Cerebral venous thrombosis in Morocco: retrospective study of 30 cases

Souirti, Zouhayr; Messouak, O.; Belahsen, M.F.

doi:10.11604/pamj.2014.17.281.165

Cited by 17 publications

(16 citation statements)

References 34 publications

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“…Pregnancy and postpartum period are important risk for CVT. High predominance of female involvement was noticed with sex ratio of 2.3 in Morocco [11]. Pregnancy itself is a thrombophilic state due to the changes in blood like increased factor VIII, fibrinogen, decreased Protein S, decreased fibrinolysis, hyperemesis gravidarum, obesity, caesarean section, immobilization and other mechanical and haemodynamic factors due to pregnant state [12].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Pregnancy- Associated Cerebral Venous Thrombosis (CVT) in Three Referral Hospitals in Khartoum, Sudan

Hummeida¹,

Amin²,

Rais³

et al. 2015

Women Heal Int

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Pregnancy- Associated Cerebral Venous Thrombosis (CVT) in Three Referral Hospitals in Khartoum, Sudan

Hummeida¹,

Amin²,

Rais³

et al. 2015

Women Heal Int

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“…5,50,65,73,81,93,[143][144][145][146][147][148][149][150][151][152][153][154][155][156] Considering studies distinguishing CVT occurrence pre or postpartum, we found reports of 65 cases during pregnancy and 199 cases associated with puerperium (ratio 1:3). A summary of the number of CVT cases associated with pregnancy/puerperium, the male:female ratio and the proportion of women with CVT associated with pregnancy in each cohort is described in Table 4.…”

Section: (Recommendations)mentioning

confidence: 99%

“…However, only a few studies clearly stated that women with pregnancy-related CVT received anticoagulation 73,100 and obstetric complications were not a pre-specified outcome in most studies. 81,93,137,144,145,[148][149][150]153,154,156 The anticoagulation trial by Misra et al 73 also included 12 patients with CVT related to pregnancy and, although two patients receiving UFH had vaginal bleeding, there was no reference to specific obstetric complications in pregnant or puerperal women.…”

mentioning

confidence: 99%

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – Endorsed by the European Academy of Neurology

Ferro

Bousser

Canhão

et al. 2017

European Stroke Journal

183

103

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The current proposal for cerebral venous thrombosis guideline followed the Grading of Recommendations, Assessment, Development, and Evaluation system, formulating relevant diagnostic and treatment questions, performing systematic reviews of all available evidence and writing recommendations and deciding on their strength on an explicit and transparent manner, based on the quality of available scientific evidence. The guideline addresses both diagnostic and therapeutic topics. We suggest using magnetic resonance or computed tomography angiography for confirming the diagnosis of cerebral venous thrombosis and not screening patients with cerebral venous thrombosis routinely for thrombophilia or cancer. We recommend parenteral anticoagulation in acute cerebral venous thrombosis and decompressive surgery to prevent death due to brain herniation. We suggest to use preferentially low-molecular weight heparin in the acute phase and not using direct oral anticoagulants. We suggest not using steroids and acetazolamide to reduce death or dependency. We suggest using antiepileptics in patients with an early seizure and supratentorial lesions to prevent further early seizures. We could not make recommendations due to very poor quality of evidence concerning duration of anticoagulation after the acute phase, thrombolysis and/or thrombectomy, therapeutic lumbar puncture, and prevention of remote seizures with antiepileptic drugs. We suggest that in women who suffered a previous cerebral venous thrombosis, contraceptives containing oestrogens should be avoided. We suggest that subsequent pregnancies are safe, but use of prophylactic low-molecular weight heparin should be considered throughout pregnancy and puerperium. Multicentre observational and experimental studies are needed to increase the level of evidence supporting recommendations on the diagnosis and management of cerebral venous thrombosis. KeywordsCerebral venous thrombosis, dural sinus thrombosis, Grading of Recommendations, Assessment, Development, and Evaluation, angiography, venography, D dimers, prothrombotic screening, cancer screening, anticoagulation, heparin, thrombolysis, thrombectomy, acetazolamide, steroids, decompressive surgery, hemicraniectomy, lumbar puncture, shunt, pregnancy, puerperium, contraception, antiepileptic drugs These guidelines followed the traditional methodology of combining review of scientific evidence with expert opinion and classifying evidence and recommendations in complex grading systems, using a matrix combining classes of recommendations with levels of evidence.Since 2010-2011 new information has accumulated on multiple aspects of the diagnosis and management of CVT. We aim to update previous EFNS guidelines using a clearer and evidence base methodology. To achieve that aim, the current proposal for CVT guidelines followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, 3 formulating relevant diagnostic and treatment questions, performing systematic reviews of all available eviden...

