Pediatric Cortical Vein Thrombosis

Ritchey, Zak; Hollatz, Amanda L.; Weitzenkamp, David; Fenton, Laura Z.; Maxwell, Emily C.; Bernard, Timothy J.; Stence, Nicholas

doi:10.1161/strokeaha.115.011291

Cited by 28 publications

(10 citation statements)

References 7 publications

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“…In our study, a higher incidence (61.4%) of concomitant CVT was found among adult CVST patients than pediatric CVST patients (24%) and the rate reported in a previous study (17%) [ 3 , 6 ], which might be due to the integration of multiple imaging techniques for the detection of CVTs in our study (see Additional file 1 : Tables S1 and S2).…”

Section: Discussionsupporting

confidence: 48%

“…With the development of non-invasive neuroimaging techniques (e.g., magnetic resonance imaging [MRI] and computed tomography [CT]) and improved recognition of CVT, a greater incidence of CVT has been diagnosed with contemporary neuroimaging techniques compared to the past decade. In a recent study that included pediatric CVST patients [ 6 ], concomitant CVT was found to be not rare (24%) and was associated with seizures and brain lesions. However, the significance of concomitant CVT in adult CVST patients is not clear.…”

Section: Introductionmentioning

confidence: 99%

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Cortical vein thrombosis in adult patients of cerebral venous sinus thrombosis correlates with poor outcome and brain lesions: a retrospective study

Liang

Chen

et al. 2017

BMC Neurol

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BackgroundCortical vein thrombosis (CVT) receives little attention in adult patients with cerebral venous sinus thrombosis (CVST). This study aimed to investigate the clinical and radiological features of adult CVST patients with concomitant CVT.MethodsFrom May 2009 to May 2016, we recruited 44 adult CVST patients (diagnosed within 1 month of onset; 33.8 ± 14.0 years of age, 28 males). CVT was primarily confirmed using computed tomography venography and magnetic resonance imaging sequence of contrast enhanced three dimensions magnetization prepared rapid acquisition with gradient echo. Patients with concomitant CVT were divided into the CVT group; otherwise, the patients were placed into the non-CVT group. The clinico-radiological characteristics were compared between the two groups.ResultsThe CVT group included 27 patients (61.4%), and the non-CVT group included 17 patients (38.6%). Seizure (63.0% versus 11.8%), focal neurological deficits (44.4% versus 5.9%), and consciousness disorders (33.3% versus 0) occurred more frequently in the patients in the CVT group than in those of the non-CVT group (P < 0.05). The modified Rankin Scale (mRS) score at discharge was higher for the CVT group patients (median 2, range 1–4) than for the non-CVT group patients (median 0, range 0–4) (P < 0.001). Venous infarction (63.0% versus 11.8%), parenchymal hemorrhage (40.7% versus 5.9%), and subarachnoid hemorrhage (22.2% versus 0) were identified more frequently in the CVT group than in the non-CVT group (P < 0.05).ConclusionsThis study demonstrates that concomitant CVT is a common finding in adult patients with CVST and is associated with severe clinical manifestations, poor short-term outcomes, and brain lesions.Electronic supplementary materialThe online version of this article (10.1186/s12883-017-0995-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Cortical vein thrombosis in adult patients of cerebral venous sinus thrombosis correlates with poor outcome and brain lesions: a retrospective study

Liang

Chen

et al. 2017

BMC Neurol

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“…Our findings are partially consistent with those of previous researchers, but there are some discrepancies (5,13). According to their studies, seizure, FND, altered consciousness, venous infarction, ICH, SAH, and concurrent SSS thrombosis were more frequent in the CVI group than in the CVI negative group (5,13) and the mRS score at discharge was higher for the CVI group than the CVI-negative group (5). Although we cannot accurately explain why our results differ from those of other researchers, it might be caused by differences in the patient population.…”

Section: Discussionsupporting

confidence: 91%

“…Regarding the CVI of CVT in our patients, the CVI was demonstrated in 31 patients (63.3%) and the CV was the most common site of CVT, which is higher than those of previous studies (2,9,10,13). They reported 3.4% -23% incidence of CVI.…”

Section: Discussioncontrasting

confidence: 64%

Clinical and Radiological Manifestations of Cerebral Venous Thrombosis: Are There Any Differences According to Presence or Absence of Cortical Vein Involvement?

et al. 2018

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Background: Cerebral venous thrombosis (CVT) is difficult to diagnose because of the variety of its clinical and imaging findings and the many anatomical variations in the cerebral venous system. Objectives: We aimed to investigate the clinical and radiological CVT and to evaluate differences in their findings, according to the presence or absence of cortical vein involvement (CVI). Patients and Methods: From the 13 years database of our institution, forty-nine patients were enrolled in the study. In all patients, CVT was confirmed on CT venography, MR venography and/or digital subtraction angiography (DSA). We retrospectively reviewed the clinical presentations and CT and MR findings of the patients and compared their findings, according to the presence or absence of CVI. Results: CVI was detected in 31 patients (63.3%). The most common clinical symptom was headache (61.2%), followed by focal neurologic deficit (FND) (49.0%), seizure (40.8%), and altered consciousness (18.4%). FND was frequent in the CVI group (67.7 vs. 16.7%, P = .001). On CT (n = 49) and/or MR (n = 38), intracranial hemorrhage was present in 33 patients (67.3%) and parenchymal hyperintensity was detected in 24/38 (63.2%). Subarachnoid hemorrhage (SAH) was frequent in the CVI group (51.6 vs. 16.7%, P = .018). The cortical vein (CV) was the most common site of CVT (63.3%), followed by superior sagittal (61.2%), transverse (53.1%), sigmoid (42.9%), and straight (20.4%) sinuses. The superior sagittal sinus thrombosis was frequently associated with concomitant CV thrombosis (74.2 vs. 38.9%, P = .032). Conclusion: CVT commonly involved the CV. Although its clinical manifestation was diverse, FND was common in the CVI group. Intracranial hemorrhage and parenchymal hyperintensity were common CT and MR findings and SAH was commonly associated in the CVI group.

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“…Traditionally, cortical vein thrombosis has been thought to be rare. However, a recent study of cortical vein thrombosis in children reported that almost a quarter of the patients with CSVT actually had cortical vein thrombosis; the children with cortical vein thrombosis also were more likely to have significant neurological complications, such as infarction and seizures [ 5 ].…”

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confidence: 99%