Updates in Cerebral Venous Thrombosis

Alimohammadi, Arshia; Kim, Diana; Field, Thalia S.

doi:10.1007/s11886-021-01622-z

Cited by 17 publications

(38 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cerebral venous sinus thrombosis (CVST) is a rare condition with an approximate incidence rate of 1-2 per 100,000 person-years [1]. When left untreated, CVST can result in severe neurological complications, such as stroke, seizures, or coma [1][2][3][4][5][6][7][8]. Patients with underlying CVST account for 0.5-1% of all stroke cases [1,5].…”

Section: Introductionmentioning

confidence: 99%

A 44-Year-Old Male With Cerebral Venous Sinus Thrombosis

Shabbir¹,

Hunsucker²,

Martin³

et al. 2023

Cureus

View full text Add to dashboard Cite

Cerebral venous sinus thrombosis (CVST) is a rare condition that can result in severe neurological complications when left untreated. Disease pathology results from thrombus development within the superficial cortical veins or the dural sinuses. Thrombosis impedes cerebral drainage leading to venous congestion and consequent increase in cerebral pressure, parenchymal damage, and blood-brain barrier disruption. Headache is the most common presenting symptom; other symptoms include focal neurological signs, seizures, papilledema, and altered sensorium. Diagnosis is typically made with visualization of obstructed flow in the cerebral venous system using one of three imaging modalities: computed tomography-venography (CTV), magnetic resonance imaging with venography (MRV), and diagnostic cerebral angiography. First-line therapy for CVST is anticoagulation, and the prognosis is generally favorable with early detection and prompt treatment. In this case report, we discuss a singular case of a patient presenting with loss of consciousness who was found to have CVST and treated with anticoagulation therapy in the setting of an intraparenchymal hemorrhage.

show abstract

Section: Introductionmentioning

confidence: 99%

A 44-Year-Old Male With Cerebral Venous Sinus Thrombosis

Shabbir¹,

Hunsucker²,

Martin³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…[10][11][12][13][14] Since the publication of ISCVT, there have been advances in the diagnosis and treatment of CVT patients. [15][16][17][18] However, it remains unclear whether these advances have impacted outcomes of CVT patients. Risk stratification of patients may help with clinical decision making and identify those who could benefit from further treatment and study.…”

Section: Introductionmentioning

confidence: 99%

“…From this cohort, the ISCVT risk score (ISCVT-RS) for poor neurological outcome was derived and validated, and has subsequently seen more widespread use than similar scores [ 10 - 14 ]. Since the publication of ISCVT, there have been advances in the diagnosis and treatment of CVT patients [ 15 - 18 ]. However, it remains unclear whether these advances have impacted outcomes of CVT patients.…”

Section: Introductionmentioning

confidence: 99%

Outcome Prediction in Cerebral Venous Thrombosis: The IN-REvASC Score

et al. 2022

View full text Add to dashboard Cite

Background We identified risk factors, derived and validated a prognostic score for poor neurological outcome and death for use in cerebral venous thrombosis (CVT). Methods We performed an international multicenter retrospective study including consecutive patients with CVT from January 2015 to December 2020. Demographic, clinical, and radiographic characteristics were collected. Univariable and multivariable logistic regressions were conducted to determine risk factors for poor outcome, mRS 3-6. A prognostic score was derived and validated. Results A total of 1,025 patients were analyzed with median 375 days (interquartile range [IQR], 180 to 747) of follow-up. The median age was 44 (IQR, 32 to 58) and 62.7% were female. Multivariable analysis revealed the following factors were associated with poor outcome at 90- day follow-up: active cancer (odds ratio [OR], 11.20; 95% confidence interval [CI], 4.62 to 27.14; P<0.001), age (OR, 1.02 per year; 95% CI, 1.00 to 1.04; P=0.039), Black race (OR, 2.17; 95% CI, 1.10 to 4.27; P=0.025), encephalopathy or coma on presentation (OR, 2.71; 95% CI, 1.39 to 5.30; P=0.004), decreased hemoglobin (OR, 1.16 per g/dL; 95% CI, 1.03 to 1.31; P=0.014), higher NIHSS on presentation (OR, 1.07 per point; 95% CI, 1.02 to 1.11; P=0.002), and substance use (OR, 2.34; 95% CI, 1.16 to 4.71; P=0.017). The derived IN-REvASC score outperformed ISCVT-RS for the prediction of poor outcome at 90-day follow-up (area under the curve [AUC], 0.84 [95% CI, 0.79 to 0.87] vs. AUC, 0.71 [95% CI, 0.66 to 0.76], χ2 P<0.001) and mortality (AUC, 0.84 [95% CI, 0.78 to 0.90] vs. AUC, 0.72 [95% CI, 0.66 to 0.79], χ2 P=0.03). Conclusions Seven factors were associated with poor neurological outcome following CVT. The INREvASC score increased prognostic accuracy compared to ISCVT-RS. Determining patients at highest risk of poor outcome in CVT could help in clinical decision making and identify patients for targeted therapy in future clinical trials.

show abstract

“…CVT accounts approximately 1/3 of pregnancy-associated strokes with an incidence of 9/100.000 pregnancies [13]. Oral contraceptives (OC) are a contributing factor in up to 70 % of cases, additionally it is known that there is a synergistic effect of obesity and OC [14]. Independent risk factors in the puerperium are excessive vomiting, infections, caesarean delivery, increasing maternal age and arterial hypertension [13].…”

mentioning

confidence: 99%

“…10 -15 % of patients still have modified Rankin score (mRS) 3-6, but majority have good functional outcome [13]. Worse prognosis is described in older age patients, male, when ICH is present at admission and if patient has depressed level of consciousness at the presentation [14]. The most frequent complication of CVT is arteriovenous fistula.…”

mentioning

confidence: 99%