scholarly journals Cerebral venous thrombosis: a practical guide

2020 ◽  
Vol 20 (5) ◽  
pp. 356-367 ◽  
Author(s):  
Leonardo Ulivi ◽  
Martina Squitieri ◽  
Hannah Cohen ◽  
Peter Cowley ◽  
David J Werring
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Stroke Care ◽  
Future Research ◽  
Supporting Evidence ◽  
Permanent Disability ◽  
Decompressive Craniotomy ◽  
Relative Rarity

All neurologists need to be able to recognise and treat cerebral venous thrombosis (CVT). It is difficult to diagnose, partly due to its relative rarity, its multiple and various clinical manifestations (different from ‘conventional’ stroke, and often mimicking other acute neurological conditions), and because it is often challenging to obtain and interpret optimal and timely brain imaging. Although CVT can result in death or permanent disability, it generally has a favourable prognosis if diagnosed and treated early. Neurologists involved in stroke care therefore also need to be aware of the treatments for CVT (with varying degrees of supporting evidence): the mainstay is prompt anticoagulation but patients who deteriorate despite treatment can be considered for endovascular procedures (endovascular thrombolysis or thrombectomy) or neurosurgery (decompressive craniotomy). This review summarises current knowledge on the risk factors, diagnosis, treatment and prognosis of CVT in adults, and highlights some areas for future research.

scholarly journals Cerebral venous thrombosis and Covid 19: Literature review

2021 ◽  
Vol 11 (2) ◽  
pp. 57-68
Author(s):  
Carlos Alexandre Martins Zicarelli ◽  
Jonathan Vinicius Martins ◽  
Wesley Vieira Doni ◽  
Rafael Rodrigues Pinheiro dos Santos ◽  
Ana Carla Mondek Rampazzo ◽  
...  
Keyword(s):  
Literature Review ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Risk Of Death ◽  
Cranial Sinus Thrombosis ◽  
Stent Retrievers ◽  
Low Incidence

Introduction: Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) was first detected in December 2019 in the city of Wuhan, China, and has since taken on worldwide proportions. It is known that individuals with Coronavirus disease-19 (COVID-19) have systemic clinical manifestations. Among the multisystemic effects, cerebral venous thrombosis (CVT) is responsible for high mortality rates. In this sense, understanding the association between CVT and SARS-CoV-2 infection directly impacts the disease's morbidity and mortality. Methodology: Literature review in the PubMed and Embase databases, with the following search terms: “COVID-19”, “SARS-CoV-2”, “Venous thromboembolism”, “Thrombosis”, “Cerebral Venous Thrombosis”, “Intracranial Sinus Thrombosis” and “Cranial Sinus Thrombosis”. The selected articles were written in English, which addressed the various aspects of COVID-19. Results and discussion: CVT are a rare complication of COVID-19, with an incidence between 0.02 to 1% of hospitalized patients. However, it can reach about 75% of mortality in affected individuals. Pathophysiology seems to be associated with the state of hypercoagulability and the systemic inflammatory process resulting from viral infection. Thus, recent studies show a consensus on the early anticoagulation of patients affected by the virus, to reduce mortality in these cases. However, the differences between the types of anticoagulation, Low Molecular Weight Heparin (LMWH), Unfractionated Heparin (UFH), Dabigatran have not yet been well established, although there is a predilection for the use of LMWH. Also, thrombectomy is a therapeutic intervention option that should be evaluated, due to the risk of additional endothelial injury from the use of stent retrievers. Conclusion: Although it has a relatively low incidence, CVT aggravates the condition and increases the risk of death for patients with COVID-19. Because of this, early diagnosis and evaluation of therapeutic options for CVT are essential for the development of clinical management.

scholarly journals Aggressive multiple sclerosis (2): Treatment

2020 ◽  
Vol 26 (9) ◽  
pp. 1045-1063 ◽  
Author(s):  
Georgina Arrambide ◽  
Ellen Iacobaeus ◽  
Maria Pia Amato ◽  
Tobias Derfuss ◽  
Sandra Vukusic ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Current Knowledge ◽  
Companion Paper ◽  
Therapeutic Window ◽  
Future Research ◽  
Permanent Disability ◽  
European Committee ◽  
Efficacious Treatment ◽  
History Of ◽  
Definition Of

The natural history of multiple sclerosis (MS) is highly heterogeneous. A subgroup of patients has what might be termed aggressive MS. These patients may have frequent, severe relapses with incomplete recovery and are at risk of developing greater and permanent disability at the earlier stages of the disease. Their therapeutic window of opportunity may be narrow, and while it is generally considered that they will benefit from starting early with a highly efficacious treatment, a unified definition of aggressive MS does not exist and data on its treatment are largely lacking. Based on discussions at an international focused workshop sponsored by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), we review our current knowledge about treatment of individuals with aggressive MS. We analyse the available evidence, identify gaps in knowledge and suggest future research needed to fill those gaps. A companion paper details the difficulties in developing a consensus about what defines aggressive MS.

scholarly journals Clinicoepidemiological profile of cerebral venous thrombosis in Algarve, Portugal: A retrospective observational study

