Clinical features and phathogenesis of cerebral venous sinus thrombosis in patients with malignancy

Abstract

Objective To investigate the clinical features of cerebral venous sinus thrombosis (CVST) in patients with malignancy as well as its underlying pathogenesis. Methods The clinical data, including clinical presentation, laboratory results, neurological images were retrospectively reviewed in hospital patients with active malignant tumor and cerebral venous thrombosis from January 2006 to December 2016. Results Among the 586 CVST patients, 24 patients (4.10%) were with malignant tumor. Among these 24 patients, there were 8 males and 16 females with an average age of (39.88 ± 21.71) years old. Four patients (16.67%) had the risk factors of cerebral venous sinus thrombosis, while the other 20 patients (83.33%) had not any such risk factors. At the symptom onset of CVST, 22 patients (91.67%) had headache and focal neurological deficit, such as limbs weakness and numbness. The common substyles of malignant tumor were lung cancer (33.33%), breast cancer (29.17%) and acute lymphocytic leukemia (20.83%). Most patients (58.33%) were found to have cerebral metastasis .22 patients (91.67%) had elevated plasma D-dimmer level, and 19 patients (79.17%) had elevated plasma cancer biochemical marker levels. Conclusions Cancer-related CVST had the features including lacking conventional risk factors, elevated plasma D-dimmer and cancer biochemical marker levels. Cerebral metastasis and hypercoagulable state may be responsible for the pathogenesis of CVST. Key words: Malignancy; Cerebral venous sinus thrombosis; Clinical features; Pathogenesis; Retrospective studies