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“…The incidence of the cerebral venous sinus thrombosis was among younger age group between 21-40 years which is in concordance with the study done by Mangshetty B et al and Vishwanath K et al 7,8 The mean age of the females in our study was 27 years which is almost similar to the study findings of Souirti Z et al, Simone et al and Basavaraj et al The study findings of Sidhom Y and Yii YL were much higher when compared to our study results. 7,[9][10][11][12] Seizure was common clinical presentation in our study and was higher in our study compared to results of Souirti Z et al, Nagarajan E et al, and Patil VC et al 9,13,14 Headache was seen in 47% of the female patients in our study and was less common presentation compared to the study findings of Souirti Z et al, Appenzeller S et al and Rajoor UG et al The other clinical presentation like seizure, pallor and anemia seen in our study was also seen in other studies. 7,9,10,11,15 The few of the risk factors like hypertension, DM seen in our study was like other studies but the incidence of the risk factors in other studies and our study varied due to difference in study population and regional differences.…”

Section: Discussionmentioning

confidence: 99%

Cerebral venous sinus thrombosis a study to assess clinical profile among female patients in a tertiary care hospital

2019

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Background: The Incidence of Cerebral Venous Thrombosis (CVT) is around 3-4 cases among one million population affecting children and young adults. In India the puerperal CVT is 10-12 times more common than western countries. Even though there is apparent “rarity” of the condition but advances in knowledge and available investigation in terms of imaging (CT scan/MRI) diagnosis can be done early for appropriate treatment and decreasing the morbidity and mortality.Methods: A prospective study was conducted at Karnataka Institute of Medical Sciences, Hubli, Karnataka from December 2014 to November 2015. A total of 36 patients were included in the study.Results: Mean age of females in the study was 27.06±9.033years. 75% had seizures, 47.2% had headache, 19.4% had focal neurological deficit, 13.9% had altered sensorium, 8.3% had cranial nerve deficits 5.6% had speech deficits. 72.22% of patients and were in peripartum period and 27.8% were non-pregnant. 72.2% had superior sagittal sinus involvement, 47.2% had transverse sinus, 47.2% had sigmoid sinus, and 13.9% had internal jugular vein and 5.6% straight sinus. 47.2% had single sinus involvement, and 52.8% had multiple sinus involvement. 94.4% patients were managed conservatively and 5.6% were managed by neurosurgical intervention. 94.4% patients survived and 5.6% had mortality.Conclusions: Cerebral venous sinus thrombosis is most common in young females during peripartum period. Early diagnosis, treatment and if necessary neurosurgical intervention has good outcome.

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Cerebral venous thrombosis in Morocco: retrospective study of 30 cases

Cited by 17 publications

References 34 publications

Epidemiology of Pregnancy- Associated Cerebral Venous Thrombosis (CVT) in Three Referral Hospitals in Khartoum, Sudan

Epidemiology of Pregnancy- Associated Cerebral Venous Thrombosis (CVT) in Three Referral Hospitals in Khartoum, Sudan

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – Endorsed by the European Academy of Neurology

Cerebral venous sinus thrombosis a study to assess clinical profile among female patients in a tertiary care hospital

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