terms “COVID-19,” “vaccine,” “thrombosis” was performed. STUDY SELECTION: Articles were chosen for inclusion based on their relevance to coronavirus disease 2019, vaccine, and thrombosis. DATA SYNTHESIS: Vaccine-induced immune thrombotic thrombocytopenia manifests most often as unusual thromboses (cerebral venous sinus thrombosis, splanchnic vein thrombosis) but sometimes also “usual” thromboses (arterial stroke, pulmonary embolism, deep-vein thrombosis), with oftentimes severe thrombocytopenia, that becomes clinically evident 5–30 days after adenovirus-vectored coronavirus disease 2019 vaccine administration. Most patients have disseminated intravascular coagulation. These features are the result of vaccine-triggered formation of anti-platelet factor 4 immunoglobulin G that activate platelets, clinically mimicking autoimmune heparin-induced thrombocytopenia. Early recognition based on thrombosis (sometimes, hemorrhage), thrombocytopenia, and d -dimer elevation within the day 5–30 postvaccine “window” is important given treatment with high-dose IV immunoglobulin plus nonheparin anticoagulation. CONCLUSIONS: Vaccine-induced immune thrombotic thrombocytopenia is a serious complication of vaccination that is not feasible to anticipate or prevent. When the patient presents with sustained headache, neurologic symptoms/signs, abdominal pain, dyspnea, or limb pain/swelling beginning 5–30 days post vaccination, platelet count and d -dimer must be measured, and imaging for thrombosis performed. Confirmation of vaccine-induced immune thrombotic thrombocytopenia diagnosis should be ordered (platelet factor 4/polyanion enzyme-linked immunosorbent assay; platelet factor 4–enhanced platelet activation testing) as treatment is initiated (nonheparin anticoagulation, IV immunoglobulin).

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Cerebral venous thrombosis in Argentina: clinical presentation, predisposing factors, outcomes and literature review

Cited by 21 publications

References 32 publications

Clinical and radiological profile of patients with cerebral venous and sinus thrombosis in a tertiary care hospital

Clinical and radiological profile of patients with cerebral venous and sinus thrombosis in a tertiary care hospital

The incidence of sinus thrombosis in Iceland 2008-2020

Recognizing Vaccine-Induced Immune Thrombotic Thrombocytopenia

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