Cerebral Venous Thrombosis

2018 ◽  
pp. 253-264
Author(s):  
Juan Ramos-Canseco ◽  
Maxim Mokin
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Heart Association ◽  
Diagnostic Value ◽  
Surgical Interventions ◽  
Evidence Based Guidelines ◽  
And Control

Establishing the diagnosis of cerebral venous thrombosis (CVT) can often be challenging to physicians. CVT presents with variable symptoms, resulting in delay in establishing the correct diagnosis and treatment. This chapter provides practical recommendations on the currently available diagnostic and treatment options in patients with suspected acute CVT. The diagnostic value of computed tomography, magnetic resonance imaging, and catheter angiography are also discussed. This chapter also includes recommendations for medical treatment with systemic anticoagulation, the role of endovascular therapy, and indications for surgical interventions including hemicraniectomy and control of intracranial pressure. Formal evidence-based guidelines released by the American Heart Association in 2011 are also outlined in this chapter.

scholarly journals Diagnostic value of D-dimer’s serum level in Iranian patients with cerebral venous thrombosis

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Leila Hashami ◽  
Vahid Rakhshan ◽  
Hoda Karimian ◽  
Mehdi Moghaddasi
Keyword(s):  
Serum Level ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Binary Logistic Regression ◽  
Diagnostic Value ◽  
High Morbidity ◽  
Potential Association ◽  
Sensitivity Specificity ◽  
And Control ◽  
D Dimer

Cerebral venous thrombosis (CVT) is a longterm debilitating vascular brain disease with high morbidity and mortality. It may be associated with rise in D-dimer level. The aim of this study was to examine this potential association and identify the critical D-dimer cut-off level corresponding to increase the risk of CVT. This case-control study was conducted on two groups of patients with and without CVT attending the Rasool Akram Hospital (Iran) during 2014 and 2015. D-dimer levels were measured by the rapid sensitive D-dimer assay. Data were analyzed by Spearman’s correlation coefficient test, independent-samples t-test, backward-selection multiple linear regression and multiple binary logistic regression analyses. Sensitivity-specificity tests were used to detect D-dimer cut-off for CVT. Differences between the D-dimer levels of the case and control groups were significant (P<0.001). It showed that each level of increase in the number of symptoms could increase the risk of thrombosis occurrence for about 3.5 times. All symptom types except for headache were associated with D-dimer level, while headache has negative association with D-dimer level. D-dimer cut-off point for CVT diagnosis was estimated at 350 ng/mg. We concluded that D-dimer serum level significantly rises in CVT patients. A rounded cut-off point of 350 ng/mg can be used as a diagnostic criterion for CVT prediction.

scholarly journals When Does the Incremental Risk Format Aid Informed Medical Decisions? The Role of Learning, Feedback, and Number of Treatment Options

2020 ◽  
Vol 40 (2) ◽  
pp. 212-221 ◽  
Author(s):  
Kevin E. Tiede ◽  
Felicia Ripke ◽  
Nicole Degen ◽  
Wolfgang Gaissmaier
Keyword(s):  
Medical Information ◽  
Treatment Options ◽  
Control Group ◽  
Total Risk ◽  
Medical Decisions ◽  
Medical Treatments ◽  
Multiple Trials ◽  
Number Of Treatment ◽  
And Control

Background. Informed medical decisions require understanding the benefits and risks of treatments. This entails comparing treatment outcomes to a control group. The incremental risk format has been recommended as it directly visualizes the differences between treatment and control group in 1 graph, whereas they have to be calculated from 2 separate graphs in the total risk format. We investigated when the incremental risk format aids understanding. Methods. In 2 experiments, participants received information about medical treatments, either as incremental or total risk format. We assessed verbatim knowledge (precise quantitative knowledge), gist knowledge (knowledge of essential meaning), and evaluations of the formats. Study 1 ( N = 99) consisted of only 1 trial with medical information and also assessed recall. Study 2 ( N = 222) assessed learning across multiple trials and also varied the presence of feedback and the number of treatment options. Results. In study 1, the incremental risk format (v. total risk format) led to worse knowledge, recall, and evaluations. In study 2, participants learned to understand the incremental risk format over time, resulting in comparable verbatim knowledge and evaluations as in the total risk format, as well as in even better gist knowledge. Feedback and number of treatment options did not moderate the effect of risk format. Limitations. The studies were conducted with nonpatient samples, and study 2 employed hypothetical treatments. Conclusions. The incremental risk format was initially less understandable than the total risk format. After a short learning period, however, the incremental risk format resulted in better gist knowledge and was comparable otherwise, which suggests that participants had to get used to that format. This has important implications for the study of new formats.

