Specific Polymorphism 4G/5G Gene for PAI-1 as a Possible Cause of Cerebral Venous Thrombosis: A Case Report

Matic, Tatjana Boskovic; Gavrilović, Aleksandar; Simovic, Sladjana; Aleksić, D; Vesić, Katarina; Azanjac, Ana; Tončev, Slavčo; Miletić-Drakulić, Svetlana

doi:10.1515/sjecr-2016-0038

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…Thrombosis of the cerebral venous sinus is more common in those less than 50 years of age, with 75% of cases being found in women [ 1 ]. There is a wide range of CSVT etiologies that have been recognized which can be divided into two major categories: direct causes and hypercoagulable states.…”

Section: Discussionmentioning

confidence: 99%

“…Headache is the most frequent presentation but the least specific [ 4 ]. On the other hand, neurological manifestations are the most specific but less frequent signs [ 1 ]. Headaches typically increase gradually over days in most cases but sometimes over minutes to hours, mimicking the “thunderclap headache” of a potential subarachnoid hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

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Cerebral Sinus Venous Thrombosis in a Patient Using Etonogestrel/Ethinyl Estradiol Vaginal Ring

Selim

Rakhra

Kassim

et al. 2018

Cureus

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A case of 43-year-old female presented to the emergency department (ED) with a new onset grand mal tonic-clonic seizure lasting at least two minutes with post-ictal confusion. Imaging was consistent with cerebral sinus venous thrombosis (CSVT) associated with intracranial hemorrhage. After ruling out most common causes of thrombosis, the etiology was attributed to estrogen vaginal ring. The patient was treated with anticoagulation therapy and had increasing hemorrhagic changes in the first few days, which eventually improved. The estimated annual incidence of cerebral sinus vein thromboses is approximately 3-4 cases per 1 million adults, mostly occurring in females. More than 80% of patients have favorable neurologic outcomes due to increased awareness of the condition as well as availability of advanced imagining and treatment options. The treatment is still controversial due to the high risk of intracranial hemorrhage with sinus thrombosis, especially for patients on anticoagulation. Still, most guidelines support starting anticoagulation. In this report, we highlight the association of CSVT with estrogen vaginal ring and discuss recent management recommendations per different society guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cerebral Sinus Venous Thrombosis in a Patient Using Etonogestrel/Ethinyl Estradiol Vaginal Ring

Selim

Rakhra

Kassim

et al. 2018

Cureus

View full text Add to dashboard Cite

show abstract

“…or non- infective nature (head trauma, brain tumors, neurosurgical procedures, pregnancy and puerperium, consuming of oral contraceptive drugs and asparaginase therapy, inflammatory multisystem diseases, etc. ), prothrombotic state (thrombophilias) stands out, it’s diagnosis is based on highly sophisticated tests [ 2 , 3 ]. In the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) inherited and acquired thrombophilia includes protein C or S deficiency, antithrombin deficiency, factor V Leiden mutation, prothrombin G20210A mutation, MTHFR gene mutation, hyperhomocysteinemia [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Plasminogen Activator Inhibitor-1 (PAI-1) Gene Polymorphisms Associated with Cardiovascular Risk Factors Involved in Cerebral Venous Sinus Thrombosis

et al. 2021

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Cerebral venous sinus thrombosis (CVST), accounting for less than 1% of stroke cases, is characterized by various causes, heterogeneous clinical presentation and different outcome. The plasminogen activator inhibitor-1 (PAI-1) gene polymorphisms has been found to be associated with CVST. The aim of this retrospective study was to determine the potential association of PAI-1 675 4G/5G polymorphisms and homocysteine levels with cardiovascular risk factors in a group of young patients with CVST. Eighty patients with CVST and an equal number of age and sex matched controls were enrolled. The protocol included demographic and clinical baseline characteristics, neuroimagistic aspects, genetic testing (PAI-1 675 4G/5G polymorphisms), biochemical evaluation (homocysteine—tHcy, the lipid profile, blood glucose, glycohemoglobin—HbA1c, high-sensitive C-reactive protein—hsCRP) data, therapy and prognosis. The PAI-1 675 4G/5G gene polymorphisms were significantly correlated with increased homocysteine level (tHcy) (p < 0.05), higher total cholesterol (TC) (p < 0.05), low- density lipoprotein cholesterol (LDLc) (p = 0.05) and high- sensitive C- reactive protein (hsCRP) (p < 0.05) in patients with CVST when compared with controls. From the PAI-1 gene polymorphisms, the PAI-1 675 4G/5G genotype presented statistically significant values regarding the comparisons of the blood lipids values between the CVST group and control group. The homocysteine (tHcy) was increased in both groups, patients versus controls, in cases with the homozygous variant 4G/4G but the level was much higher in the group with CVST (50.56 µmol/L vs. 20.22 µmol/L; p = 0.03). The most common clinical presentation was headache (91.25%), followed by seizures (43.75%) and focal motor deficits (37.5%). The superior sagittal sinus (SSS) was the most commonly involved dural sinus (56.25%), followed by the lateral sinus (LS) (28.75%). Intima—media thickness (IMT) values were higher in the patients’ group with CVST (0.95 mm vs. 0.88 mm; p < 0.05). The fatal outcome occurred 2.5% of the time. PAI-1 675 4G/5G gene polymorphisms and higher homocysteine concentrations were found to be significantly associated with CVST in young patients.

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Specific Polymorphism 4G/5G Gene for PAI-1 as a Possible Cause of Cerebral Venous Thrombosis: A Case Report

Cited by 2 publications

References 24 publications

Cerebral Sinus Venous Thrombosis in a Patient Using Etonogestrel/Ethinyl Estradiol Vaginal Ring

Cerebral Sinus Venous Thrombosis in a Patient Using Etonogestrel/Ethinyl Estradiol Vaginal Ring

Plasminogen Activator Inhibitor-1 (PAI-1) Gene Polymorphisms Associated with Cardiovascular Risk Factors Involved in Cerebral Venous Sinus Thrombosis

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