Recanalization in Cerebral Venous Thrombosis

Sousa, Diana Aguiar de; Neto, Lia Lucas; Canhão, Patrı́cia; Ferro, José M.

doi:10.1161/strokeaha.118.022129

Cited by 79 publications

(65 citation statements)

References 31 publications

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“…Similarly to our patient, Verma et al described early recanalization of venous sinuses thrombosis with protein S deficiency after 15 days of anticoagulant therapy [4]. According to data available in the literature, a high recanalization grade of CVST independently predicts positive neurological outcome [15], while lack of venous recanalization is associated with worse clinical outcome [16]. A study on 50 subjects indicated that patients with multiple sinus thromboses have a higher case fatality rate [17].…”

Section: Discussionsupporting

confidence: 67%

Bilateral Abducens Nerve Palsy Due to Extensive Cerebral Venous Sinus Thrombosis

et al. 2019

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Cerebral venous sinus thrombosis (CVST) is a relatively rare condition. We present a case of an acute aseptic thrombosis of the sagittal, transverse and sigmoid sinus in a puerperium patient with protein S deficiency. The specifics of the case include high intracranial pressure (ICP) caused by sinus thrombosis with typical symptomatology and bilateral papilloedema, which also manifested in transient bilateral abducens nerve palsy and, consequently, bilateral horizontal diplopia. The recovery of the cranial nerve function occurred 3 to 4 weeks after it was initially reported. Prompt and adequate anticoagulant therapy contributed to the almost complete recanalization of the dural venous sinus thrombosis and a positive outcome of the disease.

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Section: Discussionsupporting

confidence: 67%

Bilateral Abducens Nerve Palsy Due to Extensive Cerebral Venous Sinus Thrombosis

et al. 2019

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“…More than 80% of CVT patients achieved recanalization, either complete or partial, which was associated with a good functional recovery [27,28]. However, it is still unclear whether the lack of recanalization should influence anticoagulant treatment duration, as the evidence on its correlation with CVT recurrence was scarce [28].…”

Section: Prognosismentioning

confidence: 99%

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Riva

Ageno

2020

JCM

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Cerebral vein thrombosis (CVT) and splanchnic vein thrombosis (SVT) are two manifestations of venous thromboembolism (VTE) at unusual sites. They have an incidence at least 25–50 times lower than usual site VTE, but represent true clinical challenges. Recent evidence on the epidemiology, risk factors, prognosis, and treatment of CVT and SVT has been published in the last two decades, thus contributing to a better understanding of these diseases. The improvement in imaging techniques and a higher degree of clinical suspicion may have led to the observed increased frequency, whereas a better knowledge of provoking mechanisms could have contributed to reducing the proportion of events classified as unprovoked or idiopathic (13–21% of CVT, 15–27% of SVT). Few small randomized clinical trials and a number of observational studies, although hampered by heterogeneous therapeutic approaches, shed light on the safety and effectiveness of anticoagulant therapy in these populations. However, there are still some grey areas that warrant future research. In this narrative review, we discuss recent advances and therapeutic challenges in CVT and SVT.

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“…Furthermore, other prognostic factors have been suggested in a single-center cohort study on 81 patients, which brought up a cardiac marker, plasma cardiac troponin (cTn) elevation as a poor prognostic factor of CVT (89). There have been a limited number of studies suggesting venous recanalization as a surrogate biomarker for functional outcomes in CVT (90).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, there was a statistical relationship between clinical outcomes and recanalization. However, it is required to collect further data to ascertain the need for recanalization in patients under anticoagulant therapy with a clinical resolution of the symptoms (90).…”

Section: Discussionmentioning

confidence: 99%

An Update on Diagnosis and Treatment of Cerebral Venous Thrombosis in Adults: A Narrative Review

Paybast

Aghamiri

2020

J Vessel Circ

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Background and Aim: Cerebral venous thrombosis (CVT) is a relatively common disorder of the cerebral venous system accounting for less than 1% of all strokes with a higher prevalence in Iran. Despite the considerable advances in recent years, the diagnosis and treatment of CVT are still challenging predominantly in the emergency setting. Therefore, the present study sought to provide an update on the diagnosis and treatment of CVT. Materials and Methods: PubMed, Web of Science, Google Scholar, Scopus, Elsevier, and Iranian domestic scientific databases were searched within January 1, 2000, to July 1, 2020. In all the electronic databases, the keywords (in the title/abstract) of "cerebral vein thrombosis" OR "CVT" OR "Cerebral venous sinus thrombosis" OR "CVST" AND "risk factor", "diagnosis", "treatment", and "prognosis" were searched. The unrelated articles, studies not concerning humans or pediatric population, and case reports were excluded from the study. In addition, the articles related to CVT in association with coronavirus disease 2019 infection were excluded from the present review. Results: According to the findings of the present study, the diagnosis of CVT might be delayed due to a wide range of clinical manifestations from a subacute headache with or without the signs of intracranial hypertension to the acute focal neurologic deficit and even loss of consciousness. Although the diagnosis is typically based on brain magnetic resonance imaging and magnetic resonance venography, there has been evidence suggesting that the plain computed tomography markers with an attenuation value of > 60.4 Hounsfield unit (HU) and Hounsfield-hematocrit (H: H) ratio of > 1.42 are specific enough for the diagnosis regardless of confirmatory imaging, such as venography. Additionally, the usefulness of D-dimer is still debatable, and an unacceptable false-negative rate of up to 26% has been illustrated. In terms of therapeutic aspects, although warfarin is still the mainstay of treatment, there has been increasing interest in new oral anticoagulants with promising results in both thrombus recanalization and excellent functional recovery. Balloon angioplasty and mechanical thrombectomy might also be considered in severely progressive cases without response to conventional treatments. It is worth mentioning that even for those achieving favorable outcomes, CVT can remain a disabling condition leading to at least neuropsychiatric complaints. Conclusion: The CVT is a rare and important cause of stroke accounting for less than 5% of all strokes mainly affecting young females. With regard to the rarity of the disease and novelty of the therapeutic approaches, there is a long way to fully identify the best diagnostic and therapeutic approaches to the disease.

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Recanalization in Cerebral Venous Thrombosis

Cited by 79 publications

References 31 publications

Bilateral Abducens Nerve Palsy Due to Extensive Cerebral Venous Sinus Thrombosis

Bilateral Abducens Nerve Palsy Due to Extensive Cerebral Venous Sinus Thrombosis

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

An Update on Diagnosis and Treatment of Cerebral Venous Thrombosis in Adults: A Narrative Review

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