Intracerebral hemorrhage in the context of cerebral amyloid angiopathy and varied time of onset of cerebral venous thrombosis: a case report

Mendel, Tadeusz; Błażejewska-Hyżorek, Beata; Szpak, Grażyna M.; Stępień, Tomasz; Lewandowska, Eliza; Tarka, Sylwia; Kurkowska‐Jastrzębska, Iwona; Wierzba-Bobrowicz, Teresa

doi:10.5114/fn.2017.70490

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…Based on the follow-up data analyzed by the Kaplan-Meier analysis, the risk of rebleeding or death at different time points was divided into high, moderate, and low risk, and the strength of this association varied between high, intermediate, and low risk. Risk factors for hemorrhagic disease in non-aneurysmal and non-inflammatory vascular disease (na-ni-ivl-SAH), including carotid artery dissection (CAD), dural arteriovenous fistulas (DAVF), cerebral amyloid angiopathy (CAA), and cerebral venous thrombosis (CVT) (Lin et al, 2006;Mendel et al, 2017). The radiological features of na-ni-ivl-SAH predominantly show cortical sulci and convex hemorrhage on CT, and the aneurysm is negative in contrast.…”

Section: Discussionmentioning

confidence: 99%

Novel Subgroups in Subarachnoid Hemorrhage and Their Association With Outcomes—A Systematic Review and Meta-Regression

Wang

Song

et al. 2021

Front. Aging Neurosci.

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Background and Purpose: Subarachnoid hemorrhage (SAH) has long been classified into two main forms, aneurysmal SAH (aSAH) and non-aneurysmal SAH (naSAH), but the related risk factors for aSAH and naSAH are heterogeneous. Our objective was to determine the risk factors for SAH of known or unknown origin with respect to diagnostic evaluation in a large patient cohort. We sought to determine whether our classification system can further predict middle long-term stroke and death.Methods: We performed a systematic review and meta-analysis to identify risk factors for each SAH subtype. The discovery phase analyzed 11 risk factors from case studies in the literature. Kruskal-Wallis, Cox regression, logistic regression, and Kaplan-Meier analyses were used to compare the two groups.Results: A total of 14,904 (34.53%) male and 22,801 (52.84%) female patients were eligible for this study. At a median follow-up of 45.6 months, the 5-years overall survival was 97.768% (95% CI: 0.259–0.292) for aSAH patients and 87.904% (95% CI: 1.459–1.643) for naSAH patients. The 10-years survival rate was 93.870% (95% CI: 2.075–3.086) and 78.115% (95% CI: 2.810–3.156), respectively. Multi-risk factor subgroups showed significant intergroup differences. We identified eight risk factors (drugs, trauma, neoplastic, vessels lesion, inflammatory lesion, blood disease, aneurysm, peri-mesencephalic hemorrhage) using logistic regression, which were optimally differentiated among the aSAH [aSAH-S (AUC: 1), a-d-SAH (AUC: 0.9998), aSAH-T (AUC: 0.9199), aSAH-N (AUC: 0.9433), aSAH-V (AUC: 1), aSAH-I (AUC: 0.9954), a-bd-SAH (AUC: 0.9955)] and naSAH [na-pmSAH (AUC: 0.9979), na-ni-ivl-SAH (AUC: 1), na-t-SAH (AUC: 0.9997), na-ne-SAH (AUC: 0.9475), na-d-SAH (AUC: 0.7676)] subgroups. These models were applied in a parallel cohort, showing eight risk factors plus survival rates to predict the prognosis of SAH.Conclusions: The classification of risk factors related to aSAH and naSAH is helpful in the diagnosis and prediction of the prognosis of aSAH and naSAH patients. Further validation is needed in future clinical applications.

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Section: Discussionmentioning

confidence: 99%

Novel Subgroups in Subarachnoid Hemorrhage and Their Association With Outcomes—A Systematic Review and Meta-Regression

Wang

Song

et al. 2021

Front. Aging Neurosci.

