Prothrombin 20210A and Oral Contraceptive Use as Risk Factors for Cerebral Venous Thrombosis

Gadelha, Telma; André, Charles; Juca, A; Nucci, Márcio

doi:10.1159/000081911

Cited by 53 publications

(48 citation statements)

References 27 publications

(32 reference statements)

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“…A study from Brazil showed similar results. 18 In a meta-analysis that included 16 studies, the authors reported an increased risk of CVT in oral contraceptive users (relative risk 15.9, 95% CI 6.98 to 36.2). 59 In another meta-analysis of 17 studies, 28 an increased risk of CVT was found in patients who used oral contraceptives (OR 5.59, 95% CI 3.95 to 7.91; PϽ0.001).…”

Section: Class Iiamentioning

confidence: 99%

Diagnosis and Management of Cerebral Venous Thrombosis

Saposnik¹,

Barinagarrementería²,

Brown³

et al. 2011

Stroke

1,654

1,229

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Background— The purpose of this statement is to provide an overview of cerebral venous sinus thrombosis and to provide recommendations for its diagnosis, management, and treatment. The intended audience is physicians and other healthcare providers who are responsible for the diagnosis and management of patients with cerebral venous sinus thrombosis. Methods and Results— Members of the panel were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and represent different areas of expertise. The panel reviewed the relevant literature with an emphasis on reports published since 1966 and used the American Heart Association levels-of-evidence grading algorithm to rate the evidence and to make recommendations. After approval of the statement by the panel, it underwent peer review and approval by the American Heart Association Science Advisory and Coordinating Committee. Conclusions— Evidence-based recommendations are provided for the diagnosis, management, and prevention of recurrence of cerebral venous thrombosis. Recommendations on the evaluation and management of cerebral venous thrombosis during pregnancy and in the pediatric population are provided. Considerations for the management of clinical complications (seizures, hydrocephalus, intracranial hypertension, and neurological deterioration) are also summarized. An algorithm for diagnosis and management of patients with cerebral venous sinus thrombosis is described.

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Section: Class Iiamentioning

confidence: 99%

Diagnosis and Management of Cerebral Venous Thrombosis

Saposnik¹,

Barinagarrementería²,

Brown³

et al. 2011

Stroke

1,654

1,229

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“…Of the 17 studies included, 16 were written in the English language [21][22][23][24]26,[29][30][31]35,[37][38][39]41,43,45,46 and 1 in the Chinese language. 32 All included studies were case-control studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eight studies evaluated the frequency of OC use in patients with CVT and in a control population. [21][22][23]29,30,39,41,45 Sixteen studies evaluated the role of different thrombophilic factors in the CVT pathogenesis 21 23,24 ; 1 antiphospholipid syndrome 23 ; and 1 anticardiolipin antibodies. 37 No studies specifically studied patients with more than 1 hereditary or acquired prothrombotic defect, except as discussed in "OCs and thrombophilic factor interactions.…”

Section: Study Characteristicsmentioning

confidence: 99%

Thrombophilic abnormalities, oral contraceptives, and risk of cerebral vein thrombosis: a meta-analysis

Dentali

Crowther

Ageno

2006

Blood

236

142

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Recent studies suggest that thrombophilic abnormalities and the use of oral contraceptives (OCs) are the leading causes of cerebral vein thrombosis (CVT). The purpose of this study was to assess the association between CVT and thrombophilic states, OCs, and their interaction. For data sources, we used the MEDLINE, EMBASE, and Cochrane Library databases (January 1994 to March 2005), reference lists of retrieved articles, and contact with content experts. We selected studies comparing the prevalence of OC use and the prevalence of prothrombitic abnormalities in patients with CVT compared with healthy controls. Two reviewers independently selected studies and extracted study characteristics, quality, and outcomes. Odds ratios (ORs) were calculated for each trial and pooled using the Mantel-Haenszel method. Seventeen studies were included. There was an increased risk of CVT in patients using OCs (OR 5.59; 95% confidence interval [CI] 3.95 to 7.91; P < .001), and in patients with factor V Leiden (OR 3.38; 95% CI 2.27 to 5.05; P < .001), with mutation G20 210A of prothrombin (OR 9.27; 95% CI 5.85 to 14.67; P < .001) and with hyperhomocysteinemia (OR 4.07; 95% CI 2.54 to 6.52; P < .001). We concluded that OC users, and patients with factor V Leiden, the prothrombin G20 120A mutation, and hyperhomocysteinemia are at a significantly increased risk of CVT. (Blood. 2006;

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“…20,22,36,41,50,58 It is well known that thirdgeneration contraceptives substantially increase the risk of CVST. 20 Likewise, the risk of CVST is increased during the last trimester of pregnancy and during the postdelivery period.…”

mentioning

confidence: 99%

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

Filippidis¹,

Kapsalaki

Patramani

et al. 2009

FOC

115

160

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Cerebral venous sinus thrombosis (CVST) is a rare clinicopathological entity. The incidence of CVST in children and neonates has been reported to be as high as 7 cases per million people, whereas in adults the incidence is 3–4 cases per million. The predisposing factors to this condition are mainly genetic and acquired prothrombotic states and infection. The clinical picture of CVST is nonspecific, highly variable, and can mimic several other clinical conditions. Diagnosis of CVST is established with the implementation of neuroimaging studies, especially MR imaging and venography. Identification and elimination of the underlying cause, anticoagulation, proper management of intracranial hypertension, and anticonvulsant prophylaxis constitute cornerstones of CVST treatment. Newer treatment strategies such as endovascular thrombolysis and decompressive craniectomy have been recently used in the treatment of patients with CVST with variable success rates. Further clinical research must be performed to delineate the exact role of these newer treatments in the management of severe cases of CVST. The recent advances in the diagnosis and treatment of patients with CVST have significantly lowered the associated mortality and morbidity and have improved the outcome of these patients.

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Prothrombin 20210A and Oral Contraceptive Use as Risk Factors for Cerebral Venous Thrombosis

Cited by 53 publications

References 27 publications

Diagnosis and Management of Cerebral Venous Thrombosis

Diagnosis and Management of Cerebral Venous Thrombosis

Thrombophilic abnormalities, oral contraceptives, and risk of cerebral vein thrombosis: a meta-analysis

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

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