Cerebral venous thrombosis with lupus anticoagulants. Report of two cases.

Levine, Steven R.; Kieran, Stuart N.; Puzio, K.; Feit, Hermann; Patel, Suresh; Welch, K. M. A.

doi:10.1161/01.str.18.4.801

Cited by 78 publications

(30 citation statements)

References 39 publications

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“…Cerebral venous thrombosis was the presenting symptom of SLE in the patient of Shiozawa et al 3 and in our case 1. Cerebral venous thrombosis occurred during pregnancy in the first patient of Levine et al 5 and in our case 6. Assays for antinuclear and anti-DNA antibodies were negative in the patients of Levine et al s and in our cases 1 and 4.…”

Section: Discussionsupporting

confidence: 54%

“…Three of the five 2 -4 fulfilled four or more criteria for SLE. Among the patients of Levine et al, 5 one fulfilled three criteria (arthritis, nephritis, and thrombocytopenia) and can be considered as having probable SLE; the other patient had a history of spontaneous abortions, deep venous thrombosis, pulmonary embolism, and thrombocytopenia with lupus anticoagulant. Cerebral venous thrombosis was the presenting symptom of SLE in the patient of Shiozawa et al 3 and in our case 1.…”

Section: Discussionmentioning

confidence: 99%

“…5 We retrospectively studied six patients fulfilling the classical criteria for SLE 6 who developed cerebral venous thrombosis documented angiographically or anatomically.…”

mentioning

confidence: 99%

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Cerebral venous thrombosis in systemic lupus erythematosus.

Vidailhet

Piette

Wechsler

et al. 1990

Stroke

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We describe six cases of cerebral venous thrombosis in patients with systemic lupus erythematosus. In one patient, cerebral venous thrombosis was the initial manifestation of lupus; in the five others, it occurred 1-33 years after the diagnosis of lupus. The main clinical features of cerebral venous thrombosis were persistent headache in all six patients, focal symptoms in four, and seizures in three; papilledema was present in only one patient. Cerebral venous thrombosis was diagnosed based on angiography or magnetic resonance imaging. Both the transverse (in five patients) and the superior sagittal (in three) sinuses were involved. Extracranial arterial and/or venous thrombosis were present in three patients, abortion in two, thrombocytopenia in four, and lupus anticoagulant in three. The neurologic symptoms resolved rapidly in five patients treated with steroids and heparin. Cerebral venous thrombosis should be suspected in patients with lupus who complain of persistent headache, especially in the presence of neurologic symptoms. (Stroke 1990;21:1226-1231

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Cerebral venous thrombosis in systemic lupus erythematosus.

Vidailhet

Piette

Wechsler

et al. 1990

Stroke

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“…84 - 85 Steroids have failed to prevent systemic thrombosis 41 and are probably not effective in preventing stroke 78 -80 in patients with SLE or LA. The risks of steroid therapy at the levels proven to be effective against spontaneous abortion (40 mg/day) may be acceptable for the duration of a pregnancy, but not for the years required for stroke prevention.…”

mentioning

confidence: 99%

Frequency, etiology, and prevention of stroke in patients with systemic lupus erythematosus.

Futrell

Millikan

1989

Stroke

182

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We retrospectively and prospectively reviewed the incidence of stroke in 105 patients with systemic lupus erythematosus (SLE). Stroke occurred in 14 (15%) of 91 consecutive patients with documented SLE; nine (64%) of the 14 had multiple cerebral infarcts. Factors associated with stroke and the frequency of stroke were systemic thrombosis (30%), elevated partial thromboplastin time (36%), spontaneous abortion (50%), age over 60 years (57%), transient ischemic attacks (57%), previous stroke (64%), and cardiac valvular disease (86%).

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“…Hypercoagulability ap peared to be the final common pathway of all of the risk factors that were found, but this is to be expected when one is studying nonseptic, nontraumatic SSST. The cor relation of pregnancy, the puerperium, malignancy and oral contraceptive pills with SSST has been shown in several previous studies [1][2][3][4][5][6], but the association with the 'lupus anticoagulant' has only been shown in one previous study by Levine et al [7], We recommend searching for the 'lupus anticoagulant' when no other eti ology of SSST is identified.…”

Section: Discussionmentioning

confidence: 96%

Outcome in Nonseptic Spontaneous Superior Sagittal Sinus Thrombosis in Adults

Kaplan¹,

Biller²,

Adams³

1991

Cerebrovasc Dis

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We reviewed clinical features and outcomes of 16 patients (3 men and 13 women) aged 18–68 years, with nonseptic, nontraumatic superior sagittal sinus thrombosis (SSST). Most common risk factors were oral contraceptives, a postpartum state or malignancy. Two patients were noted to have a ‘lupus anticoagulant’; 1 of these had prior venous thrombosis in the legs and recurrent spontaneous abortions but no antiphospholipid antibodies. Five patients had ;poor outcomes, including 4 deaths. Of the 11 patients with good outcomes, 9 had no residual deficits. Intracranial hemorrhage was noted on initial CT in 3 patients. One had hemorrhagic transformation of a bland cerebral infarction without use of anticoagulants, as did 1 after receiving only 1,600 IU of intravenous heparin. Of the 11 patients who had a good outcome, 5 received full-dose intravenous heparin. Of the 5 patients who had a poor outcome, none received full-dose heparin due to the presence of either a large infarction or hemorrhage. Due to its infrequent occurrence and heterogenous nature, recommendations regarding heparin therapy for patients with nonseptic SSST should be individualized.

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Cerebral venous thrombosis with lupus anticoagulants. Report of two cases.

Cited by 78 publications

References 39 publications

Cerebral venous thrombosis in systemic lupus erythematosus.

Cerebral venous thrombosis in systemic lupus erythematosus.

Frequency, etiology, and prevention of stroke in patients with systemic lupus erythematosus.

Outcome in Nonseptic Spontaneous Superior Sagittal Sinus Thrombosis in Adults

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