The clinical characteristic, diagnosis, treatment, and prognosis of cerebral cortical vein thrombosis: a systematic review of 325 cases

Song, Shu; Lan, Duo; Wu, Xinxin; Wang, Mengqi

doi:10.1007/s11239-020-02229-x

Cited by 17 publications

(34 citation statements)

References 14 publications

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“…CVT can present with a multitude of neurological symptoms depending on many factors such as age and the anatomical location of the thrombus [ 6 - 7 ]. Headache is notoriously the most common symptom of CVT (up to 90% of all cases) [ 7 ] and can result from either mechanical stretching of trigeminal nerve fibers in the walls of the occluded sinus or from cortical and dural inflammation [ 1 - 2 ]. However, CVT-related headache location and characteristics are extremely heterogeneous, ranging from thunderclap pain to less specific features (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Other less common risk factors include genetic or paraneoplastic thrombophilia, infectious or autoimmune disorders, and traumatic skull injury [1][2][4][5]. CVT can present with a multitude of neurological symptoms depending on many factors such as age and the anatomical location of the thrombus [6][7]. Headache is notoriously the most common symptom of CVT (up to 90% of all cases) [7] and can result from either mechanical stretching of trigeminal nerve fibers in the walls of the occluded sinus or from cortical and dural inflammation [1][2].…”

Section: Introductionmentioning

confidence: 99%

“…throbbing pain with nausea, vomit, phono/photophobia-mimicking migraine, or other primary headache disorders [6,8]. Few studies attempting to identify a recurrent headache pattern have failed to provide univocal data [6][7] so that the clinical suspicion of acute CVT still relies on the concomitant presence of risk factors and neuroimaging findings [1][2][4][5][6][7][8]. Furthermore, the relationship between headache and neuroimaging findings has been not univocally characterized, and the only reported association is between occipital pain and sigmoid sinus thrombosis [9][10].…”

Section: Introductionmentioning

confidence: 99%

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Clinicoradiological Profile and Functional Outcome of Acute Cerebral Venous Thrombosis: A Hospital-Based Cohort Study

Foschi¹,

Pavolucci²,

Rondelli³

et al. 2021

Cureus

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Introduction Acute cerebral venous thrombosis (CVT) may result in a variety of clinical presentations, with headache being the most common. The relationship between clinical and neuroradiological characteristics in acute CVT patients is still not univocally characterized. Materials and methods We enrolled 32 consecutive acute CVT patients admitted to our emergency department from January 1, 2012, to June 30, 2019. Clinicoradiological associations and their relationship with the functional outcome at the discharge were tested. Results Headache was the presenting symptom in 85% of patients, more frequently subacute (82%), new-onset (67%), with unusual features in respect to prior headache episodes (100%), and associated with concomitant neurological symptoms/signs (74%). Patients with holocranial headache showed more frequent venous ischemia (VI) compared to those with bilateral and unilateral headache (50% vs. 20% vs. 0%, respectively; p=0.027). Patients with concomitant neurological defects had a higher prevalence of VI (50.0% vs. 15.0%; p=0.049) and superior sagittal sinus thrombosis (67% vs. 30%; p=0.043) than those without. Vomit was more frequently observed in patients with straight sinus thrombosis (67% vs. 8%; p=0.005). Increasing age and VI were independently associated with poor (modified Rankin scale (mRS) 2-5) functional outcome (odds ratio (OR) = 1.081, 95% confidence interval (CI) 1.004-1.165; p=0.038 and OR = 12.089, 95% CI 1.141-128.104; p=0.039, respectively). Conclusions Our study confirms and enriches available data on the clinicoradiological profile of patients with acute CVT and suggests that increasing age and venous ischemia are independently associated with poor outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinicoradiological Profile and Functional Outcome of Acute Cerebral Venous Thrombosis: A Hospital-Based Cohort Study

Foschi¹,

Pavolucci²,

Rondelli³

et al. 2021

Cureus

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“…Several reviews have implicated IH as a contributor to ICVT. 2,26 Based on data from our hospital, the incidence of ICVT observed in patients with IH was ~ 0.4%…”

Section: Discussionmentioning

confidence: 99%

Intracranial hypotension as a contributor to isolated cortical vein thrombosis

et al. 2022

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Background: Isolated cortical vein thrombosis (ICVT), a rare type of cerebral venous thrombosis (CVT), is diagnostically challenging in some cases, and intracranial hypotension (IH) is known to cause CVT. Methods:In this study, we reviewed the clinical and imaging characteristics of ICVT in patients with IH caused by spinal cerebrospinal fluid leakage, based on a literature review and investigation of cases from our hospital.

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“…It is well-established that ICoVT is the rarest subtype of CVST that presents as an isolated occlusion of anastomotic surface veins ( 2 , 14 ). It remains a poorly understood condition without established guidelines for rapid identification or precise treatment.…”

Section: Discussionmentioning

confidence: 99%

Malignant Isolated Cortical Vein Thrombosis as the Initial Manifestation of Primary Antiphospholipid Syndrome: Lessons on Diagnosis and Management From a Case Report

et al. 2022

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BackgroundAntiphospholipid syndrome (APS) with isolated cortical vein thrombosis (ICoVT) is an extremely rare but potentially malignant entity. It is particularly challenging to diagnose APS-related ICoVT because of the non-specific clinical manifestations and the frequent absence of typical neuroimaging. Moreover, there is currently limited knowledge on the clinical features and management strategies for the condition. Delays in diagnosis and treatment may lead to life-threatening consequences.Case PresentationWe present a rare case of a 74-year-old Chinese woman who presented with sudden onset of headache and right arm weakness that mimicked acute ischemic stroke. Her initial computed tomography was unremarkable, and intravenous thrombolysis was performed. Serial neuroimages confirmed ICoVT 4 days after symptom onset, and low-molecular-weight heparin (LMWH) was started at a dose of 0.4 ml twice per day, according to the 2019 Chinese guidelines. The workup for the predisposing causes of ICoVT revealed triple positivity APS. LMWH dose was adjusted according to the anti-Xa chromogenic assay. However, the patient’s condition deteriorated rapidly, and there was a progressive enlargement of the venous infarction despite treatment with anticoagulants. Transtentorial herniation developed on day 12, and decompressive craniectomy was immediately performed. The patient’s symptoms did not improve significantly after surgery, and she remained aphasic and hemiplegic at the 3-month follow-up, with a modified Rankin Scale score of 5.ConclusionICoVT is a rare yet potentially fatal manifestation of APS, and its diagnosis and treatment are extremely challenging. Timely diagnosis, prompt treatment, and close monitoring are essential to improve the clinical prognosis of patients with APS-related ICoVT.

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The clinical characteristic, diagnosis, treatment, and prognosis of cerebral cortical vein thrombosis: a systematic review of 325 cases

Cited by 17 publications

References 14 publications

Clinicoradiological Profile and Functional Outcome of Acute Cerebral Venous Thrombosis: A Hospital-Based Cohort Study

Clinicoradiological Profile and Functional Outcome of Acute Cerebral Venous Thrombosis: A Hospital-Based Cohort Study

Intracranial hypotension as a contributor to isolated cortical vein thrombosis

Malignant Isolated Cortical Vein Thrombosis as the Initial Manifestation of Primary Antiphospholipid Syndrome: Lessons on Diagnosis and Management From a Case Report

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