scholarly journals Prognostic value of systemic immune–inflammation index in acute/subacute patients with cerebral venous sinus thrombosis

2020 ◽  
Vol 5 (4) ◽  
pp. 368-373
Author(s):  
Shen Li ◽  
Kai Liu ◽  
Yuan Gao ◽  
Lu Zhao ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Cox Regression Analysis ◽  
Venous Sinus Thrombosis ◽  
Immune Inflammation ◽  
Poor Outcomes

ObjectiveTo evaluate the prognosis values of systemic immune–inflammation index (SII) in non-chronic cerebral venous sinus thrombosis (CVST).Methodspatients with CVST, admitted to the First Affiliated Hospital of Zhengzhou University, were retrospectively identified from January 2013 to December 2018. We selected patients in acute/subacute phase from database. Functional outcomes of patients were evaluated with the modified Rankin Scale (mRS)—mRS 3–6 as poor outcomes and mRS 6 as death. The overall survival time was defined as the date of onset to the date of death or last follow-up date. Survival analysis was described by the Kaplan-Meier curve and Cox regression analysis. Multivariate logistic regression analysis assessed the relationship between SII and poor functional outcome. The area under the Receiver Operating Curve curve (AUC) was estimated to evaluate the ability of SII in prediction.ResultsA total of 270 patients were included and their duration of follow-up was 22 months (6–66 months), of whom 31 patients had poor outcomes and 24 patients dead. Cox regression analysis showed that SII (HR=1.304, 95% CI: 1.101 to 1.703, p=0.001) was a predictor of death in non-chronic CVST. Patients with higher SII presented lower survival rates (p=0.003). The AUC of SII was 0.792 (95% CI: 0.695 to 0.888, p=0.040) with a sensitivity of 69.6% and specificity of 80.1%. Subgroups analysis demonstrated that SII was an important predictor of poor outcomes in male (OR=1.303, 95% CI: 1.102 to 1.501, p=0.011) and pregnancy/puerperium female (OR=1.407, 95% CI: 1.204 to 1.703, p=0.034).ConclusionsSII was a potential predictor in the poor prognosis of patients with acute/subacute CVST, especially in male and pregnancy/puerperium female.

Safety and Validity of Mechanical Thrombectomy and Thrombolysis on Severe Cerebral Venous Sinus Thrombosis

Neurosurgery ◽  
2013 ◽  
Vol 72 (5) ◽  
pp. 730-738 ◽  
Author(s):  
Guangwen Li ◽  
Xianwei Zeng ◽  
Mohammed Hussain ◽  
Ran Meng ◽  
Yi Liu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Treatment Modality ◽  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Magnetic Resonance Venography ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Digital Subtract Angiography

Abstract BACKGROUND: Although the majority of patients with cerebral venous sinus thrombosis (CVST) obtain an optimistic clinical outcome after heparin or warfarin treatment, there remains a subgroup of patients who do not respond to conventional anticoagulation treatment. These patients, especially younger people, as documented by hospital-based studies, have a high morbidity and mortality rate. OBJECTIVE: To verify the safety and efficacy of a dual mechanical thrombectomy with thrombolysis treatment modality option in patients with severe CVST. METHODS: Fifty-two patients diagnosed with CVST were enrolled and treated with mechanical thrombectomy combined with thrombolysis. Patients underwent urokinase 100 to 1500 × 103 IU intravenous sinus injection via a jugular catheter after confirming diagnoses of CVST by using either magnetic resonance imaging/magnetic resonance venography or digital subtract angiography. Information obtained on the patients included recanalization status of venous sinuses as evaluated by magnetic resonance venography or digital subtract angiography at admission, during operation, and at 3- and 6-month follow-up after treatment. RESULTS: The percentage of patients that showed complete and partial recanalization were 87% and 6%, respectively, after mechanical thrombectomy combined with thrombolysis treatment; 8% of the patients showed no recanalization. The modified Rankin Scale scores were 1.0 ± 0.9, 0.85 ± 0.63, and 0.37 ± 0.53 for discharge, and 3- and 6-month follow-up, respectively. A total of 6 patients died despite receiving aggressive treatment. No cases of relapse occurred after 3 to 6 months of follow-up. CONCLUSION: Thrombectomy combined with thrombolysis is a safe and valid treatment modality to use in severe CVST cases or in intractable patients that have shown no adequate response to antithrombotic drugs.

scholarly journals Cerebral Venous Sinus Thrombosis, a Nonenhanced CT Diagnosis?

