Cerebral Venous Sinus Thrombosis in Children with Acute Lymphoblastic Leukemia carrying the MTHFR TT677 Genotype and Further Prothrombotic Risk Factors

1999 ◽  
Vol 211 (04) ◽  
pp. 211-214 ◽  
Author(s):  
C. Wermes ◽  
G. Fleischhack ◽  
R. Junker ◽  
R. Schobess ◽  
D. Schwabe ◽  
...  
2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098629
Author(s):  
Jingwei Liu ◽  
Chunfeng Yang ◽  
Zhen Zhang ◽  
Yumei Li

Acute lymphoblastic leukemia (ALL) is a hematological malignancy. There are many risk factors for thrombus development in patients with ALL, and thrombi may develop in different parts of the body. Cerebral venous sinus thrombosis (CVST) is a rare complication of ALL that usually appears during treatment. We present a patient who developed CVST twice, once before diagnosis and once after treatment for ALL. We also reviewed the literature describing ALL and CVST.


2021 ◽  
pp. 104-104
Author(s):  
Dragan Nikolic ◽  
Marijana Basta-Nikolic ◽  
Vladimir Manojlovic ◽  
Zeljko Zivanovic ◽  
Sanja Vickovic ◽  
...  

Introduction/Objective. Coagulopathy induced by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) can be an underlying cause of cerebral venous sinus thrombosis (CVST), a less common type of stroke with a variable clinical presentation and high mortality rate. Objective: to present a series of CVST cases associated with SARS-CoV-2 infection. Methods. This retrospective study evaluated clinical, laboratory and radiological presentation, risk factors, barriers to diagnosis, treatment and outcome of patients with SARS-CoV-2 infection induced CVST. Results. The study comprised 6 patients diagnosed with COVID-19 induced CVST during the 18 months period. Majority (66.7%) had no significant risk factors for developing CVST. Median time from initial COVID-19 diagnosis to onset of neurologic deficit was 7 days (interquartile range 0.5-7 days). Clinical presentation comprised non specific neurological symptoms: headache (83.3%) and decreased consciousness (33.3%), together with elevated levels of D-dimer and inflammatory biomarkers. The transverse (n = 4 or 66.7%), superior sagittal sinuses (n = 3 or 50%) and sigmoid sinus (n = 2 or 33.3%) were most commonly affected. Five patients (83.3%) had minimal to no symptoms at discharge (mRS ? 2). In-hospital mortality in our current series was relatively high (16.7%). Conclusion. The high mortality rate of SARS-CoV-2-associated CVST urges clinicians to suspect CVST in patients with a history of COVID-19 infection presenting with non-specific neurological symptoms in order to provide proper treatment and prevent complications.


2020 ◽  
Author(s):  
Yugang Wang ◽  
Qi Fang

Abstract Objective : This study aimed to assess the clinical characteristics of cerebral venous sinus thrombosis (CVT) patients with new-onset headache and to identify the risk factors for headache in this population.Methods : We retrospectively reviewed the demographic and clinical data of 69 CVT patients recruited between September 2017 and September 2019. Patients were classified into two groups, the headache group and the non-headache group, according to the presence or absence of new-onset headache symptoms at admission. The following characteristics and parameters were measured and analyzed, including gender, age, Diseased sinus amount(DSA), and so on.Results : The incidence of headache was 75% in this cohort. The proportion of female patients in the headache group was higher than that in the non-headache group. Patients in the headache group were younger than those without headache. CVT patients of headache group showed higher LR, BUN, and (ICP)compared to the non-headache group, whereas MCV and levels of protein (CSF) and LDH (CSF) were lower in headache patients. The data also revealed younger age and the increased level of chloride ion CL - (CSF) were the risk factors for the occurrence of headache in CVT patients.Conclusions: The age, LR, MCV, BUN levels, ICP, protein (CSF), and LDH (CSF) in patients with headache were significantly different from those in the non-headache group at admission. Younger age and a level of CL - (CSF) were risk factors for headache in CVT patients. These findings may provide guidance for clinical diagnosis and treatment of CVT.


2009 ◽  
Vol 4 (2) ◽  
pp. 111-123 ◽  
Author(s):  
Mohammad Saadatnia ◽  
Farzad Fatehi ◽  
Keivan Basiri ◽  
Seyed Ali Mousavi ◽  
Gilda Kinani Mehr

2016 ◽  
Vol 44 (6) ◽  
pp. 1454-1461 ◽  
Author(s):  
Hafize Nalan Gunes ◽  
Burcu Gokce Cokal ◽  
Selda Keskin Guler ◽  
Tahir Kurtulus Yoldas ◽  
Umit Yavuz Malkan ◽  
...  

