Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature

Khanal, Prasun; Thapa, Lekhjung; Shrestha, Ashish; Bhattarai, Suman; Sapkota, D.; Sharma, Neha; Devkota, Upendra Prasad

doi:10.1155/2016/8314040

Cited by 8 publications

(10 citation statements)

References 26 publications

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“…Furthermore, structural obstruction of the cerebral venous sinuses include traumatic compression, direct injury due to fractures or compression from mass lesions including tumors, arteriovenous malformations, and dural arteriovenous fistulae [12-14]. This gender-ratio is reversed at high altitude [5-7]. While this observation was reported in single case reports or small case series, our study confirms this phenomenon in the yet largest published series of 21 patients.…”

Section: Discussionsupporting

confidence: 75%

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Cerebral Venous Thrombosis at High Altitude: A Retrospective Cohort of Twenty-one Consecutive Patients

Khattar

Sumardi

Zemmar

et al. 2019

Cureus

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Background Cerebral venous thrombosis (CVT) is a rare cerebrovascular disorder, comprising <1% of all strokes. The incidence of CVT is higher in females but a small number of cases suggest that men have a higher risk for CVT in high elevation. The aim of this retrospective cohort study is to investigate this gender-related relationship and to describe the baseline characteristics and treatment outcomes of patients who suffered CVT at high altitude in eastern Nepal. Methods We conducted a retrospective analysis of 21 consecutive patients with CVT at a tertiary care center in Nepal from July 2017 to January 2018. Clinical data, radiologic characteristics, therapeutic strategies, and outcomes were analyzed. The Glasgow Outcome Scale (GOS) at discharge was reported for each patient.

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Section: Discussionsupporting

confidence: 75%

“…Nepal is one of the few countries in the world with a higher average altitude (10,000 ft). Increased incidence of CVT has been associated with high elevation [5-7], and strenuous activity at peak summits [6,8-11]. Most of the reports reported an increased incidence of CVT in men at high altitude.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Venous Thrombosis at High Altitude: A Retrospective Cohort of Twenty-one Consecutive Patients

Khattar

Sumardi

Zemmar

et al. 2019

Cureus

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“…Several authors reported CVT at extreme HA [>7200 towards Cho Oyu (8201 m), >5000 m towards Gasherbrum I (8068 m), Mount Everest at 8848 m and at 8511 m] with a length of stay ranging from 20 to 45 days. 66 , 74 - 76 Interestingly, while Khanal et al 66 reported the involvement of the right transverse and sigmoid sinus in a subject with low protein S plasma activity, all the other authors reported the involvement of the superior sagittal sinus in subjects without any known risk factors. 74 - 76 Familial thrombophilia (protein S or C deficiency, heterozygous Factor V Leiden mutation) was identified as the cause of few CVT case reports occurred between 3000 and 8848 m asl.…”

Section: Literature and Research Methodsmentioning

confidence: 99%

Recommendations for traveling to altitude with neurological disorders

Falla

Giardini²,

Angelini

2021

J Cent Nerv Syst Dis

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Background Several neurological conditions might worsen with the exposure to high altitude (HA). The aim of this review was to summarize the available knowledge on the neurological HA illnesses and the risk for people with neurological disorders to attend HA locations. Methods A search of literature was conducted for several neurological disorders in PubMed and other databases since 1970. The neurological conditions searched were migraine, different cerebrovascular disease, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, delirium, dementia, and Parkinson’s disease (PD). Results Attempts were made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation and advice for or against traveling to altitude. Individual cases should be advised after careful examination and risk evaluation performed either in an outpatient mountain medicine service or by a physician with knowledge of HA risks. Preliminary diagnostic methods and anticipation of neurological complications are needed. Conclusions Our recommendations suggest absolute contraindications to HA exposure for the following neurological conditions: (1) Unstable conditions–such as recent strokes, (2) Diabetic neuropathy, (3) Transient ischemic attack in the last month, (4) Brain tumors, and 5. Neuromuscular disorders with a decrease of forced vital capacity >60%. We consider the following relative contraindications where decision has to be made case by case: (1) Epilepsy based on recurrence of seizure and stabilization with the therapy, (2) PD (± obstructive sleep apnea syndrome-OSAS), (3) Mild Cognitive Impairment (± OSAS), and (4) Patent foramen ovale and migraine have to be considered risk factors for acute mountain sickness.

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“…In the present study headache was seen in 94% of patients which was in agreement with previous studies (2,17) . Clinical presentation of CVST is extremely variable, ranging from isolated headache to focal deficits to encephalopathy to psychiatric manifestations to coma (2,8,(18)(19)(20) . Clinical presentation of our cohort is almost identical to what has been reported from the west.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Etiological and Prognostic Factors of Cerebral Venous Sinus Thrombosis in Kashmir-North India

Ahmad¹

2017

jmscr

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Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature

Cited by 8 publications

References 26 publications

Cerebral Venous Thrombosis at High Altitude: A Retrospective Cohort of Twenty-one Consecutive Patients

Cerebral Venous Thrombosis at High Altitude: A Retrospective Cohort of Twenty-one Consecutive Patients

Recommendations for traveling to altitude with neurological disorders

Clinical, Etiological and Prognostic Factors of Cerebral Venous Sinus Thrombosis in Kashmir-North India

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