Severe Cerebral Venous and Sinus Thrombosis: Clinical Course, Imaging Correlates, and Prognosis

Kowoll, Christina M.; Kaminski, Julia; Weiß, Verena; Bösel, Julian; Dietrich, W.; Jüttler, Eric; Flechsenhar, Julia; Guenther, Albrecht; Huttner, Hagen B.; Niesen, Wolf‐Dirk; Pfefferkorn, Thomas; Schirotzek, Ingo; Schneider, Hauke; Liebig, Thomas; Dohmen, Christian

doi:10.1007/s12028-016-0256-8

Cited by 52 publications

(46 citation statements)

References 20 publications

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“…The majority of patients who recover completely achieve relative independence, usually expressed as between 0 and 2 on the modified Rankin Scale (mRS), although mild residual symptoms, such as headache, motor deficits, linguistic difficulties, and impaired vision or cognition, often remain . Only 5–10% of patients who survive the acute phase remain moderately or severely dependent (mRS 3 or 4) ; however, this proportion increases up to 34% in those with massive CVST .…”

Section: Prognosismentioning

confidence: 99%

Cerebral venous sinus thrombosis

Capecchi

Abbattista

Martinelli

2018

Journal of Thrombosis and Haemostasis

164

174

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The cerebral venous system is an unusual site of thrombosis, with a particularly high incidence in young adults. This incidence has increased in past decades because of the improvement of neuroradiological techniques. Risk factors for cerebral venous sinus thrombosis overlap with those of other venous thromboembolism sites; however, some are specific for this particular anatomical district. Prognosis is favorable in most cases if diagnosis is made rapidly and treatment is promptly initiated, even if acute complications or chronic invalidity still occur in a quarter of patients. The mainstay of treatment is anticoagulation, which is necessary in order to block clot propagation and obtain recanalization. Intracranial bleeding does not contraindicate anticoagulation. Endovascular procedures are reserved for patients with a particularly severe presentation or rapidly declining neurological symptoms despite appropriate anticoagulation, although data from clinical trials are lacking. Specifically, this review addresses the epidemiology, clinical presentation and course, risk factors, and treatment of cerebral venous sinus thrombosis, with a special focus on the pediatric population.

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Section: Prognosismentioning

confidence: 99%

Cerebral venous sinus thrombosis

Capecchi

Abbattista

Martinelli

2018

Journal of Thrombosis and Haemostasis

164

174

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“…Possible explanations are improvements in treatment, a shift in may be achieved in many cases. However, Kowoll et al 6) reported that the mortality rate exceeded 30% in severe-status patients with consciousness disorder (Glasgow coma scale score: ≤9). In patients whose clinical outcome may become poor, endovascular treatment should be positively considered as salvage therapy in addition to anticoagulant risk factors, and, most importantly, the identification of less severe cases by improved diagnostic methods.…”

Section: Discussionmentioning

confidence: 99%

“…1) Anticoagulant therapy reduces the mRS score to 0-2 after 3 months in 94%-95% of patients; 4,5) an improvement in the outcome therapy to promptly and accurately achieve sinus recanalization. As predictors of a severe status or poor outcome, a National Institutes of Health Stroke Scale (NIHSS) score of ≥3 after admission, 6) motor paralysis or sensory disturbance on the initial consultation, 7) brain edema, 8) and an insufficient collateral pathway around the occluded sinus 9) have been reported. In the present case, the condition on arrival was not severe, but brain edema and motor paresis were noted, suggesting that the condition may become severe.…”

Section: Discussionmentioning

confidence: 99%

Thrombus in the Superior Sagittal Sinus Was Successfully Aspirated by Coaxial Catheter Technique: A Technical Case Report

Fujii

Yoshimura

Hirota

et al. 2019

JNET

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“…Especially, whether the location of the venous thrombus contributes to cerebrovascular complications is a very controversial matter [2, 3]. The reason for this may be that the clinical manifestations depend on not only the localization of the thrombus but also on the rate of progression and the extent of venous collateralization [4].…”

Section: Introductionmentioning

confidence: 99%

Venous Stasis and Cerebrovascular Complications in Cerebral Venous Sinus Thrombosis

et al. 2017

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Background/Aims: The factors related to cerebrovascular complications in cerebral venous sinus thrombosis (CVST) are controversial. We focused on venous stasis and investigated its relationship with cerebrovascular complications in CVST. Methods: CVST patients between June 2013 and October 2016 were enrolled. Relationships between cerebrovascular complications, defined as cerebral venous infarction, intracerebral hemorrhage, or subarachnoid hemorrhage, and cerebrum venous stasis and other clinical information were retrospectively analyzed. Venous stasis was evaluated by the prominence of the veins on susceptibility-weighted imaging (SWI). The cerebrum was divided into 10 regions according to the venous drainage territories, and venous stasis was quantified by adding one point for venous prominence on SWI for each region (CVST SWI score). Results: All 5 cases in the noncomplicated group had a CVST SWI score of 0. The 3 patients with CVST SWI scores higher than 0 had cerebrovascular complications. The CVST SWI scores were higher in the complicated group than in the noncomplicated group (3.0 vs. 0, p = 0.010). Seizures were seen in all patients with complications and in none of the patients without complications (3 vs. 0, p = 0.018). Conclusion: Venous stasis evaluated by SWI can help predict cerebrovascular complications in CVST. A seizure is an important initial symptom that suggests cerebrovascular complications in CVST.

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Severe Cerebral Venous and Sinus Thrombosis: Clinical Course, Imaging Correlates, and Prognosis

Cited by 52 publications

References 20 publications

Cerebral venous sinus thrombosis

Cerebral venous sinus thrombosis

Thrombus in the Superior Sagittal Sinus Was Successfully Aspirated by Coaxial Catheter Technique: A Technical Case Report

Venous Stasis and Cerebrovascular Complications in Cerebral Venous Sinus Thrombosis

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