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Alsafi ◽  
Amish Lakhani ◽  
Lalani Carlton Jones ◽  
Kyriakos Lobotesis
Keyword(s):  
Internal Carotid ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Hounsfield Units ◽  
Venous Sinus Thrombosis ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Internal Carotid Arteries

Purpose. Retrospectively evaluate the density of cerebral venous sinuses in nonenhanced head CTs (NCTs) and correlate these with the presence or absence of a cerebral venous sinus thrombus (CVST).Materials and Methods.Institutional review board approval was obtained and informed consent waived prior to commencing this retrospective study. Over a two-year period, all CT venograms (CTVs) performed at our institution were retrieved and the preceding/subsequent NCTs evaluated. Hounsfield Units (HUs) of thrombus when present as well as that of normal superior sagittal and sigmoid sinuses were measured. HU of thrombus was compared to that of normal vessels with and without standardisation to the average HU of the internal carotid arteries.Results. 299 CTVs were retrieved, 26 with a thrombus. Both raw and standardised HU measurements were significantly higher in CVST (p<0.0001) compared to normal vessels. Both raw and standardised HUs are good predictors of CVST. A HU of ≥67 and a standardised measurement of ≥1.5 are associated with high probability of CVST on NCT.Conclusion.Cerebral venous sinus HU measurements may help improve sensitivity and specificity of NCT for venous sinus thrombosis and avoid potentially unnecessary follow-up examinations.

scholarly journals Comparison of MRI Sequences for the Detection of Cerebral Venous Sinus Thrombosis During Follow-Up Examination

2018 ◽  
Vol 78 (5) ◽  
pp. 330
Author(s):  
Ji Eun Choi ◽  
Young Cheol Weon ◽  
Gyeong Min Park ◽  
Jee-Hyun Kwon ◽  
Wook-Joo Kim ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Mri Sequences

scholarly journals Cerebral venous sinus thrombosis after vestibular schwannoma surgery: a call for evidence-based management guidelines

2018 ◽  
Vol 45 (1) ◽  
pp. E4 ◽  
Author(s):  
Hussam Abou-Al-Shaar ◽  
Yair M. Gozal ◽  
Gmaan Alzhrani ◽  
Michael Karsy ◽  
Clough Shelton ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Sinus Thrombosis ◽  
Anticoagulation Therapy ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Evidence Based ◽  
Posterior Fossa Surgery ◽  
Venous Sinus Thrombosis ◽  
True Incidence

OBJECTIVEPostoperative cerebral venous sinus thrombosis (CVST) is an uncommon complication of posterior fossa surgery. The true incidence of and optimal management strategy for this entity are largely unknown. Herein, the authors report their institutional incidence and management experience of postoperative CVST after vestibular schwannoma surgery.METHODSThe authors undertook a retrospective review of all vestibular schwannoma cases that had been treated with microsurgical resection at a single institution from December 2011 to September 2017. Patient and tumor characteristics, risk factors, length of stay, surgical approaches, sinus characteristics, CVST management, complications, and follow-up were analyzed.RESULTSA total of 116 patients underwent resection of vestibular schwannoma. The incidence of postoperative CVST was 6.0% (7 patients). All 7 patients developed lateral CVST ipsilateral to the lesion. Four cases occurred after translabyrinthine approaches, 3 occurred after retrosigmoid approaches, and none occurred following middle cranial fossa approaches. Patients were managed with anticoagulation or antiplatelet therapy. Although patients were generally asymptomatic, one patient experienced intraparenchymal hemorrhage, epidural hemorrhage, and obstructive hydrocephalus, likely as a result of the anticoagulation therapy. However, all 7 patients had a modified Rankin scale score of 1 at the last follow-up.CONCLUSIONSPostoperative CVST is an infrequent complication, with an incidence of 6.0% among 116 patients who had undergone vestibular schwannoma surgery at one institution. Moreover, the management of postoperative CVST with anticoagulation therapy poses a serious dilemma to neurosurgeons. Given the paucity of reports in the literature and the low incidence of CVST, additional studies are needed to better understand the cause of thrombus formation and help to establish evidence-based guidelines for CVST management and prevention.

