Superior Sagittal Sinus Thrombosis Associated with Primary Antiphospholipid Syndrome —Case Report—

Nagai, Shoichi; Horie, Yukio; Akai, Takuya; Takeda, Shigenori; Takaku, Akira

doi:10.2176/nmc.38.34

Cited by 20 publications

(5 citation statements)

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“…Shlebak 128 IgG Transverse sinus, sigmoid sinus Warfarin Shlebak 128 IgG Transverse sinus Warfarin Behrendt et al 129 IgM and IgG Superior sagittal sinus, right transverse sinus Warfarin, venticuloperitoneal shunt Pelegrina Molina et al 130 IgG Superior sagittal sinus, right transverse sinus Warfarin, corticosteroids Nagai et al 131 Unspecified Superior sagittal sinus, cortical vein Corticosteroids Miki et al 132 Unspecified Straight sinus Anticoagulation Ikejiri et al 133 IgG Right transverse sinus NR Numata et al 134 Unspecified Cortical vein Therapeutic heparin Hsieh et al 135 IgM Superior sagittal sinus, right transverse sinus Warfarin, corticosteroids Sakamoto et al 136 Unspecified Superior sagittal sinus Warfarin brain small vessels leading to inflammatory vascular occlusion. 79 Despite that SLE is characterized by low complement levels, elevated complement levels were associated with stroke.…”

Section: Reference Antibody Subtype Vein Treatmentmentioning

confidence: 99%

Lupus, antiphospholipid syndrome, and stroke: An attempt to crossmatch

Hasbani

Uthman

2023

Lupus

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Cerebrovascular accidents (CVAs) or strokes are part of the common thrombotic manifestations of Systemic Lupus Erythematosus (SLEs) and Antiphospholipid syndrome (APS). Such neurological thrombotic events tend to occur in patients with SLE at a higher frequency when Antiphospholipid antibodies (aPLs) are present, and tend to involve the large cerebral vessels. The mechanism of stroke in SLE can be driven by complement deposition and neuroinflammation involving the blood–brain barrier although the traditional cardiovascular risk factors remain major contributing factors. Primary prevention with antiplatelet therapy and disease activity controlling agent is the basis of the management. Anticoagulation via warfarin had been a tool for secondary prevention, especially in stroke recurrence, although the debate continues regarding the target international normalized ratio (INR). The presence of either of the three criteria antiphospholipid antibodies (aPLs) and certain non-criteria aPL can be an independent risk factor for stroke. The exact mechanism for the involvement of the large cerebral arteries, especially in lupus anticoagulant (LAC) positive cases, is still to be deciphered. The data on the role of non-criteria aPL remain very limited and heterogenous, but IgA antibodies against β2GPI and the D4/5 subunit as well as aPS/PT IgG might have a contribution. Anticoagulation with warfarin has been recommended although the optimal dosing or the utility of combination with antiplatelet agents is still unknown. Minimal data is available for direct oral anticoagulants (DOACs).

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Section: Reference Antibody Subtype Vein Treatmentmentioning

confidence: 99%

Lupus, antiphospholipid syndrome, and stroke: An attempt to crossmatch

Hasbani

Uthman

2023

Lupus

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“…75 In addition, anti-b2GPI antibodies can lead to sinovenous thrombosis in adults. 76 Pediatric ischemic arterial stroke. Most of the data present for the association of anti-b2GPI antibodies and pediatric ischemic stroke discussed the role of the IgG isotype (Table 6).…”

Section: Anti-b2-glycoprotein I Antibodymentioning

confidence: 99%

Antiphospholipid antibodies and cerebrovascular thrombosis in the pediatric population: Few answers to many questions

Hasbani

Taher

Sunji

et al. 2021

Lupus

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Most of the knowledge in pediatric antiphospholipid syndrome (APS) is derived from studies performed on the adult population. As in adults, antiphospholipid antibodies (aPL) can contribute to thrombosis, especially cerebrovascular thrombosis, in neonates and children. Since aPL have the potential to cross the placental barrier, and since the pediatric population is prone to infections, re-testing for their positivity is essential to specify their role in cerebrovascular thrombosis. In this review, we aimed at assessing the prevalence of aPL, criteria or non-criteria, in neonatal and childhood ischemic stroke and sinovenous thrombosis trying to find an association between aPL and cerebrovascular thrombosis in the neonatal and pediatric population. Also, we looked into the effect of aPL and anticoagulants/antiplatelets on the long term neurological outcomes of affected neonates or children. The questions regarding the prevalence of aPL among pediatric patients with cerebrovascular thrombosis, the relationship between the titers of aPL and incidence and recurrence of cerebrovascular events, the predictability of the long term neurological outcomes, and the most optimal anticoagulation plan are still to be answered. However, it is crucial for clinicians to screen neonates and children with cerebrovascular thrombosis for aPL and confirm their presence if positive.

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“…It is an acquired thrombophilia and clearly associated with venous thrombosis -including CVST (178,179). It is an acquired thrombophilia and clearly associated with venous thrombosis -including CVST (178,179).…”

Section: Non-pregnancy-specific Causes Of Strokementioning

confidence: 99%