Manifestation Of Cerebral Venous Thrombosis Research Articles

Abstract TMP62: The Delayed Seizure CVT Score Predicts Delayed Seizure After Cerebral Venous Thrombosis - A Secondary Analysis of ACTION-CVT

Introduction: Seizures are a common initial manifestation of cerebral venous thrombosis (CVT). We sought to establish predictive factors for delayed seizures to stratify risk and guide clinical management. Methods: We analyzed data from the Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT) study of consecutive patients with CVT from 2015 - 2020. The primary outcome was delayed seizure(s), occurring after 7 days from CVT diagnosis. Patients with outcome data for late seizures and follow-up of at least 7 days from time of diagnosis were included. Univariate analysis was performed using Chi-square, rank-sum, and t-tests. Variables with P-value < 0.2 were included in the backward stepwise regression model with 0.2 as cutoff, based on which we constructed the Delayed Seizure CVT (Delayed Seizures after CVT) score. Results: We identified 599 patients who met inclusion criteria: mean age 44.9(± 16.6) years, 62.9% female. Delayed seizures occurred in 37 (6.1%) patients. Risk factors included intracranial hemorrhage (OR 2.0 95% CI 0.7-5.74 p=0.196), alcohol abuse (OR 3.88 95% CI 1.45-10.38 p=0.007), focal neurologic deficit (OR 2.05 95% CI 0.95-4.44 p=0.067), seizure on presentation (OR 2.88 95% CI 1.32-6.29 p=0.008), hormonal birth control (OR 2.38 95% CI 1.06-5.37 p=0.0036), endovascular therapy (OR 2.86 95% CI 1.16-7.07 p=0.023) and decompressive hemicraniectomy (OR 3.357 95% CI 1.02-10.99 p=0.046), respectively. Based on coefficients of these variables, a 7-item score was created with acceptable performance for seizure prediction (AUC 0.796, 95% CI 0.72 - 0.86) (Table 1). Conclusions: Delayed seizure CVT score is a clinical tool to identify risk of delayed seizure in CVT. Further research is needed to validate these findings in an external cohort.

Neurological manifestations of cerebral venous thrombosis: experience from a tertiary care center

Background and Objective: 
 Cerebral venous thrombosis (CVT) is a common cause of cerebrovascular accident (stroke). CVT is caused due to blockage in blood flow either in cerebral veins or in dural sinuses. The objective of this study was to determine prevalence of various clinical and imaging characteristics in patients with cerebral venous thrombosis.
 Methods:
 A descriptive retrospective cross-sectional patient data was collected from November 2019 to February 2021. This study was conducted in Neurology Department in Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. This study contains patient medical histories of 60 patients who were admitted in two and a half year time. Monitoring for any seizure occurrence was carried out for all the patients included in this study. Patient medical histories were examined and CT, MRI and MRV Brain were performed.
 Results:
 Superior sagittal sinus was spotted as a hot spot location for CVT. Mean age calculated was 30 while more frequency was recorded in female patients.
 Conclusion:
 CVT is a condition with more prevalence in younger population with more affected females than males. Most common presentation of CVT is headache. Superior sagittal sinuses involved in majority of cases reported. Specificity of modalities used and neurological manifestations needs a validation through a larger cohort study.

Predicting the occurrence of early seizures after cerebral venous thrombosis using a comprehensive nomogram

BackgroundSeizure is a common clinical manifestation of cerebral venous thrombosis (CVT). The mortality rate of patients with CVT with seizure is three times higher than that of patients without seizure. The aim of this study was to develop a nomogram to predict the individual probability of acute seizure events in patients with CVT. MethodThis was a single-center, retrospective cohort study. We analyzed and compared demographic variables, epidemiological risk factors, clinical presentation, laboratory results and imaging data in a cohort of 142 patients who were diagnosed with CVT in our hospital from January 2013 to December 2018. A nomogram was constructed to predict the risk of early seizure (ES) in these patients according to the multivariable logistic regression analysis results. The concordance index, GiViTi calibration belt and decision curve analysis (DCA) were used to assess nomogram performance. ResultsForty-three (30.28%) patients experienced seizure within 2 weeks after a CVT diagnosis. Multivariate analysis identified focal neurologic deficit, Glasgow Coma Scale (GCS) scores ≤ 8 on admission, hemorrhagic lesions, superior sagittal sinus thrombosis (SSST) and frontal lobe lesions as independent predictive factors for ES occurrence after CVT. A nomogram was generated based on these predictive factors with the concordance index reaching 0.82, indicating that the clinical tool was well calibrated. DCA showed that the model was useful with a threshold probability in the range of 0–77%. ConclusionsWe developed the first nomogram that could predict the risk of ES in CVT patients. This effective and convenient tool has shown promising clinical benefit and will assist clinicians in making treatment decisions.