2015 ◽  
Vol 06 (04) ◽  
pp. 613-616
Author(s):  
Hipólito Nzwalo ◽  
Fátima Rodrigues ◽  
Patricia Carneiro ◽  
Ana Macedo ◽  
Fátima Ferreira ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Venous Thrombosis ◽  
Rural Areas ◽  
Cerebral Venous Thrombosis ◽  
Adult Population ◽  
Diagnostic Delay ◽  
Clinical Manifestations ◽  
Complete Recovery ◽  
Case Review ◽  
Retrospective Case

ABSTRACT Background: Cerebral venous thrombosis (CVT) is a very uncommon disorder with a wide variety of clinical manifestations. There are few studies describing the clinical and epidemiological profile of CVT in peripheral or rural areas. Over the last decades, the frequency in which this disease is diagnosed has increased due to greater awareness and availability of noninvasive diagnostic techniques. Materials and Methods: A hospital-based retrospective case review of adult (≥15 years) patients with CVT between 2001 and 2012 is described. 31 patients with confirmed imagiological diagnosis of CVT were included. Statistical Analysis Used: Statistical analysis was performed using R version 2.15.2. Incidence rate was computed as number of new cases by time. Confidence interval (CI) was set at 95% and P < 0.05 was considered significant. Results: The average annual incidence was 0.84 (CI: 0.58–1.18) to 0.73 (CI: 0.5–1.02) per 100 000 cases for adult population. There were 23 (74%) women and 8 (26%) men. Predominant initial manifestations were headache, followed by altered mental status and seizures. Median diagnostic delay from onset of illness was 8 days. All patients were treated with unfractionated heparin or low-molecular heparin followed by warfarin. Complete recovery occurred in the majority of cases 22 (78.6%) but two patients died during hospitalization. Conclusions: Albeit with some particularities, the epidemiology and clinical manifestations we found are comparable to what has been reported in western studies.

Early clinical manifestations in patients with cerebral venous thrombosis

2013 ◽  
Vol 333 ◽  
pp. e176
Author(s):  
I. Macavei ◽  
O. Costache ◽  
C. Popa ◽  
A. Treaba ◽  
A. Macavei ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Clinical Manifestations

scholarly journals Gender Differences in Risk Factor Profile and Clinical Characteristics in 89 Consecutive Cases of Cerebral Venous Thrombosis

2021 ◽  
Vol 10 (7) ◽  
pp. 1382
Author(s):  
Zoltan Bajko ◽  
Anca Motataianu ◽  
Adina Stoian ◽  
Laura Barcutean ◽  
Sebastian Andone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Clinical Manifestations ◽  
Important Variable ◽  
Term Outcome ◽  
Hematological Disorders ◽  
Risk Factor Profile ◽  
Male Patients

Gender has been shown to be an important variable in cerebral venous thrombosis (CVT) risk and significantly influences its clinical manifestations and outcome. The aim of our study was to investigate the gender-specific risk factor profile and clinical picture of this rare cerebrovascular disorder. Materials and methods: We retrospectively reviewed the medical records of 89 consecutive cases of CVT at a tertiary neurology clinic in Târgu Mures, Romania, between June 2009 and January 2021 to analyze the gender-related differences in etiology, clinical presentation, and outcome. Results: Women comprised 62.5% of the cohort. Females were significantly younger than males (37.3 years versus 48.8 years, respectively, p = 0.001), and the main risk factors were hormone related in 37.9% of the cases, followed by primary thrombophilia (34.4%), smoking (25.8%), obesity (17.2%), infections (17.2%), mechanical factors (17.2%), cancer (8.6%), systemic autoimmune disorders (8.6%), and hematological disorders (8.6%). In male patients, the main risk factors were smoking (41.9%), primary thrombophilia (29%), infections (22.6%), heavy alcohol consumption (16.1%), and venous thromboembolism in the medical history (12.9%). Frequency of headache was higher in females than in males (75.9% versus 67.7%), whereas frequency of coma (6.5% in males versus 1.7% in females) and dizziness (19.4% in males versus 10.3% in females) was higher in males. CVT onset was acute in 41.4% of females and 38.7% of males. The Rankin score at discharge was significantly lower in females compared with males (0.6 versus 1.6), reflecting a more favorable short-term outcome. Mortality was 6.4% in males and 1.7% in females. Conclusions: CVT is a multifactorial disorder that has a broad spectrum of risk factors with important gender-related differences in clinical manifestation and prognosis. Female patients, especially those with hormone-related risk factors, have a more favorable outcome than male patients.

scholarly journals New Insights on Diagnosis and Treatment of Cerebral Venous Thrombosis – A Narrative Review

2021 ◽  
Vol 3 (2) ◽  
pp. 17-20
Author(s):  
Thomas Gabriel Schreiner
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Randomized Clinical Trials ◽  
Acute Stage ◽  
Diagnosis And Treatment ◽  
Future Research ◽  
Symptomatic Therapy ◽  
Invasive Treatment ◽  
Research Directions ◽  
Future Research Directions

