Intrasinus thrombolysis in cerebral venous sinus thrombosis: Experience from a university hospital, India

Mathukumalli, Neeharika L; Susarla, Ram Murti; Kandadai, Mridula R; Turaga, Suryaprabha; Shaik, Jabeen A; Alladi, Suvarna; Kanikannan, Meena A; Borgohain, Rupam; Kaul, Subhash

doi:10.4103/0972-2327.186785

Cited by 8 publications

(2 citation statements)

References 15 publications

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“…CVT treatment is mainly supportive. Endovascular thrombolysis or surgical thrombectomy are reserved for patients with persistent or aggravated symptomatology, despite optimal anticoagulant therapy [ 11 ]. There are two phases for the anticoagulant treatment strategy: immediate treatment to prevent subsequent thrombotic events (a risk that may be prolonged for 3 months after the initial event), and secondary prophylaxis [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Cerebral vein thrombosis associated with MTHFR A1289C mutation gene in a young postpartum woman

Bostan¹,

Țăpoi²,

Barcan³

et al. 2019

Arch Clin Cases

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Cerebral venous thrombosis is a rare cerebrovascular disease that accounts for approximately 1% of strokes, with an incidence of 3-4 cases / million inhabitants per year, with a significant mortality rate of 10-13%. Pregnancy and puerperal period are physiological states that predispose to thrombosis through hypercoagulability due to hormonal change. These alterations occur in blood flow, vascular wall and clotting factors and while superimposed on a genetically predisposing field, create the optimal conditions for the occurrence of embolic phenomena. Here we present the case of a young, secondipara woman with recurrent thrombotic events, even under optimal anticoagulation therapy, where the extensive laboratory investigations identified the predisposing terrain: the heterozygous mutation of the MTHFR A1289C gene.

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Section: Discussionmentioning

confidence: 99%

Cerebral vein thrombosis associated with MTHFR A1289C mutation gene in a young postpartum woman

Bostan¹,

Țăpoi²,

Barcan³

et al. 2019

Arch Clin Cases

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“…Based on previous real-world study, the incidence of recovery was observed 94% [ 10 ] in pregnancy-related group and 73.9% [ 11 ] in non-pregnancy-related women. Fifty-one patients in each group could achieve more than 80% power to a significance level of 0.05 2-tailed.…”

Section: Study Methodsmentioning

confidence: 99%

The outcomes of pregnant and postpartum patients with cerebral venous sinus thrombosis after anticoagulant therapy

Meng

Liu²,

Zuo

et al. 2021

Medicine

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Background: To describe the outcome of the patients with cerebral venous sinus thrombosis (CVST) during pregnancy and postpartum treated with anticoagulant therapy. Methods: This is a retrospective cohort study and patients with CVST were collected from October 2009 to March 2018. Patients were divided into pregnancy-related (occurred during pregnancy and postpartum) group and non-pregnancy-related. Recovery rate at 12 months after anticoagulant therapy, adverse events, characteristics of patients with poor outcomes were statistically analyzed. Results: Fifty-eight pregnancy-related CVST patients (17 pregnancy and 41 postpartum) as study group and 76 non-pregnancy-related CVST women as control group were enrolled. Study group was statistically different to control group in several baseline variables. More pregnancy-related patients had modified rankin scale (mRS) = 5 (15.5% vs 11.8%, P = 8.1×10 −3 ) before anticoagulant therapy. At 12 months heparinization, difference in recovery rate was not statistically significant (80% vs 87.5%, P = .29) between 2 groups. No differences were found of adverse events between 2 groups. Patients with poor outcomes had less sigmoid sinus thrombosis (16.7% vs 61.5%, P = .14), more coma (41.2% vs 17.2%, P = 5.2×10 −7 ), more mRS = 4 (33.3% vs 19.2%, P = 1.63 × 10 −4 ), more mRS = 5 (66.7% vs 9.6%, P = 1.63 × 10 −4 ) before treatment. Conclusion: Pregnancy-related CVST patients had severer condition before treatment, but can achieve comparable recovery rate at 12 months after anticoagulant therapy with non-pregnancy-related women. Pregnancy-related patients with poor prognosis had less sinus sigmoid occlusion, more coma, high mRS at admission.

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Seizure in cerebral venous and sinus thrombosis

2018

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SummaryMany conflicting issues exist about seizure in the setting of cerebral venous and sinus thrombosis (CVST). In this article we aimed to address the existing data regarding incidence, characteristics, predictors, treatment, and prognosis of acute and late seizures in patients with CVST and to prepare more practical information for clinicians. PubMed, Embase, Web of science and Cochrane databases were searched within 1966–2016 using relevant keywords. A total of 63 papers met the inclusion criteria. Seizures are classified as acute symptomatic seizures (ASS; first 14 days) and post‐CVST epilepsy (PCE; after 14 days). The incidence had been reported in a wide range of 6.9–76% for ASS and 4–16% for PCE. Focal and generalized seizures were observed with different predominance. ASS commonly occurred in patients with loss of consciousness, focal neurological deficits, supratentorial lesions and thrombosis in superior sagittal sinus, straight sinus, and cortical veins. PCE had been predisposed by occurrence of ASS, motor deficit, and supratentorial lesions, particularly hemorrhage. Most experts believe that primary prophylaxis with antiepileptic drugs in the acute phase is not indicated. However, the initiation of prophylaxis after the first seizure in patients with supratentorial lesions or focal neurological deficit should be recommended. The quality of current evidence is low and most conclusions are based on expert opinions. More accurate reports of seizure semiology, detailed antiepileptic treatment plans, and outcomes are necessary to answer the existing questions.

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Intrasinus thrombolysis in cerebral venous sinus thrombosis: Experience from a university hospital, India

Cited by 8 publications

References 15 publications

Cerebral vein thrombosis associated with MTHFR A1289C mutation gene in a young postpartum woman

Cerebral vein thrombosis associated with MTHFR A1289C mutation gene in a young postpartum woman

The outcomes of pregnant and postpartum patients with cerebral venous sinus thrombosis after anticoagulant therapy

Seizure in cerebral venous and sinus thrombosis

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