Objective Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disease affecting young adults. The majority of the patients are female. The aim of this study is to assess the clinical associations, risk factors and outcomes of the patients with CVST. Methods The data of 75 patients with CVST admitted to our hospital between 2006 and 2016 were reviewed. Demographic and clinical features and the thrombophilic risk factors of the patients were recorded. The localizations of the thrombi were determined and modified Rankin score at the time of onset and discharge were calculated. Results The majority of our patients (78.7%) were female. Median age was 35 years (16–76). The most common symptom was headache (86.7%). In 82.6% of our patients, inherited or acquired risk factors for thrombosis were detected. Transverse sinus was the most common site of thrombosis followed by sigmoid and superior sagittal sinuses. Two thirds of the patients had involvement of multiple sinuses. The patients with the involvement of sagittal sinus had better disability at the time of admittance ( p = 0.013) while the number of involved sinuses was correlated worse disability ( p = 0.015). The neurologic states in the majority of the patients were improved by the end of the hospitalization period ( p = 0.001). There was no significant difference in disability score at discharge between men and women ( p = 0.080). No patient with CVST died in the hospitalization period. Conclusions This study is one of the largest cohort studies on CVST in our region. The results of the study disclosed that CVST had wide range of clinical manifestations and non-specific symptoms at the beginning. For that reason, in especially high risk groups for thrombosis, the diagnosis of CVST should be kept in mind.


2021 ◽  
Vol 10 (34) ◽  
pp. 2960-2963
Author(s):  
Maria Prothasis ◽  
Yash Gupte ◽  
Sourya Acharya ◽  
Samarth Shukla ◽  
Neema Acharya

Thrombosis of cerebral venous channel is a known complication of hypercoagulable states. Hyperhomocysteinaemia is a known hypercoagulable state. Obesity is a modern-day global epidemic. Disorders such as myocardial infarction (MI), stroke, and venous thromboembolism are on the rising trend and its increased morbidity and mortality is being associated with obesity. To date, however, the knowledge about the association between obesity and adult cerebral venous thrombosis (CVT) is sparse. We report a 44-year-old young morbidly obese metabolically unhealthy female who presented with headache, nausea, vomiting and giddiness. On evaluation, magnetic resonance venogram showed cerebral venous sinus thrombosis. On investigations, she had concomitant hyperhomocysteinaemia and metabolic syndrome. Cerebral venous sinus thrombosis causing stroke in young adults is uncommon with various conditions precipitating it.1,2,3 Severe headache (70 - 90 %), focal lateralized signs (25 % - 75 %), seizures (30 – 40 %) as well as behavioural symptoms such as delirium, amnesia, and disturbances in consciousness are the various associated clinical symptoms. The known inherited hypercoagulable risk factors that cause CVST are gain of function mutations in the genes encoding factor V (factor V Leiden) and prothrombin, Protein C, S and antithrombin III deficiency. Hyperhomocysteinaemia, is a known risk factor for causing venous thrombosis of the lower limbs. However, till date there is no data available showing its role in causing cerebral venous thrombosis. The interaction between genetic and acquired determinants result in high plasma levels of total homocysteine (tHcy).4,5,6 Vitamins such as folic acid, pyridoxine, and cobalamin are involved in the metabolic pathways of homocysteine and its deficiencies represent the acquired determinants. Venous thromboembolism (VTE) comprises of deep vein thrombosis of the leg and pulmonary embolism and obesity is now being recognised as one of the risk factors causing it. The risk of VTE is approximately increased to 2-fold in an individual with a body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) of 30 or more compared with a normal BMI (< 25), and higher BMIs increase more risk with approximately 3 times higher risk in individuals with a BMI greater than 40.7, 8,9 Again obesity as a risk factor for CVST is less known.


2021 ◽  
Author(s):  
Wang Shujun ◽  
Zhang Huijie ◽  
Bai Xia ◽  
Wang Hongjian

Abstract BACKGROUND: Cerebral venous sinus thrombosis (CVST) is a rare and devastating complication of inflammatory bowel disease (IBD). Early diagnose and prompt treatment could improve prognosis.AIM: The aim of our study was to investigate the clinical data and risk factors of inflammatory bowel disease with diagnosis of CVST. METHODS: All data of IBD patients were collected from July 2013 and September 2020. Clinical data, risk factors and prognosis were compared between CVST in IBD patients and IBD control group. RESULTS: The incidence of CVST in our study was 0.48%. The mean age of IBD patients with CVST was 34.9 years. Average disease duration of IBD was 4 years when cerebrovascular events occur. Clinical presentation of CVST included headache (73.1%), vomiting (30.8%), limb dysmetria (26.9%), speech impairment (11.5%), blurred vision (7.7%), Epileptic seizures (7.7%) and drowsiness (3.8%). The most common location for CVST was transverse sinus (61.5%), followed by superior sagittal sinus (30.8%). Anemia, low albumin and elevated D-dimer were independent predictors of CVST in IBD patients. Anticoagulation therapy was effective. Prognosis of IBD patients with CVST was worse than those without CVST.CONCLUSION: Early identification the risk of and clinical features of CVST in IBD patients is important. Prompt antithrombotic therapy is safe and effective treatment.


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