Cerebral venous thrombosis (CVT), although accounting for only 0.5-1% of all strokes, remains a potentially fatal neurological emergency, which must be promptly diagnosed and treated. Consisting of two parts, this review aims to highlight the most important data from recent years regarding diagnosis and treatment of CVT, illustrating both the current modern therapeutic approach and the future research directions in the field. Regarding the clinical diagnosis, the neurologist may sometimes have difficulties in recognizing this pathology, given the diverse clinical picture of the acute stage of CVT that can mimic various neurological disorders. In addition, although most risk factors (procoagulation status, infections, trauma, systemic diseases) are known and can be easily detected, in a significant percentage of cases the etiology remains uncertain. For paraclinical diagnosis, among the imaging investigations essential to support the diagnosis, CT angiography and MRI venography are reliable alternatives to digital subtraction angiography which represent the gold standard nowadays. In terms of treatment, international guidelines provide general directions for anticoagulation, with low molecular weight heparin being highly recommended. Regarding invasive treatment methods (thrombolysis, thrombectomy) that could be used in severe cases where anticoagulation has been shown to be insufficient, as well as symptomatic therapy, the evidence is often insufficient, new randomized clinical trials with large cohorts of patients being required.

Cerebral venous thrombosis

2003 ◽  
Vol XXXV (1-2) ◽  
pp. 52-57
Author(s):  
E. I. Bogdanov ◽  
A. T. Zabbarova
Keyword(s):  
Early Diagnosis ◽  
Venous Thrombosis ◽  
19Th Century ◽  
Cerebral Venous Thrombosis ◽  
Clinical Manifestations ◽  
Effective Therapy ◽  
Neurological Symptoms ◽  
Early 19Th Century ◽  
Autopsy Data

Classical descriptions of cerebral venous thrombosis (CVT) have been known since the early 19th century and are based on autopsy data. Focal neurological symptoms, seizures, and coma were considered typical clinical manifestations of CVT. Progress in the development of neuroimaging technology has contributed to the expansion of ideas about the etiology, pathogenesis, spectrum of clinical manifestations and the course of this disease. Currently, the most urgent are the problems of early diagnosis and effective therapy of CVT.

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

2018 ◽  
Vol 9 (3) ◽  
pp. 6-9 ◽  
Author(s):  
Hamed Amirifard ◽  
Alireza Khosravi ◽  
Hoseinali Akbarian
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Clinical Symptoms ◽  
Post Partum ◽  
Oral Contraceptive Pill ◽  
Clinical Manifestations ◽  
City Hospital ◽  
Blood Clots ◽  
Prevalent Symptom

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

The fibroblastic sleeve, the neglected complication of venous access devices: A narrative review

2020 ◽  
pp. 112972982095103
Author(s):  
Giovanna Passaro ◽  
Mauro Pittiruti ◽  
Antonio La Greca
Keyword(s):  
Venous Thrombosis ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Venous Access ◽  
Narrative Review ◽  
Access Device ◽  
Physiological Phenomenon ◽  
Intravascular Foreign Body ◽  
Vascular Access Device ◽  
Venous Access Devices

The presence of a vascular access device (or of any intravascular foreign body) inside the bloodstream is often associated with the formation of a connective tissue sleeve around the catheter (often named—erroneously—“fibrin sleeve”). Such sleeve is usually a physiological phenomenon with little or no clinical relevance, but its pathogenesis is still unclear, so that it is frequently confused with venous thrombosis; also, its relationship with other major catheter-related complications, such as venous thrombosis and bloodstream infection, is uncertain. This narrative review tries to convey in a systematic form the current knowledge about pathogenesis, incidence, clinical manifestations, diagnosis, and management of this phenomenon.

scholarly journals Atypical Vascular Involvement in a Case of Behçet's Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Alejandro Rodríguez Morata ◽  
Ana Hidalgo Conde ◽  
Carlos de la Cruz Cosme ◽  
Susana Gómez Ramírez ◽  
Rafael Gómez Medialdea
Keyword(s):  
Venous Thrombosis ◽  
Behçet’S Disease ◽  
Cerebral Venous Thrombosis ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Unknown Etiology ◽  
Vascular Intervention ◽  
Behcet's Disease

Introduction. Behçet's disease (BD) is a form of vasculitis of unknown etiology which is rare in our environment. It is characterized by a variety of clinical manifestations and usually affects young adults. Recurrent oral and genital ulcers are a characteristic and extremely frequent symptom, but mortality is linked with more significant symptoms such as aortic pseudoaneurysm, pulmonary pseudoaneurysm, and cerebral venous thrombosis.Patient and Method. We present a case of a young male with atypical BD and severe polyvascular involvement (previous cerebral venous thrombosis and current peripheral venous thrombosis, acute ischemia, and peripheral arterial pseudoaneurysm) who required urgent surgical intervention due to a symptomatic external iliac pseudoaneurysm.Result. The pseudoaneurysm was successfully treated, we performed an iliofemoral bypass, and we treated it with steroids and immunosuppressive therapy.Conclusions. These rare clinical manifestations highlight the importance of considering BD in young patients, even in usual cases of vascular intervention, whether arterial or venous in nature.

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