Isolated Cortical Vein Thrombosis After Epidural Anesthesia: Report of Three Cases

Yıldız, Özlem; Balaban, Hatice; Çil, Gülsüm; Öztoprak, İbrahim; Bolayır, Ertuğrul; Topaktaş, Suat

doi:10.3109/00207451003778751

Cited by 13 publications

(7 citation statements)

References 11 publications

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“…Reduction in CSF decreases brain buoyancy and induces a downward shift of the brain, causing pachymeningeal inflammation and mechanical distortion of the cortical veins, which activates the endogenous blood coagulation pathway leading to thrombosis. 1,2,38,48 Four patients were considered to be in a hypercoagulable state. One patient was using oral contraception, which increases risk for venous thrombosis through decreased function of the endogenous anticoagulation pathway.…”

Section: Discussionmentioning

confidence: 99%

Isolated cortical vein thrombosis: case series

Singh¹,

Cope²,

Zhou³

et al. 2015

JNS

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The majority of these patients were adult females, consistent with published data. Seizures and headaches were the most common presenting symptoms. Hypercoagulable state and intracranial hypotension, both known risk factors for thrombosis, were the most commonly noted ICVT risk factors. Intraparenchymal involvement was prevalent in nearly all ICVT cases and presented as vasogenic edema, early intraparenchymal hemorrhage, or hemorrhagic venous infarction. Susceptibility-weighted imaging was the most sensitive imaging technique in diagnosing ICVT.

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Section: Discussionmentioning

confidence: 99%

Isolated cortical vein thrombosis: case series

Singh¹,

Cope²,

Zhou³

et al. 2015

JNS

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“…The mean age of 51 patients with ICVT was 38.3 years (range, 14–78 years), similar to that of patients with overall CVT (39.1 years), 3) and male:female ratio was 1:2.0 with proportionally more males than in CVT (1:2.9). 3) Coagulation abnormalities were observed in 7 cases, including reduced protein C/S activity, 4) factor V Leiden, 2 , 5) mutation of methylenetetrahydrofolate reductase, 6) and the 4G/4G genotype of plasminogen activator inhibitor-1. 6) Many patients were suspected to be in a hypercoagulable state because of contraceptive intake, 2 , 7 – 12) postpartum status, 2 , 4 – 6 , 13) Behcet's disease, 2) Hodgkin's disease, 11) leukemia, 14) and ulcerative colitis.…”

Section: Discussionmentioning

confidence: 99%

“…Ten patients (23.3%) had intracranial hypotension syndrome (IHS) (7 after lumber puncture), which was the second largest group with underlying disease. 2 , 6 , 7 , 11 , 13 , 16 , 17) IHS was reported to be a risk factor for CVT. 18 – 20) The proportion associated with IHS of ICVT was relatively higher than that of CVT (2%).…”

Section: Discussionmentioning

confidence: 99%

Isolated Superficial Sylvian Vein Thrombosis With Long Cord Sign: Case Report and Review of the Literature

Kitamura

Hara

Tsunematsu

2014

Neurol. Med. Chir.(Tokyo)

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Isolated cortical vein thrombosis (ICVT) is extremely rare. Only single case or small series of ICVT have been reported; clinical details are still uncertain. We report a case of isolated superficial sylvian vein thrombosis with exceedingly long cord sign. A 14-year-old female with severe sudden onset headache visited our hospital. Fluid attenuated inversion recovery and echo-planar T 2 * susceptibility-weighted imaging (T 2 *SW) showed a long cord sign on the surface of the sylvian fissure. The patency of dural sinuses and deep cerebral veins were confirmed by magnetic resonance venography (MRV), and diagnosis of ICVT was made. She recovered completely without anticoagulant agents. To clarify the clinical characteristics of ICVT, we reviewed 51 ICVT cases in the literature. In many cases, T 2 *SW was the most useful examination to diagnose ICVT. In contrast with general cerebral venous thrombosis, MRV and conventional angiography were either supporting or useless. Anastomotic cortical veins were involved frequently; symptoms of gyri around the veins were common. It also suggested that ICVTs of the silent area might have been overlooked because of nonspecific symptoms, and more patients with ICVT may exist. In cases involving patients with nonspecific symptoms, the possibility of ICVT should be considered.

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“…This leads us to assume an analogy between the present case and a post-dural-puncture patient regarding the mechanism of CVT formation. 8–15) After dural puncture, CSF leakage leads to IH and decreased CSF. A “rostrocaudal sagging” effect acts on the intracranial contents.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Thrombosis after Ventriculoperitoneal Shunting: A Case Report

Matsubara

Ayuzawa

Aoki

et al. 2014

Neurol. Med. Chir.(Tokyo)

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Ventriculoperitoneal shunting (VPS) is a simple procedure, but there are several potential complications. We describe the first reported case of cerebral venous thrombosis (CVT) after VPS. A 69-year-old man suffering from normal pressure hydrocephalus underwent left VPS. Two months later he developed CVT and cerebral venous hemorrhage in the left frontal lobe. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the thrombus formation just adjacent to the shunt tube. One possible cause is compression of the cortical vein after brain shift and/or tension of the cortical vein due to intracranial hypotension (IH). A protein C deficiency was also detected. Surgeons should be aware that cerebral venous thrombosis can occur after VPS.

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Isolated Cortical Vein Thrombosis After Epidural Anesthesia: Report of Three Cases

Cited by 13 publications

References 11 publications

Isolated cortical vein thrombosis: case series

Isolated cortical vein thrombosis: case series

Isolated Superficial Sylvian Vein Thrombosis With Long Cord Sign: Case Report and Review of the Literature

Cerebral Venous Thrombosis after Ventriculoperitoneal Shunting: A Case Report

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