Cerebral Venous Thrombosis: An Unusual Cause of Complex Ophthalmoplegia in an Elderly Man

Cerebral venous thrombosis (CVT) is a neurological condition occurring because of thrombosis involving the cerebral venous sinuses. This case report is an unusual clinical manifestation of cerebral venous thrombosis in a 76-year-old Chinese man who presented with restricted eye movement and double vision. Despite extensive investigation, there was no better explanation for his clinical symptom and sign apart from cerebral venous thrombosis which was confirmed by magnetic resonance venography (MRV) of the brain. Once cerebral venous thrombosis was diagnosed, he was initiated on anticoagulation and discharged with oral warfarin. This case emphasizes the need to consider cerebral venous thrombosis as one of the rare causes of complex ophthalmoplegia especially when typical cardiovascular risk factors are lacking in an individual.

Subdural hematoma as a manifestation of cerebral venous thrombosis. Case report

Cerebral venous thrombosis (CVT) is a common complication in pregnant, postpartum and eclampsia patients in a developing country, more common with another pathology prothrombotic profile. Commonly, acute non-traumatic subdural hematomas are rare in young patients without haematological disorders. We reported a case of acute subdural hematoma (ASH) in a patient with cerebral venous thrombosis. A 34-year-old postpartum woman who present seizure in a postpartum period, was studied in the ICU of our hospital. She is under sedation and CT cranial study to show hyperdensity in the superior longitudinal sinus and the left transverse sinus with diffuse subcortical cortical hypodensity in both parietal and occipital lobes and delta sign. All date according a CVT. In addition, a subdural hematoma is appreciate in the left temporal region. The management was non-surgical and a subsequent CT cranial scan showed resolution of the hematoma. Subsequently prothrombotics studies ruled out a hematological problem. The patient was discharged asymptomatic and with anticoagulant treatment. Patients with CVT are frequently in our environment but it does not exist a large number of studies from the neurological point of view. Neurological manifestations are varied and infrequent in a general neurological approach. Our case illustrates that subdural hematomas can be a symptom of cerebral venous thrombosis.

Anaemia with neuro ophthalmic symptoms as a manifestation of cerebral venous thrombosis

Anaemia with neuro ophthalmic symptoms as a manifestation of cerebral venous thrombosis - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/2395-1451.2019.0032, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Ophthalmol

Clinical and Radiological Manifestations of Cerebral Venous Thrombosis: Are There Any Differences According to Presence or Absence of Cortical Vein Involvement?

