Lesion probability map in cerebral vein thrombosis due to Behçet's disease

Abstract

Aim Behçet's disease (BD) is a multisystemic inflammatory disease. Cerebral venous sinus thrombosis (CVST) is the second most common form of neuro‐BD after parenchymal central nervous system involvement. The purpose of this study was to construct flow‐void probability maps of patients with CVST with and without BD to visually illustrate the impacted cerebral venous sinuses, to compare the subgroups of patients, and investigate the effect of thrombus localization on clinical findings. Methods Seventeen patients with a diagnosis of BD‐related CVST (CVST‐BD) and 23 patients with a diagnosis of CVST related to other etiologies (CVST‐O) were included. We collected data including gender, age at onset of BD and CVST, presenting symptoms, neurological findings, and the etiology. High‐resolution magnetic resonance venographies obtained during CVST were used to mark and digitalize thrombosed areas. Thrombus probability and subtraction maps were created to reveal the differences between the subgroups. Results Remarkably, all patients with CVST‐BD had thrombosis in the transverse sinus (TS). However, TS was affected in 73.9% of the CVST‐O patients (17/17 in CVST‐BD vs 17/23 in CVST‐O, P = .03). Thrombosis developed mostly in the superior sagittal sinus (SSS) and TS in the CVST‐O group (11/23, 47.8% and 17/23, 73.9%, respectively). The frequency of SSS thrombosis tended to be higher in the CVST‐O (47.8% vs 23.5%, P = .19). Conclusion Venous infarction and hemorrhage were less common in patients with CVST‐BD. The only clinical symptom in most of the CSVT patients with BD was headache due to elevated intracranial pressure. TS thrombosis was more common in patients with BD.

Characteristics of Cerebral Venous Sinus Thrombosis Due to Autoimmune Diseases

“…12 The most frequently involved sinuses are TS and SSS in BS, SLE, and SS, respectively. 4,12,20,24,28 Multiple or dual sinus thrombosis occurs in ~two-thirds of patients in BS and 70.6% in SLE. 20,28 However, studies also state that the SSS is most frequently affected or that single sinus thrombosis is more common in BS.…”

“…4,12,20,24,28 Multiple or dual sinus thrombosis occurs in ~two-thirds of patients in BS and 70.6% in SLE. 20,28 However, studies also state that the SSS is most frequently affected or that single sinus thrombosis is more common in BS. 22,29,30 In our study, multiple or dual sinus thrombosis was predominant in the cohort (75%).…”

“…CVST in BS is strongly associated with systemic major vessel thrombosis, and extracranial vascular thrombosis is more common in patients who develop CVST 12 . The most frequently involved sinuses are TS and SSS in BS, SLE, and SS, respectively 4,12,20,24,28 . Multiple or dual sinus thrombosis occurs in ~two-thirds of patients in BS and 70.6% in SLE 20,28 .…”

Long‐term efficacy, safety, and cumulative retention rate of antitumor necrosis factor‐alpha treatment for patients with Behcet's uveitis: A systematic review and meta‐analysis

“…Vascular involvement is occurred in 20%‐50% of patients in BD, and BD has a greater impact on veins 5–7 . However, the ocular and mucocutaneous systems are the most frequently affected organ systems in BD 8 .…”

“…4 Vascular involvement is occurred in 20%-50% of patients in BD, and BD has a greater impact on veins. [5][6][7] However, the ocular and mucocutaneous systems are the most frequently affected organ systems in BD. 8 It has been reported that approximately 50%-70% of BD patients experience ocular involvement, which can manifest as either anterior or posterior uveitis, vitreous inflammation, retinal vasculitis, scleritis, or optic neuropathy.…”