Cerebral venous and sinus thrombosis diagnosis: preliminary study of clinical picture and D-dimer concentration correlation

Domitrz, Izabela; Sadowski, Artur; Domitrz, Wojciech; Kochanowski, Jan

doi:10.5603/pjnns.a2020.0006

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…D-dimer is one of the important indicators for CVT diagnosis. [21][22][23][24] However, in our study, the level of D-dimer was not associated with the presence of CVT in patients with DAVF. The result is consistent with a small study including 18 patients with DAVF, which showed no significant difference between the mean value of D-dimer and sinus occlusion.…”

Section: Discussioncontrasting

confidence: 80%

Dural Arteriovenous Fistulas With or Without Cerebral Venous Thrombosis: A Cross-Sectional Analysis of 511 Patients

Wan,

Han,

Huang

et al. 2023

Neurosurgery

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BACKGROUND AND OBJECTIVES: Recent studies suggest a bidirectional relationship of dural arteriovenous fistula (DAVF) with cerebral venous thrombosis (CVT). We aimed to compare the characteristics of patients with DAVF with or without CVT and to analyze the risk factors for the coexistence of CVT in a DAVF population. METHODS: A total of 511 adult patients with DAVF were enrolled consecutively in our hospital from February 2019 through November 2022. Demographic data, clinical manifestations, and imaging characteristics were reviewed in detail. The patients with DAVF were divided into two groups: DAVF with CVT (DAVF-CVT) group and without CVT (DAVF alone) group. Univariate logistic regression and multivariate logistic regression were used to analyze the risk factors for the coexistence of CVT and DAVF. RESULTS: CVT was found in 19.8% of patients with DAVF. In univariate analysis, compared with the DAVF-alone group, the DAVF-CVT group was more likely to have tinnitus (P = .001), blurred vision (P < .001), visual field loss (P = .001), focal neurological deficits (P = .002), seizures (P = .008), and cognitive impairment (P = .046) and less likely to have spinal cord/brain stem dysfunction (P = .004). In addition, there were significant differences in age (P = .009), sex (P = .019), the occurrence of venous cerebral infarction (P = .001), and DAVF location (P < .001) between the two groups. Furthermore, multivariate analysis showed that blurred vision, venous cerebral infarction, large sinus DAVF, and multiple DAVF were risk factors for the coexistence of CVT in patients with DAVF, with the odds ratio of 2.416 (95% CI 1.267-4.606, P = .007), 6.018 (95% CI 1.289-28.100, P = .022), 5.801 (95% CI 2.494-13.496, P < .001), and 5.640 (95% CI 2.122-14.989, P = .001), respectively. CONCLUSION: CVT occurred in approximately one fifth of patients with DAVF. Blurred vision, venous cerebral infarction, large sinus DAVF, and multiple DAVF may be the risk factors for predicting the coexistence of CVT in patients with DAVF.

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Section: Discussioncontrasting

confidence: 80%

Dural Arteriovenous Fistulas With or Without Cerebral Venous Thrombosis: A Cross-Sectional Analysis of 511 Patients

Wan,

Han,

Huang

et al. 2023

Neurosurgery

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“…It should be noted that although the use of Ddimer testing has been well established in ruling out the venous thromboembolism, such as pulmonary embolism and deep vein thrombosis, the usefulness of which is still debatable in CVT, with an unacceptable false-negative rate of up to 26%. Nevertheless, positive D-dimer strengthens the suspicion of CVT in patients with acute headache (23,(58)(59)(60)(61)(62)(63).…”

Section: Cerebral Angiographymentioning

confidence: 97%

An Update on Diagnosis and Treatment of Cerebral Venous Thrombosis in Adults: A Narrative Review

Paybast

Aghamiri

2020

J Vessel Circ

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Background and Aim: Cerebral venous thrombosis (CVT) is a relatively common disorder of the cerebral venous system accounting for less than 1% of all strokes with a higher prevalence in Iran. Despite the considerable advances in recent years, the diagnosis and treatment of CVT are still challenging predominantly in the emergency setting. Therefore, the present study sought to provide an update on the diagnosis and treatment of CVT. Materials and Methods: PubMed, Web of Science, Google Scholar, Scopus, Elsevier, and Iranian domestic scientific databases were searched within January 1, 2000, to July 1, 2020. In all the electronic databases, the keywords (in the title/abstract) of "cerebral vein thrombosis" OR "CVT" OR "Cerebral venous sinus thrombosis" OR "CVST" AND "risk factor", "diagnosis", "treatment", and "prognosis" were searched. The unrelated articles, studies not concerning humans or pediatric population, and case reports were excluded from the study. In addition, the articles related to CVT in association with coronavirus disease 2019 infection were excluded from the present review. Results: According to the findings of the present study, the diagnosis of CVT might be delayed due to a wide range of clinical manifestations from a subacute headache with or without the signs of intracranial hypertension to the acute focal neurologic deficit and even loss of consciousness. Although the diagnosis is typically based on brain magnetic resonance imaging and magnetic resonance venography, there has been evidence suggesting that the plain computed tomography markers with an attenuation value of > 60.4 Hounsfield unit (HU) and Hounsfield-hematocrit (H: H) ratio of > 1.42 are specific enough for the diagnosis regardless of confirmatory imaging, such as venography. Additionally, the usefulness of D-dimer is still debatable, and an unacceptable false-negative rate of up to 26% has been illustrated. In terms of therapeutic aspects, although warfarin is still the mainstay of treatment, there has been increasing interest in new oral anticoagulants with promising results in both thrombus recanalization and excellent functional recovery. Balloon angioplasty and mechanical thrombectomy might also be considered in severely progressive cases without response to conventional treatments. It is worth mentioning that even for those achieving favorable outcomes, CVT can remain a disabling condition leading to at least neuropsychiatric complaints. Conclusion: The CVT is a rare and important cause of stroke accounting for less than 5% of all strokes mainly affecting young females. With regard to the rarity of the disease and novelty of the therapeutic approaches, there is a long way to fully identify the best diagnostic and therapeutic approaches to the disease.

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“…Cerebral venous and sinus thrombosis (CVST) is another disease where headache is the predominant symptom. As with SuS, it affects typically young adults, mainly females, which can lead to misdiagnosis [41]. CVST has a lot of varying clinical manifestations similar to SuS, but it is important to remember that the treatment differs significantly.…”

Section: Differential Diagnosismentioning

confidence: 99%

Susac’s syndrome diagnostic difficulties — the neurological point of view

Fonderska¹,

Tomalka-Kochanowska²,

Kochanowski

et al. 2022

Neurol Neurochir Pol.

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Cerebral venous and sinus thrombosis diagnosis: preliminary study of clinical picture and D-dimer concentration correlation

Cited by 5 publications

References 17 publications

Dural Arteriovenous Fistulas With or Without Cerebral Venous Thrombosis: A Cross-Sectional Analysis of 511 Patients

Dural Arteriovenous Fistulas With or Without Cerebral Venous Thrombosis: A Cross-Sectional Analysis of 511 Patients

An Update on Diagnosis and Treatment of Cerebral Venous Thrombosis in Adults: A Narrative Review

Susac’s syndrome diagnostic difficulties — the neurological point of view

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