The Novel Biomarkers-Based HALP (Hemoglobin, Albumin, Lymphocyte And Platelet)-Prognostic Model For Acute And Subacute Patients With Cerebral Venous Sinus Thrombosis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Shen Li ◽  
Kai Liu ◽  
Yuan Gao ◽  
Lu Zhao ◽  
Hui Fang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Functional Outcomes ◽  
Prognostic Model ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Clinical Prognosis ◽  
Venous Sinus Thrombosis

Abstract Background: To evaluate the prognosis values of HALP in acute or subacute cerebral venous sinus thrombosis (CVST), to explore the new prognostic model for CVST.Methods: Consecutive patients who were diagnosed as having acute and subacute CVST were retrospectively investigated. We determined the patients' functional outcomes by modified Rankin Scale (mRS). Multivariate logistic regression analysis was used to assess the relationship between factors and poor functional outcomes. The area under the ROC curve (AUC) was estimated to evaluate the ability of markers and models in predicting clinical prognosis. The prognostic model was presented as nomogram. In addition, the decision curve analysis (DCA) was used to analyze the benefit of this model. Furthermore, survival curves were described by the Kaplan‑Meier analysis. Results: A total of 270 patients were included of which 31 had poor outcome. Multivariable logistic regression analysis demonstrated HALP (OR=0.978, 95%CI: 0.958-0.999, P=0.039) was a protective predictor of outcome. The AUC of HALP was 0.749 (95% CI: 0.633-0.865, P=0.044). DCA demonstrated that this model significantly improved risk prediction at threshold probabilities of CVST at 0 to 85%. Patients with higher HALP (P=0.006) presented higher overall survival rates. Conclusions: HALP may be a potential protective marker in acute and subacute CVST patients. The new prognostic model with HALP had potentially better value for Chinese CVST patients.

scholarly journals The Novel Biomarkers-Based HALP (Hemoglobin, Albumin, Lymphocyte and Platelet)-Prognostic Model for Acute and Subacute Patients with Cerebral Venous Sinus Thrombosis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Shen Li ◽  
Kai Liu ◽  
Yuan Gao ◽  
Lu Zhao ◽  
Hui Fang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Functional Outcomes ◽  
Prognostic Model ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Clinical Prognosis ◽  
Venous Sinus Thrombosis

Abstract Background and purpose: To evaluate the prognosis values of HALP in acute or subacute cerebral venous sinus thrombosis (CVST), to explore the new prognostic model for CVST.Methods: Consecutive patients who were diagnosed as having acute and subacute CVST were retrospectively investigated. We determined the patients' functional outcomes by modified Rankin Scale (mRS). Multivariate logistic regression analysis was used to assess the relationship between factors and poor functional outcomes. The area under the ROC curve (AUC) was estimated to evaluate the ability of markers and models in predicting clinical prognosis. The prognostic model was presented as nomogram. In addition, the decision curve analysis (DCA) was used to analyze the benefit of this model. Furthermore, survival curves were described by the Kaplan‑Meier analysis. Results: A total of 270 patients were included of which 31 had poor outcome. Multivariable logistic regression analysis demonstrated HALP (OR=0.978, 95%CI: 0.958-0.999, P=0.039) was a protective predictor of outcome. The AUC of HALP was 0.749 (95% CI: 0.633-0.865, P=0.044). DCA demonstrated that this model significantly improved risk prediction at threshold probabilities of CVST at 0 to 85%. Patients with higher HALP (P=0.006) presented higher overall survival rates. Conclusions: HALP may be a potential protective marker in acute and subacute CVST patients. The new prognostic model with HALP had potentially better value for Chinese CVST patients.