Background: Cerebral venous thrombosis (CVT) is difficult to diagnose because of the variety of its clinical and imaging findings and the many anatomical variations in the cerebral venous system. Objectives: We aimed to investigate the clinical and radiological CVT and to evaluate differences in their findings, according to the presence or absence of cortical vein involvement (CVI). Patients and Methods: From the 13 years database of our institution, forty-nine patients were enrolled in the study. In all patients, CVT was confirmed on CT venography, MR venography and/or digital subtraction angiography (DSA). We retrospectively reviewed the clinical presentations and CT and MR findings of the patients and compared their findings, according to the presence or absence of CVI. Results: CVI was detected in 31 patients (63.3%). The most common clinical symptom was headache (61.2%), followed by focal neurologic deficit (FND) (49.0%), seizure (40.8%), and altered consciousness (18.4%). FND was frequent in the CVI group (67.7 vs. 16.7%, P = .001). On CT (n = 49) and/or MR (n = 38), intracranial hemorrhage was present in 33 patients (67.3%) and parenchymal hyperintensity was detected in 24/38 (63.2%). Subarachnoid hemorrhage (SAH) was frequent in the CVI group (51.6 vs. 16.7%, P = .018). The cortical vein (CV) was the most common site of CVT (63.3%), followed by superior sagittal (61.2%), transverse (53.1%), sigmoid (42.9%), and straight (20.4%) sinuses. The superior sagittal sinus thrombosis was frequently associated with concomitant CV thrombosis (74.2 vs. 38.9%, P = .032). Conclusion: CVT commonly involved the CV. Although its clinical manifestation was diverse, FND was common in the CVI group. Intracranial hemorrhage and parenchymal hyperintensity were common CT and MR findings and SAH was commonly associated in the CVI group.

Risk factors and clinical manifestations of cerebral venous thrombosis in patients admitted to Zahedan city hospitals during 2011-2017

Background: In Cerebral venous thrombosis (CVT), blood clots are create in the veins and, blood clots may form in the veins or sinuses. In 78% of cases this problem occurred in people lower than 50 years and in women more than men. The annual prevalence of CVT in Iran was 12.3 per one million which was 2.5 times more than world prevalence.Aims and Objective: The aim of this study was to investigate the Risk factors and clinical manifestations of cerebral venous thrombosis in patients admitted to Zahedan city hospitals. Methods and Materials: This retrospective descriptive study was done on 50 patients with CVT which hospitalized in the Zahedan city hospital. Necessary information such as clinical symptoms, risk factors and demographic data extracted from patients file and analyzed by statistical methods in SPSS.16.Results: In this study, 68% of patients were female and 32% were male. The most prevalent season was summer age group 34-43 years constituting about 28 % of the cases. The prevalent season was summer with 38 % cases and headache was the most prevalent symptom (66%). The most prevalent risk factor was infection comprising 30 % of the total patients.Conclusion: Results showed higher prevalence of CVT in women than in men which could be due to the positive relation between prevalence of this disease and risk factors such as oral contraceptive pill (OCP), pregnancy and post-partum period. Also, in this study the most prevalent symptom was headache and the most prevalent season was summer, which could be due to dehydration of patients. The validity of the current study could be further substantiated with study in the similar pattern with more sample size.Asian Journal of Medical Sciences Vol.9(2) 2018 6-9

Mutism as a Manifestation of Cerebral Venous Thrombosis

Mutism as a Manifestation of Cerebral Venous Thrombosis

Iatrogenic intracranial hypotension and cerebral venous thrombosis

ObjectiveTo assess the manifestations of cerebral venous thrombosis (CVT) associated with intracranial hypotension (IH) following lumbar puncture (LP) or spinal anesthesia (SA). MethodsAdult patients with acute CVT unrelated to infection, neurosurgery, or otolaryngological surgery were identified. CVT manifesting within 21days after LP/SA was considered associated with iatrogenic IH. Presentation of patients with and without associate IH was compared. Results42 patients were included. 11/42 who had undergone LP/SA presented symptoms and imaging characteristics of IH; 31 had no evidence of IH. Those with IH were more often females (11/11 vs. 21/31, p=0.03), presented sooner after symptom onset (6.0±2.2 vs. 15.6±14days, p=0.002), and rates of venous infarction (45% vs. 23%) and seizures (27% vs. 10%) appeared somewhat elevated (p<0.15). Patients with CVT associated with IH had significantly more cortical vein thrombi (55% vs. 16%, p=0.02). Thrombi were significantly shorter in patients with IH (102±113mm vs. 246±133mm, p=0.002). ConclusionPatients with CVT secondary to IH were typically younger females, and presented with a more acute and severe course with frequent venous infarcts. Although thrombi in the IH group were less extensive, they were more often symptomatic.

