D-dimer levels in patients with suspected acute cerebral venous thrombosis

Tardy, Bernard; Tardy‐Poncet, Brigitte; Viallon, Alain; Piot, Michèle; Garnier, P.; Mohamedi, Radouane; Guyomarc'h, S.; Venet, C.

doi:10.1016/s0002-9343(02)01151-8

Cited by 36 publications

(38 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In summary, our data together with published studies 15,16 suggest that D-dimers are useful in the diagnostic evaluation of headache patients who consult emergency departments and are clinically suspected of having CST. If the native CT scan is normal, then elevated D-dimers can be very helpful to identify the subset of patients who need further radiological diagnostics to exclude CST.…”

Section: Kosinski Et Al Usefulness Of D-dimers In Cerebral Sinus Throsupporting

confidence: 55%

“…Other groups have described normal D-dimer levels in CST patients with rather chronic headaches lasting for Ͼ3 weeks. 15,16 It is known that in acute deep venous thrombosis of the legs, initially raised D-dimer levels may decline to normal within the first week. 17 If this is also the case in CST, then we hypothesized that D-dimers levels might be inversely correlated with duration of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Tardy et al published a report of 18 patients with CST who had symptoms for Ͻ2 weeks and found elevated D-dimers in all subjects. 15 In this study, 34 control patients without CST were selected by a matched design and it was therefore impossible to calculate specificity of D-dimer measurement. Lalive et al published a series of 12 patients with CST and found D-dimers elevated in 10.…”

Section: Kosinski Et Al Usefulness Of D-dimers In Cerebral Sinus Thromentioning

confidence: 99%

See 2 more Smart Citations

Do Normal D-dimer Levels Reliably Exclude Cerebral Sinus Thrombosis?

Kosinski

Mull²,

Schwarz³

et al. 2004

Stroke

104

View full text Add to dashboard Cite

Background and Purpose-Cerebral sinus thrombosis (CST) needs to be considered in the differential diagnosis of all patients with acute headache. Early diagnosis is essential because early treatment may prevent morbidity and may even be life-saving. Definite exclusion, however, needs advanced neuroradiologic diagnostics, which are not readily available in many hospitals. Because measurement of D-dimers has been demonstrated to be helpful in excluding thromboembolic disease, our aim was to investigate whether D-dimers would be also sensitive enough to exclude CST. Methods-We undertook a prospective multicenter study over a 2.5-year period including all patients who came to the emergency departments with symptoms suggestive of CST. All patients were diagnosed either by magnetic resonance venography, spiral computed tomography scan venography, or intra-arterial digital subtraction angiography. D-dimer levels were measured at admission and analyzed by the same method in all patients. Results-A total of 343 patients were included. CST was diagnosed in 35 patients, of whom 34 had D-dimers above the cutoff value (Ͼ500 g/L). From the 308 patients not having CST, D-dimers were elevated in 27. Sensitivity of D-dimers was 97.1%, with a negative predictive value of 99.6%. Specificity was 91.2%, with a positive predictive value of 55.7%. D-dimers were positively correlated with the extent of the thrombosis and negatively correlated with the duration of symptoms (Spearman rank correlation coefficients 0.76, Ϫ0.58, respectively). Conclusions-D-dimer

show abstract

Section: Kosinski Et Al Usefulness Of D-dimers In Cerebral Sinus Throsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Kosinski Et Al Usefulness Of D-dimers In Cerebral Sinus Thromentioning

confidence: 99%

See 1 more Smart Citation

Do Normal D-dimer Levels Reliably Exclude Cerebral Sinus Thrombosis?

Kosinski

Mull²,

Schwarz³

et al. 2004

Stroke

104

View full text Add to dashboard Cite

show abstract

“…A number of small studies, all with methodological limitations, demonstrated high sensitivity for the identification of patients with CVT and a potential role for exclusion of the diagnosis, although this finding was not universal. [77][78][79][80][81] As is the case with its use in DVT and pulmonary embolism (PE), the specificity of D-dimer was poor, because there are many causes of elevated D-dimer. In a well-designed prospective, multicenter study of 343 patients presenting to the emergency department with symptoms that suggested CVT, a positive D-dimer level (defined as a level Ͼ500 g/L) was found in 34 of 35 patients with confirmed CVT and 27 of 308 patients without CVT.…”

Section: D-dimermentioning

confidence: 99%

Diagnosis and Management of Cerebral Venous Thrombosis

Saposnik¹,

Barinagarrementería²,

Brown³

et al. 2011

Stroke

1,695

1,229

View full text Add to dashboard Cite

Background— The purpose of this statement is to provide an overview of cerebral venous sinus thrombosis and to provide recommendations for its diagnosis, management, and treatment. The intended audience is physicians and other healthcare providers who are responsible for the diagnosis and management of patients with cerebral venous sinus thrombosis. Methods and Results— Members of the panel were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and represent different areas of expertise. The panel reviewed the relevant literature with an emphasis on reports published since 1966 and used the American Heart Association levels-of-evidence grading algorithm to rate the evidence and to make recommendations. After approval of the statement by the panel, it underwent peer review and approval by the American Heart Association Science Advisory and Coordinating Committee. Conclusions— Evidence-based recommendations are provided for the diagnosis, management, and prevention of recurrence of cerebral venous thrombosis. Recommendations on the evaluation and management of cerebral venous thrombosis during pregnancy and in the pediatric population are provided. Considerations for the management of clinical complications (seizures, hydrocephalus, intracranial hypertension, and neurological deterioration) are also summarized. An algorithm for diagnosis and management of patients with cerebral venous sinus thrombosis is described.

show abstract

“…32 A total of 14 studies were analysed to obtain data on 363 patients with a confirmed diagnosis of CVT. Seven out of the 14 studies [33][34][35][36][37][38][39][40][41][42][43][44][45][46] included in the metaanalysis provided data on 155 patients in whom CVT was objectively confirmed and on 771 patients in whom CVT was objectively ruled out. D-dimer was elevated in Some interesting data on potential predictors of false-negative D-dimer results in patients with CVT have been derived by the analysis of four studies.…”

Section: Part I: Diagnostic Recommendationsmentioning

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

View full text Add to dashboard Cite

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...

show abstract

D-dimer levels in patients with suspected acute cerebral venous thrombosis

Cited by 36 publications

References 17 publications

Do Normal D-dimer Levels Reliably Exclude Cerebral Sinus Thrombosis?

Do Normal D-dimer Levels Reliably Exclude Cerebral Sinus Thrombosis?

Diagnosis and Management of Cerebral Venous Thrombosis

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

Contact Info

Product

Resources

About