scholarly journals Lower lymphocyte to monocyte ratio is a potential predictor of poor outcome in patients with cerebral venous sinus thrombosis

2018 ◽  
Vol 4 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Shen Li ◽  
Kai Liu ◽  
Rui Zhang ◽  
Yuan Gao ◽  
Hui Fang ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Cox Regression ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Poor Outcome ◽  
Lymphocyte To Monocyte Ratio ◽  
The Poor ◽  
The Relationship

BackgroundLymphocyte to monocyte ratio (LMR) is associated with functional outcome in patients with stroke. But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis (CVST) has not been investigated.MethodsCVST patients, admitted to the First Affiliated Hospital of Zhengzhou University, were retrospectively identified from November 2010 to January 2017. Functional outcomes of patients were evaluated with the modified Rankin Scale (mRS). Patients were divided into good (mRS 0–2) and poor (mRS 3–6) outcomes groups. Univariate and multivariate Cox regression analyses were used to assess the relationship between LMR and the poor survival outcome.ResultsA total of 228 patients were included of which 41 had poor outcomes (18.0%). The duration of follow-up was 22 months (6–66 months). LMR (2.3±1.2 vs 3.2±1.8, p<0.01) was significantly lower in the poor outcome group. Multivariate Cox regression analysis showed that LMR (HR 0.726, 95% CI 0.546 to 0.964, p=0.027) was a independent predictor of poor prognosis.ConclusionsLMR may be a predictor of poor prognosis in CVST patients.

Endovascular Interventional Management of Cerebral Venous Sinus Thrombosis

2018 ◽  
Vol 1 (1) ◽  
pp. 28-33
Author(s):  
Sunil K. Narayan ◽  
Arunmozhimaran Elavarasi
Keyword(s):  
Risk Factors ◽  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Endovascular Management ◽  
Venous Sinus Thrombosis ◽  
Endovascular Interventions ◽  
Poor Outcomes

Cerebral venous sinus thrombosis (CVST) is relatively a rare cause of stroke and can have protean manifestations ranging from headache, seizures, diplopia, focal deficits or coma. It is usually managed with anticoagulation. However, various studies have shown a mortality of 13% to 30% and have elucidated certain risk factors such as poor sensorium at presentation and rapid deterioration in spite of anticoagulation, for poor outcomes. In these situations, it has been postulated that endovascular management using thrombolysis or mechanical thrombectomy can give better outcomes. This review tries to address the role of endovascular interventions in CVST.

scholarly journals Term Infant with Cerebral Venous Sinus Thrombosis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sanket Jani ◽  
Ralph Ariss ◽  
Pradeep Velumula ◽  
Deniz Altinok ◽  
Sanjay Chawla
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Term Infant ◽  
Venous Sinus ◽  
Common Condition ◽  
Venous Sinus Thrombosis ◽  
Gastrostomy Tubes ◽  
Sinus Venous Thrombosis ◽  
Hypernatremic Dehydration

Hypernatremic dehydration in neonates is a common condition in an exclusively breastfed infant but often underdiagnosed. Any newborn who has lost more than 10% of birthweight should be carefully evaluated and monitored for clinical features of dehydration. Efforts such as frequent follow-up for weight check, and formula supplementation, if needed, should be provided to a neonate at risk of developing complications of dehydration. Adequate lactation consultation, both inpatient and outpatient, should also be provided, especially to the primigravida mother. Here, we present a case of a neonate with severe hypernatremic dehydration caused by inadequate lactation in a primigravida mother, which resulted in cerebral venous sinus thrombosis leading to significant intracerebral hemorrhage. The infant suffered permanent neurologic damage and was sent home on technological devices (tracheostomy and gastrostomy tubes). Further, we provide a brief review of hypernatremic dehydration and sinus venous thrombosis in neonates.

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