Cerebral venous thrombosis

Silvis, Suzanne M.; Sousa, Diana Aguiar de; Ferro, José M.; Coutinho, Jonathan M.

doi:10.1038/nrneurol.2017.104

Cited by 324 publications

(358 citation statements)

References 135 publications

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“…Currently many reports showed the important role of AGEs in the pathogenesis of AS [21][22][23]. Related functions mainly include the following contents: Firstly, AGEs may lead to instability and secondary rupture of plaque surface fibrous layer.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical manifestations include symptoms and body signs of focal cerebral dysfunction, such as cognitive disorder, sensory dysfunction, paralysis, or aphasia. The observation of carotid artery AS plaque is an important indicator for preventing the development of cerebral thrombosis [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

“…Cerebral thrombosis severely threatens public health, and it is critical to investigate its risk factors for further prevention and treatment [1][2][3][4]. Advanced Glycation End Products (AGEs) are heterogeneous, long-lived protein adducts which are generated from a nonenzymatic chemical reaction between sugars and the amino acid [5].…”

Section: Introductionmentioning

confidence: 99%

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Serum levels of advanced glycation end products in type II diabetic patients with acute cerebral infarction

Ju¹,

Zhao²,

Li³

et al. 2018

biomedicalresearch

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Background: Advanced glycation end products (AGEs) are reported to be associated with diabetic vascular complications. However, the role of AGEs in the pathogenesis of cerebral thrombosis remains unclear. This study aimed to investigate the relationship between advanced glycation end products (AGEs) generation and pathogenesis of cerebral thrombosis. Methods: 100 patients with cerebral thrombosis were recruited and 50 healthy controlled individuals were served as a control group. Enzyme Linked Immunosorbent Assay (ELISA) was applied for measuring serum AGEs level. The condition of carotid intima was examined by carotid ultrasonography. Serum AGEs levels were compared among patients with certain conditions of carotid atherosclerosis. Results: AGEs levels in carotid plaque or thickening groups showed significant difference compared with those in control group. Carotid plaque patients showed remarkably different AGEs levels compared to thickening patients. AGEs levels were significantly elevated with higher severity of carotid plaque. Moderate or severe stenosis patients, or blocked group showed significantly different AGEs compared to mild stenosis group. Severe stenosis or blockade group showed remarkably different AGEs compared with moderate stenosis patients. In addition, severe stenosis group had statistically different AGEs compared with blockade group. Conclusion: AGEs level is correlated with pathogenesis of cerebral thrombosis and they are further elevated with aggravation of carotid atherosclerosis in patients, suggesting they might be used as a biomarker to evaluate the severity of atherosclerosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Serum levels of advanced glycation end products in type II diabetic patients with acute cerebral infarction

Ju¹,

Zhao²,

Li³

et al. 2018

biomedicalresearch

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“…The goal of treatment is to stabilize the clot and allow intrinsic fibrinolysis to reduce clot burden. In randomized controlled trials, this treatment has been demonstrated to be safe even in the presence of intracranial hemorrhage [6, 9]. Guideline recommendations suggest the use of unfractionated or low-molecular-weight heparin followed by vitamin K antagonists [6].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…However, a subset of patients experience progressive sinus thrombosis and clinical deterioration despite systemic heparin therapy [4-6]. In these patients with medically refractory CVT, pharmacological thrombolysis and endovascular techniques, such as aspiration thrombectomy, balloon angioplasty, and mechanical thrombectomy, have been utilized alone or in combination with medical management of raised intracranial pressure (ICP) or decompressive craniectomy to remove thrombosis and optimize edema and improve outcome [7-9]. Surgical management in medically refractory CVT has typically been limited to ICP monitoring and treatment of intracranial hypertension.…”