Role of anticoagulation in idiopathic cerebral venous thrombosis

1994 ◽  
Vol 11 (2) ◽  
pp. 146
Author(s):  
Divya S. Khurana ◽  
F. Buonnano ◽  
D. Ebb ◽  
K.S. Krishnamoorthy
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis

A Case of Multiple Sclerosis with Cerebral Venous Thrombosis: The Role of Lumbar Puncture and High-Dose Steroids

2002 ◽  
Vol 47 (1) ◽  
pp. 57-58 ◽  
Author(s):  
Dilek Ince Gunal ◽  
Nazire Afsar ◽  
Nese Tuncer ◽  
Sevinc Aktan
Keyword(s):  
Multiple Sclerosis ◽  
Venous Thrombosis ◽  
Lumbar Puncture ◽  
Cerebral Venous Thrombosis ◽  
High Dose

scholarly journals ROLE OF CT VENOGRAPHY AND MR VENOGRAPHY IN CEREBRAL VENOUS THROMBOSIS

2016 ◽  
Vol 3 (61) ◽  
pp. 3284-3291
Author(s):  
Dayananda Kumar R ◽  
Vinod Shah ◽  
Rakesh Lal ◽  
Yadav R.C
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Mr Venography ◽  
Ct Venography

scholarly journals Outpatient Management of Asthma in Children

2013 ◽  
Vol 7 ◽  
pp. CMPed.S7867 ◽  
Author(s):  
André Schultz ◽  
Andrew C. Martin
Keyword(s):  
Treatment Options ◽  
Symptom Control ◽  
Correct Diagnosis ◽  
Asthma Management ◽  
Asthma Severity ◽  
Pediatric Health Care ◽  
Asthma Symptoms ◽  
Inhaled Therapy ◽  
The Impact

The principal aims of asthma management in childhood are to obtain symptom control that allows individuals to engage in unrestricted physical activities and to normalize lung function. These aims should be achieved using the fewest possible medications. Ensuring a correct diagnosis is the first priority. The mainstay of asthma management remains pharmacotherapy. Various treatment options are discussed. Asthma monitoring includes the regular assessment of asthma severity and asthma control, which then informs decisions regarding the stepping up or stepping down of therapy. Delivery systems and devices for inhaled therapy are discussed, as are the factors influencing adherence to prescribed treatment. The role of the pediatric health care provider is to establish a functional partnership with the child and their family in order to minimize the impact of asthma symptoms and exacerbations during childhood.

scholarly journals Genetic polymorphism patterns suggest a genetic driven inflammatory response as pathogenesis in appendicitis

2019 ◽  
Vol 35 (2) ◽  
pp. 277-284
Author(s):  
Jan Dimberg ◽  
Marie Rubér ◽  
Marita Skarstedt ◽  
Manne Andersson ◽  
Roland E. Andersson
Keyword(s):  
Inflammatory Response ◽  
Diagnostic Value ◽  
Inverse Association ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Etiologic Role ◽  
Genetic Mechanisms ◽  
Stratified Analysis ◽  
And Control

Abstract Purpose The pathogenesis of appendicitis is not well understood. Environmental factors are regarded most important, but epidemiologic findings suggest a role of inflammatory and genetic mechanisms. This study determines the association of single nucleotide polymorphisms (SNPs) of inflammatory genes with appendicitis. Methods As part of a larger prospective study on the diagnostic value of inflammatory variables in appendicitis, the genotype frequency of 28 polymorphisms in 26 inflammatory response genes from the appendicitis and control patients was analyzed in blood samples from 343 patients, 100 with appendicitis, and 243 with non-specific abdominal pain, using TaqMan SNP genotyping assays. Results Associations with appendicitis were found for SNPs IL-13 rs1800925 with odds ratio (OR) 6.02 (95% CI 1.52–23.78) for T/T versus C/C + T/T, for IL-17 rs2275913 with OR 2.38 (CI 1.24–4.57) for A/A vs G/G + GA, for CCL22 rs223888 with OR 0.12 (0.02–0.90), and for A/A vs G/G + GA. Signs of effect modification of age for the association with appendicitis were found for IL-13 rs1800925 and CTLA4 rs3087243. Stratified analysis showed difference in association with severity of disease for IL-17 rs2275913 and CD44 rs187115. Conclusions The association of gene variants on risk of appendicitis and its severity suggest an etiologic role of genetically regulated inflammatory response. This may have implications for understanding the prognosis of untreated appendicitis as a possible self-limiting disorder and for understanding the inverse association of appendicitis with ulcerative colitis.

Perfusion and Infusion for Melanoma In-Transit Metastases in the Era of Effective Systemic Therapy

2015 ◽  
pp. e528-e534 ◽  
Author(s):  
Dirk J. Grünhagen ◽  
Hidde M. Kroon ◽  
Cornelis Verhoef
Keyword(s):  
Systemic Therapy ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Limb Perfusion ◽  
Effective Delivery ◽  
In Transit ◽  
And Control ◽  
Systemic Agents ◽  
Necrosis Factor

The management of melanoma in-transit metastases (IT-mets) is challenging. For many years, the absence of effective systemic therapy has prompted physicians to focus on regional therapies for melanoma confined to the limb. The introduction of isolated limb perfusion (ILP) and isolated limb infusion (ILI) has enabled effective delivery of cytotoxic drugs in an isolated circuit, so as to overcome systemic toxicity and maximize local response. Both techniques have evolved over years and both tumor necrosis factor (TNF)-alpha–based ILP and ILI have distinct indications. The development of new systemic treatment options for patients with melanoma in the past decade has shed a new light on melanoma therapy. The present manuscript focuses on the modern role of ILI and ILP in the treatment of patients with melanoma with in-transit metastases in the era of effective systemic therapy. The response and control rates of ILI/ILP are still superior to rates achieved with systemic agents. The extent of disease in patients with stage III disease, however, warrants effective systemic treatment to prolong survival. There is great potential in combining rapid response therapy such as ILI/ILP with systemic agents for sustainable response. Trial results are eagerly awaited.

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