Transient Global Amnesia as a Presenting Manifestation of Cerebral Venous Thrombosis

Transient Global Amnesia as a Presenting Manifestation of Cerebral Venous Thrombosis

A case of cavernous sinus thrombosis caused by Dialister pneumosintes, Slackia exigua and Prevotella baroniae

Introduction: Cavernous sinus thrombosis (CST) is a rare manifestation of cerebral venous thrombosis. We herein describe the first case of CST associated with the oral microbes (Dialister pneumosintes, Slackia exigua and Prevotella baroniae). Case presentation: An 82‐year‐old previously self‐supported Japanese woman presented with acute onset of impaired consciousness. Computed tomography revealed intracranial haemorrhage complicated with CST. D. pneumosintes, Slackia exigua and P. baroniae were cultivated from two sets of blood cultures and were identified with 16S rRNA sequencing. The patient was successfully discharged after ampicillin–sulbactam treatment, which was performed soon after admission. Conclusion: To our knowledge, this is the first description of CST caused by D. pneumosintes, Slackia exigua and P. baroniae. CST should be considered in cases of unusual distribution of cerebral haemorrhage.

Neurological manifestations of cerebral venous thrombosis: Retrospective case study of 100 patients with our experience in Kuwait

Neurological manifestations of cerebral venous thrombosis: Retrospective case study of 100 patients with our experience in Kuwait

Arteritis de Takayasu y trombosis venosa cerebral: a propósito de un caso

Palpitations, paresthesias and anxiety are very common reasons of consultation in primary care. We report the case of a 40 year-old Caucasian woman who came to the clinic due to these symptoms, and was finally diagnosed with Takayasu arteritis. Later, she had an episode of headache, as the initial manifestation of cerebral venous thrombosis. Takayasu arteritis is a systemic vasculitis affecting medium and large arteries, mainly leacausing stenosis of the aorta and its branches. It most frequently affects Asian women, being much rarer in Europe. The primary care doctor plays a key role in the initial diagnosis and monitoring of patients with rare diseases, such as Takayasu arteritis, and must be a basic support for the patient and family, providing information and advice, and contributing with his work to reduce the vulnerability of this group.

Localized Spontaneous Subarachnoid Hemorrhage as First Manifestation of Cerebral Venous Thrombosis

Localized Spontaneous Subarachnoid Hemorrhage as First Manifestation of Cerebral Venous Thrombosis

Subarachnoid Hemorrhage: A Rare Presentation of Cerebral Venous Thrombosis

Because of its large spectrum of clinical manifestations, diagnosis of cerebral venous thrombosis may be very difficult. Since appropriate treatment influences prognosis, early recognition of this condition is extremely important. We report a subarachnoid hemorrhage as a rare initial manifestation of cerebral venous thrombosis. A 58-year-old woman was admitted with severe headache of sudden onset, neck stiffness, dysarthria, and ataxia. Computed tomography scan showed a subarachnoid hemorrhage in the right posterior fossa. Magnetic resonance imaging coupled with magnetic resonance angiography revealed right transverse/sigmoid sinus thrombosis with hemorrhagic infarction of the right cerebellar hemisphere leading to a pseudotumoral appearance and displacing the fourth ventricle. Anticoagulant treatment resulted in rapid clinical recovery and in resolution of the radiological signs of infarction and of the subarachnoid and subdural hemorrhages.

Cerebral Venous Thrombosis: With Special Reference to Primary Aseptic Thrombosis

The book is a welcome treatise, since in most texts the discussion of cerebral venous embryology, the histology and pathology, the clinical manifestations of cerebral venous thrombosis, and therapy is cursory. The initial chapters are devoted to the embryology, anatomy, and histology of the cerebral venous system. A chapter on clinical manifestations of cerebral venous thrombosis emphasizes the complexity of this subject. It also provides an introduction to the 32 well-documented cases which form the substance of the book. These cases are divided into pediatric and adult examples; the clinical and pathological differences between the two groups warrant such a division. In addition, the series is sufficiently large to be further subdivided on the basis of chronicity. A critical analysis of the clinicopathological findings supplements the case reports. The last chapter, devoted to pathology, radiology, therapy, and prognosis of cerebral venous thrombosis, summarizes what has already been stated and presents