Cyclosporine-A-Induced Intracranial Thrombotic Complications: Systematic Review and Cases Report

Song, Shu; Wang, Zhongao; Ding, Yuchuan; Ji, Xunming; Wang, Mengqi

doi:10.3389/fneur.2020.563037

Cited by 6 publications

(5 citation statements)

References 111 publications

(10 reference statements)

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“…All CVT patients who fulfilled the screening criteria were included in the final analysis, whether or not with clear etiologies. Referring to literatures about the CVT etiologies, 2 , 12 , 13 , 14 well‐established risk factors of CVT in this study mainly covered with overweight (body mass index, BMI > 25.0 kg/m 2 ), obstetric causes (pregnancy or postpartum), oral contraceptive use, hemopathy (i.e., anemia, thrombocythemia or polycythemia vera), protein C/S deficiency, nephrotic syndrome, connective tissue disease (i.e., antiphospholipid syndrome, APS and systemic lupus erythematosus, SLE), hyperhomocysteinemia (>20.0 mmol/L), and infection (i.e., mastoiditis, periodontal abscess, etc.) as well as other causes (such as diarrhea, therapy with cyclosporine A, malignancy, ovarian hyperstimulation syndrome, hormonal therapy, etc.).…”

Section: Methodsmentioning

confidence: 99%

Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis

Zhou

et al. 2021

CNS Neurosci Ther

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Section: Methodsmentioning

confidence: 99%

Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis

Zhou

et al. 2021

CNS Neurosci Ther

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“…3,4 Alternative reports have linked renal transplant and subsequent immunosuppression to hypercoagulability, although this is more notably associated with therapies that are not relevant to this example. 4,5 Finally, premorbid atherosclerotic disease may have contributed to this patient's atypical presentation. Multiple complex comorbid conditions contributing to cerebral vascular risk further highlight the importance of aggressive, multidisciplinary management in this case.…”

Section: Discussionmentioning

confidence: 95%

Petrous Carotid Artery Thrombosis in an Immunocompromised Patient Presenting With Mastoiditis, A Case Report

Doyle

McKeon

Samy

2022

Ann Otol Rhinol Laryngol

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Objectives: The neurotologic literature commonly describes venous sinus thrombosis as a complication of mastoiditis. However, thrombosis of the internal carotid artery in the setting of mastoiditis is rarely described. We aim to document a case of carotid artery thrombosis in a patient presenting with mastoiditis. Methods: We describe this case and review relevant literature. Results: A renal transplant patient was transferred to our hospital with a left middle cerebral artery (MCA) infarct due to acute mastoiditis. Examination demonstrated middle ear effusion and radiologic workup confirmed mastoid infection adjacent to the site of arterial thrombosis. During cortical mastoidectomy and facial recess approach to the middle ear, the petrous carotid bone was found to be dehiscent with pneumatization of the petrous apex. Thrombosis was found to resolve following surgery, IV antibiotics and anticoagulation. Clinically, his focal neurological deficits improved. Proximity of the infectious process to an exposed petrous carotid artery supports the hypothesis that this patient’s thrombus was a product of infectious spread and extra-luminal compression. Conclusion: To our knowledge, this is the first report of MCA infarction due to petrous ICA arterial thrombus in the setting of mastoid infection. The patient’s immunocompromised state may have predisposed and contributed to the adverse outcome. We advocate for aggressive management of acute mastoiditis in the immunocompromised to prevent or manage complications (such as venous thrombophlebitis as well as ICA thrombus) as these patients don’t show typical signs of infection and inflammation.

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“…Treatment with cyclosporin and corticoids increased the risk of venous thromboembolism, although not specifically for CVST [9][10][11]. The mechanism of cyclosporin thrombogenicity is still controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Cyclosporin also induces endothelial cell dysfunction by suppressing nitric oxide production and initiating the coagulation pathway. Increased D-dimer and fibrinogen level was also associated with cyclosporin [11]. The time range in which cyclosporin could induce CVST is between 9 days to 11 months, and a specific time for this induction remains unclear [10].…”

Section: Discussionmentioning

confidence: 99%

Case Report of Cerebral Venous Sinus Thrombosis Complication after Microvascular Decompression Surgery in the Inactive Phase of Ulcerative Colitis

Watanabe¹,

Fachniadine²,

Maruyama³

et al. 2023

AJSCR

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Background: The risk of thrombosis is high in patients with Ulcerative Colitis. The main location of thrombosis is in the extremity and pulmonary vein. Cerebral venous thrombosis is a rare location for thrombosis with high mortality. One of the risk factors for developing thrombosis is in association with surgery, especially during an active phase of Ulcerative Colitis (UC), and very few studies report cases occurring during the inactive phase. Hence, it is important for the surgeon to understand the risk of thrombosis, especially of cerebral sinus thrombosis in the Ulcerative Colitis patient. Case: We are presenting a fatal complication in a male patient of 62, who had sagittal sinus thrombosis and multiple intra-cranial hemorrhages in both frontal lobes 3 weeks after microvascular decompression surgery for hemifacial spasm. Conclusion: The risk of cerebral venous sinus thrombosis is higher in Ulcerative Colitis patients, especially in those who undergo surgery regardless of its type. Careful peri-operative assessment and treatment related to thromboembolism prevention are important to reduce complications in such cases.

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Cyclosporine-A-Induced Intracranial Thrombotic Complications: Systematic Review and Cases Report

Cited by 6 publications

References 111 publications

Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis

Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis

Petrous Carotid Artery Thrombosis in an Immunocompromised Patient Presenting With Mastoiditis, A Case Report

Case Report of Cerebral Venous Sinus Thrombosis Complication after Microvascular Decompression Surgery in the Inactive Phase of Ulcerative Colitis

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