Section: Introductionmentioning

confidence: 99%

Surgical Superior Sagittal Sinus Thrombectomy in Refractory Thrombosis: A Technical Note

et al. 2019

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Objective: Surgical treatment options are limited for medically and endovascular refractory cerebral venous sinus thrombosis (CVT). We describe the technical feasibility of open, direct sinus thrombectomy in a pediatric patient with medically and endovascular refractory CVT. Methods: A 15-year-old patient with superior sagittal sinus (SSS) thrombosis refractory to medical and endovascular treatment experienced clinical deterioration with the progression of bifrontal hematomas and cerebral edema. The patient was treated surgically with a decompressive hemicraniectomy and burr hole SSS thrombectomy with a Fogarty balloon and direct sinus injection of tissue plasminogen activator. Results: Surgical treatment with decompressive craniotomy and direct sinus thrombectomy was technically feasible with excellent intracranial pressure control, and radiological recanalization of the superior sagittal sinus with a good clinical outcome. Conclusion: Direct surgical sinus thrombectomy is a potential concomitant treatment strategy with decompressive craniectomy for medically refractory CVT in a pediatric setting.

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Clinical Characteristics and Pharmacological Management of COVID-19 Vaccine–Induced Immune Thrombotic Thrombocytopenia With Cerebral Venous Sinus Thrombosis

et al. 2021

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IMPORTANCEThe COVID-19 pandemic saw one of the fastest developments of vaccines in an effort to combat an out-of-control pandemic. The 2 most common COVID-19 vaccine platforms currently in use, messenger RNA (mRNA) and adenovirus vector, were developed on the basis of previous research in use of this technology. Postauthorization surveillance of COVID-19 vaccines has identified safety signals, including unusual cases of thrombocytopenia with thrombosis reported in recipients of adenoviral vector vaccines. One of the devastating manifestations of this syndrome, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), is cerebral venous sinus thrombosis (CVST). This review summarizes the current evidence and indications regarding biology, clinical characteristics, and pharmacological management of VITT with CVST.OBSERVATIONS VITT appears to be similar to heparin-induced thrombocytopenia (HIT), with both disorders associated with thrombocytopenia, thrombosis, and presence of autoantibodies to platelet factor 4 (PF4). Unlike VITT, HIT is triggered by recent exposure to heparin. Owing to similarities between these 2 conditions and lack of high-quality evidence, interim recommendations suggest avoiding heparin and heparin analogues in patients with VITT. Based on initial reports, female sex and age younger than 60 years were identified as possible risk factors for VITT. Treatment consists of therapeutic anticoagulation with nonheparin anticoagulants and prevention of formation of autoantibody-PF4 complexes, the latter being achieved by administration of high-dose intravenous immunoglobin (IVIG). Steroids, which can theoretically inhibit the production of new antibodies, have been used in combination with IVIG. In severe cases, plasma exchange should be used for clearing autoantibodies. Monoclonal antibodies, such as rituximab and eculizumab, can be considered when other therapies fail. Routine platelet transfusions, aspirin, and warfarin should be avoided because of the possibility of worsening thrombosis and magnifying bleeding risk.CONCLUSIONS AND RELEVANCE Adverse events like VITT, while uncommon, have been described despite vaccination remaining the most essential component in the fight against the COVID-19 pandemic. While it seems logical to consider the use of types of vaccines (eg, mRNA-based administration) in individuals at high risk, treatment should consist of therapeutic anticoagulation mostly with nonheparin products and IVIG.

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Cerebral venous thrombosis

Cited by 324 publications

References 135 publications

Serum levels of advanced glycation end products in type II diabetic patients with acute cerebral infarction

Serum levels of advanced glycation end products in type II diabetic patients with acute cerebral infarction

Surgical Superior Sagittal Sinus Thrombectomy in Refractory Thrombosis: A Technical Note

Clinical Characteristics and Pharmacological Management of COVID-19 Vaccine–Induced Immune Thrombotic Thrombocytopenia With Cerebral Venous Sinus Thrombosis

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