Introduction: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications.
Objective: The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain.
Methods: We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 11 Spanish centres.
Results: We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3-6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score ≤ 2), with papilloedema (P=.03), focal deficits (P=.001), and encephalopathy (P <.001) showing a statistically significant association with poor prognosis (mRS> 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%.
Conclusion: The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity.
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http://dx.doi.org/10.1016/j.nrl.2021.05.016 | DOI Listing |
J Neuroendocrinol
January 2025
Department of Psychology, Columbia University, New York, New York, USA.
Among contributors to diffusible signaling are portal systems which join two capillary beds through connecting veins. Portal systems allow diffusible signals to be transported in high concentrations directly from one capillary bed to the other without dilution in the systemic circulation. Two portal systems have been identified in the brain.
View Article and Find Full Text PDFJ Cereb Blood Flow Metab
January 2025
AP-HP, Hôpital Lariboisière, Department of Anaesthesia and Critical Care, Paris, France.
In patients with acute brain injury (ABI), optimizing cerebral perfusion parameters relies on multimodal monitoring. This include data from systemic monitoring-mean arterial pressure (MAP), arterial carbon dioxide tension (PaCO), arterial oxygen saturation (SaO), hemoglobin levels (Hb), and temperature-as well as neurological monitoring-intracranial pressure (ICP), cerebral perfusion pressure (CPP), and transcranial Doppler (TCD) velocities. We hypothesized that these parameters alone were not sufficient to assess the risk of cerebral ischemia.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Background: Cases of congenital disorders of glycosylation (CDGs) are rare, and the occurrence of hemorrhagic infarction is also rare. The etiology is unclear.
Observations: A 3-year-old Asian boy with CDG type 1A was hospitalized with pneumonia.
J Trauma Acute Care Surg
January 2025
From the Spencer Fox Eccles School of Medicine (D.G., J.A.), Department of Neurosurgery (D.B., M.T.B., S.T.M., R.G.), Department of Surgery (S.L., J.C., M.M., T.E.), Division of Geriatrics and Department of Internal Medicine (M.P.), University of Utah, Salt Lake City, Utah; and Bowers Neurosurgical Frailty and Outcomes Data Science Lab (C.A.B.), Flint, Michigan.
Background: Preinjury antithrombotic (AT) use is associated with worse outcomes for geriatric (65 years or older) patients with traumatic brain injury (TBI). Previous studies have found that use of AT outside established guidelines is widespread in TBI patients.
Methods: In this single-center retrospective cross-sectional study, we examined inappropriate AT use among geriatric patients presenting with traumatic intracranial hemorrhage.
Radiol Case Rep
March 2025
Resident at Radiology Department, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
Iatrogenic intracranial hypotension is a known complication of spinal anesthesia that can lead to more severe conditions, such as dural or cerebral venous sinus thrombosis (CVST). This report presents a case of intracranial hypotension in a young woman after lumbar anesthesia for a cesarean section that was complicated by CVST and subsequently by lobar hemorrhage, clinically presenting with severe headache and seizures. The diagnosis was made via cerebral magnetic resonance (MR) imaging, and the patient was treated medically.
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