Antithrombotic therapy of Cerebral cavernous malformations

Gruschwitz, Jonas; Dinh, Bui Bao Khanh; Wanke, Isabel; Kockro, Ralf A.; Eisenring, Christian; Gasciauskaite, Greta

doi:10.1016/j.inat.2020.100851

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…In 2013, Flemming et al reported that the use of antithrombotic agents does not actually promote hemorrhages in patients with intracerebral cavernous malformations [ 119 ]. Likewise, a case report describing the normalization and regression of low-flow venous malformation by antiplatelet treatment promotes the benefits of antithrombotic therapy in vascular malformations [ 120 ]. In 2019, Zuurbier et al performed a population-based cohort study and meta-analysis and found that long- term antithrombotic therapy is associated with a lower risk of subsequent cerebral hemorrhage and/or focal neurological deficits [ 121 ].…”

Section: Anticoagulants For Patients With Ccmmentioning

confidence: 99%

Dysregulated Hemostasis and Immunothrombosis in Cerebral Cavernous Malformations

Globisch

Onyeogaziri

Smith

et al. 2022

IJMS

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Cerebral cavernous malformation (CCM) is a neurovascular disease that affects 0.5% of the general population. For a long time, CCM research focused on genetic mutations, endothelial junctions and proliferation, but recently, transcriptome and proteome studies have revealed that the hemostatic system and neuroinflammation play a crucial role in the development and severity of cavernomas, with some of these publications coming from our group. The aim of this review is to give an overview of the latest molecular insights into the interaction between CCM-deficient endothelial cells with blood components and the neurovascular unit. Specifically, we underscore how endothelial dysfunction can result in dysregulated hemostasis, bleeding, hypoxia and neurological symptoms. We conducted a thorough review of the literature and found a field that is increasingly poised to regard CCM as a hemostatic disease, which may have implications for therapy.

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Section: Anticoagulants For Patients With Ccmmentioning

confidence: 99%

Dysregulated Hemostasis and Immunothrombosis in Cerebral Cavernous Malformations

Globisch

Onyeogaziri

Smith

et al. 2022

IJMS

View full text Add to dashboard Cite

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Cerebral microbleeds in a young patient – case presentation with rare disease association and literature review

Tihamér¹,

Mihály

Kelemen

et al. 2021

Bulletin of Medical Sciences

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During the coronavirus pandemic neurology departments were forced to treat diseases that had hitherto been treated by other specialities. In our case presentation, we describe an unusual association of two diseases that raised interesting questions regarding differential diagnostics and has not yet been presented in the literature. A 34-year-old male patient was admitted to the neurology department with an urgent referral because of impaired speech comprehension and expression upon awakening. He had a history of anticoagulant therapy for thrombosis of the posterior tibial artery, discontinued after two weeks. Physical examination revealed a 1 cm diameter painful lump in the subcutis of his right thigh and a systolic murmur over the mitral and aortic valves. Nonenhanced head CT showed a small hemorrhage near the occipital horn of the left ventricle, which could not explain the mixed aphasia. In addition, the SWAN MRI sequence showed supra- and infratentorial microbleeds, suggesting cavernomatosis, which was confirmed by the detection of another typical popcorn-like bleeding cavernoma on repeated MRI examination. Due to the heart murmurs and positive inflammatory markers, a detailed cardiac examination was warranted, confirming infective endocarditis caused by Streptococcus gordonii. Due to COVID-19-related regulations the patient couldn’t be transferred to the Department of Cardiology or Infectious Diseases, thus his treatment and follow-up was carried out at the Department of Neurology. Following targeted antibiotic treatment the patient’s symptoms resolved and he underwent successful cardiac surgery 7 weeks after his discharge in a symptom-free state. The peculiarity of the case lies in the fact that the clinical picture and course of the disease, consistent with the diagnosis of infective endocarditis suggested cerebral septic emboli with microbleeds, but cerebral cavernomatosis was confirmed by brain imaging.

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Antithrombotic therapy of Cerebral cavernous malformations

Cited by 2 publications

References 2 publications

Dysregulated Hemostasis and Immunothrombosis in Cerebral Cavernous Malformations

Dysregulated Hemostasis and Immunothrombosis in Cerebral Cavernous Malformations

Cerebral microbleeds in a young patient – case presentation with rare disease association and literature review

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