The association between otogenic lateral sinus thrombosis and thrombophilia – A long-term follow-up

Schneider, Shay; Kapelushnik, Joseph; Kraus, Mordechai; Saied, Sabri El; Levi, Itai; Kaplan, Daniel M.

doi:10.1016/j.amjoto.2018.03.013

Cited by 13 publications

(11 citation statements)

References 20 publications

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“…The association between OCVST and thrombophilia is supported in other reports. 14,18,35,37 Bacterial culture testing yielded some interesting findings. Extracranial adverse events, complications, or comorbidities increased the odds of a positive culture result by up to 60% among AC patients and all culture-positive patients had extracranial abscesses.…”

Section: Discussionmentioning

confidence: 98%

Predicting Anticoagulation Need for Otogenic Intracranial Sinus Thrombosis: A Machine Learning Approach

Kaufmann

Camilon

Levi

et al. 2020

J Neurol Surg B Skull Base

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Objective The role of anticoagulation (AC) in the management of otogenic cerebral venous sinus thrombosis (OCVST) remains controversial. Our study aims to better define when AC is used in OCVST. Methods MEDLINE, EMBASE, and The Cochrane Library were searched from inception to February 14, 2019 for English and English-translated articles. References cited in publications meeting search criteria were searched. Titles and abstracts were screened and identified in the literature search, assessing baseline risk of bias on extracted data with the methodological index for nonrandomized studies (MINORS) scale. Random effects meta-regression followed by random forest machine learning analysis across 16 moderator variables between AC and nonanticoagulated (NAC) cohorts was conducted. Results A total of 92% of treated patients were free of neurologic symptoms at the last follow-up (mean 29.64 months). Four percent of AC and 14% of NAC patients remained symptomatic (mean 18.72 and 47.10 months). 3.5% of AC patients experienced postoperative wound hematomas. AC and NAC recanalization rates were 81% (34/42) and 63% (five-eights), respectively. OCVST was correlated with cholesteatoma and intracranial abscess. Among the analyzed covariates, intracranial abscess was most predictive of AC and cholesteatoma was most predictive of NAC. Comorbid intracranial abscess and cholesteatoma were predictive of AC. Conclusion The present study is the first to utilize machine learning algorithms in approaching OCVST. Our findings support the therapeutic use of AC in the management of OCVST when complicated by thrombophilia, intracranial abscess, and cholesteatoma. Patients with intracranial abscess and cholesteatoma may benefit from AC and surgery. Patients with cholesteatoma can be managed with NAC and surgery.

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Section: Discussionmentioning

confidence: 98%

Predicting Anticoagulation Need for Otogenic Intracranial Sinus Thrombosis: A Machine Learning Approach

Kaufmann

Camilon

Levi

et al. 2020

J Neurol Surg B Skull Base

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“…This finding was followed by the protein S deficiency found in 11, 44% of the cases and the factor V Leiden mutation presented in 6, 24% of the patients [9]. In another research, where 7 patients with LST participated, it was found blood disorders in 3 patients, reduction of the level of serum proteins C and S, high levels of factor IX and high levels of anticardiolipin antibodies [10].…”

Section: Express Consentmentioning

confidence: 89%

“…In some cases found during the literature review, it was realized an incision of the lateral sinus for the eventual removal of the clot; however, there are some studies showing that the prognosis doesn't improve by the exploration of the sinus nor the removal of the clot [2]. In another cases the procedure is done with mastoidectomy along with the insertion of tympanostomy tubes [10], which was also the management realized in this case and it had a favorable outcome.…”

Section: Discussionmentioning

confidence: 99%

Lateral Sinus Thrombosis as a Complication of Acute Otitis Media, Clinical Case Report in Bogotá, Colombia

Marrugo¹,

Adarme²,

Oliveros³

2019

J Otolaryngol Rhinol

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“…The authors suggested that anticoagulation therapy with LMWH should be started immediately after diagnosis and continued for 2 months or longer in those patients who do not achieve recanalization or in those who present a high-risk thrombophilia. Moreover, the authors proposed that all patients with an otogenic CVST diagnosis should be screened for thrombophilia in order to evaluate the risk of thrombosis recurrence and treatment duration [9,32]. Nonetheless, thrombophilia screening remains a matter of debate as it is expensive and no evidence of robust proof of its relevance exists [28].…”

Section: Discussionmentioning

confidence: 99%

Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review

et al. 2020

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Background: Cerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due to its subtle clinical presentation, suspicion is essential for a prompt diagnosis and appropriate management. Unfortunately, no standard treatment options are available. To discuss the possible clinical presentation, microbiology, and management, we here report the case of a child with otogenic cerebral venous sinus thrombosis and perform a literature review starting from 2011. Case presentation: The child, a 10-months-old male, presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography scan detected right sigmoid and transverse sinus thrombosis, as well as a subperiosteal abscess. Fusobacterium necrophorum and Haemophilus Influentiae were detected on cultural sampling. A multidisciplinary approach along with a combination of medical and surgical therapy allowed the patient's full recovery. Conclusion: Cerebral venous sinus thrombosis is a rare but severe complication of acute otitis media and mastoiditis. The management of this pathological condition is always challenging and an interdisciplinary approach is frequently required. Current therapeutic options include a combination of medical and surgical therapy. A patient-centered approach should guide timing and treatment management.

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The association between otogenic lateral sinus thrombosis and thrombophilia – A long-term follow-up

Cited by 13 publications

References 20 publications

Predicting Anticoagulation Need for Otogenic Intracranial Sinus Thrombosis: A Machine Learning Approach

Predicting Anticoagulation Need for Otogenic Intracranial Sinus Thrombosis: A Machine Learning Approach

Lateral Sinus Thrombosis as a Complication of Acute Otitis Media, Clinical Case Report in Bogotá, Colombia

Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review

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