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“…[1] In patients with CVST, the incidence of subarachnoid hemorrhage (SAH) was 1%. [2] Herein, we present the case of a patient with infectious thrombosis of the superior sagittal sinus that manifested as SAH.…”

Section: Introductionmentioning

confidence: 99%

Infectious thrombosis of the superior sagittal sinus with subarachnoid hemorrhage: A case report

Zhang

et al. 2023

Medicine

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Rationale: Cerebral venous sinus thrombosis (CVST) represents 0.5% to 1% of all strokes. CVST can cause headaches, epilepsy, and subarachnoid hemorrhage (SAH). CVST is easily misdiagnosed because of the variety and non-specificity of symptoms. Herein, we report a case of infectious thrombosis of the superior sagittal sinus with SAH. Patient concerns: A 34-year-old man presented to our hospital with a 4-hour history of sudden and persistent headache and dizziness with tonic convulsions of the limbs. Computed tomography revealed SAH with edema. Enhanced magnetic resonance imaging showed an irregular filling defect in the superior sagittal sinus. Diagnoses: The final diagnosis was hemorrhagic superior sagittal sinus thrombosis and secondary epilepsy. Interventions: He was treated with antibiotic, antiepileptic, fluids to rehydrate, and intravenous dehydration. Outcomes: After treatment, the seizures did not recur and the symptoms were relieved. One month after the antibiotic treatment, the muscle strength of the patient’s right extremity was restored to level 5, and there was no recurrence of his neurological symptoms. Lessons: We describe a case of infectious thrombosis of the superior sagittal sinus manifested as SAH, which is easily misdiagnosed, especially when patients present with an infection. Clinicians must therefore take care during the diagnosis and selection of the treatment strategy.

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“…Venous outflow disorders are often associated with and contribute to the development of edema as well as possible increased risk of bleeding [12]. The venous stroke associated with cerebral venous sinus thrombosis is prone to secondary hemorrhages in 36-40% of cases, which is significantly more likely than arterial [13,14] and due to the severity of vasogenic edema [7,15]. It is important that the main approach to the treatment of VIS which is more prone to secondary hemorrhage [16] is anticoagulant therapy, the safety of which in this group of the patients has not been completely determined [17,18].…”

Section: Introductionmentioning

confidence: 99%

Clinical and instrumental indicators of intracranial venous stasis and secondary ischemia in cerebral sinus thrombosis. A review

SE¹,

EA²,

IV³

et al. 2021

Med Case Rep Rev

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The purpose of the narrative review is to search for confirmation or controversy of the hypothesis according to which venous ischemia developing in cerebral venous sinustrombosis is secondary as a result of mechanical narrowing of arterioles in the area of vasogenic edema. This review discusses the issues of multimodal radiological diagnosis of a rare disease of a non-hemorrhagic ischemic venous stroke based on expert opinion, current recommendations and our experience. As a result of the review no contradictions to this hypothesis have been found, and the most characteristic symptoms of CVT, secondary ischemia, intracranial venous congestion can be identified in the order of their probable clinical manifestation from patient complaints to the results of instrumental studies: headache, subacute development and course of the disease, papilledema optic disc, increase of central venous pressure, hypodensity of the ischemic foci and hyperdensity signs of sinus on CT, earlier development of vasogenic edema on diffusion MRI, symptoms of stop-contrast and filling defect thrombosed sinuses on contrast enhancement CTA or MRA, dilatation of venous regional collaterals, moderate hyperperfusion on CT-or MR-perfusion, elevated maximum blood flow velocity Rosenthal veins; Galen's vein and rectus sinus, decreased cerebrovascular reactivity index, increased peripheral resistance index on Transcranial Doppler, clot visualization on brachiocephalic veins ultrasound duplex scanning, decreasing of brachiocephalic vessels ultrasound index of arteriovenous ratio.

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Intracerebral hemorrhage in the context of cerebral amyloid angiopathy and varied time of onset of cerebral venous thrombosis: a case report

Abstract: A b s t r a c t In patients with cerebral venous thrombosis (CVT) the incidence of intracerebral hemorrhage (ICH) is estimated at

Cited by 5 publications

References 21 publications

Novel Subgroups in Subarachnoid Hemorrhage and Their Association With Outcomes—A Systematic Review and Meta-Regression

Novel Subgroups in Subarachnoid Hemorrhage and Their Association With Outcomes—A Systematic Review and Meta-Regression

Infectious thrombosis of the superior sagittal sinus with subarachnoid hemorrhage: A case report

Clinical and instrumental indicators of intracranial venous stasis and secondary ischemia in cerebral sinus thrombosis. A review

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