Abstract W MP109: Childhood Cerebral Sinovenous Thrombosis (CSVT): Long-Term Neuropsychological Outcomes

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Aly Aziz ◽  
Robyn Westmacott ◽  
Ann-Marie Pontigon ◽  
Gabrielle deVeber ◽  
Daune MacGregor ◽  
...  
Keyword(s):  
Executive Function ◽  
Sinus Thrombosis ◽  
Neuropsychological Testing ◽  
Cerebral Sinovenous Thrombosis ◽  
Cognitive Behaviour ◽  
Significant Difference ◽  
Sinovenous Thrombosis ◽  
Neuropsychological Outcomes ◽  
Perceptual Reasoning

Background: Outcome from childhood CSVT particularly in infants is poor. Most studies report “general” neurological outcomes; few describe neuropsychological outcomes specifically. Objectives: To study the spectrum of neuropsychological deficits following childhood CSVT. Methods: Retrospective review of clinical data [incl pediatric stroke outcome measure (PSOM)] & neuropsychological testing (NPT) from 1995-2011 was conducted. NPT included IQ [Wechsler Intelligence Score for Children (WISC-IV), Wechsler Preschool & Primary Scale of intelligence (WPPSI-III)], executive function [Behaviour Rating Inventory of Executive Function (BRIEF)] & attention [Test of everyday attention for children (Tea-Ch)]. Full scale IQ (FSIQ) included verbal comprehension (VCI), perceptual reasoning (PRI), working memory (WMI) & processing speed (PSI) index. Results: NPT was performed in 48/206 subjects. 41 (34 males) were analyzed [excl: cavernous sinus thrombosis (5), prematurity (1), concurrent arterial stroke (1)]. Mean age at NPT: 5.4-y (neonatal CSVT) and 8.5-y (non-neonatal CSVT; mean time from CSVT to NPT 2.4-y). NPT was abnormal (atleast 1SD below mean) in 87% patients in one (29%) or multiple (58%) tests. FSIQ was abnormal in 64% [VCI-69%, PRI-80%, WMI-71%, PSI-79%). Compared to normative population, patients scored significantly lower on FSIQ (p=0.026), VCI (p=0.608), PRI (p= 0.032), WMI (0.124) and PSI (p=0.007). No significant difference was seen in FSIQ between groups [neonates/non-neonates (p=0.827), single/multiple sinus (p=0.2), present/absent parenchymal lesions (p=0.991)]. However males scored significantly lower on FSIQ (p=0.006), PRI (p=0.004), WMI (p=0.002)& PSI (p=0.002)] but not on VCI (0.69)]. BRIEF [metacognition (p=0.061) & executive composite (p=0.095)] & Tea-Ch (p=0.046) scores were also poorer in males. Mean cognitive/behaviour sphere score (max 2.0) of PSOM (assessed closest to NPT) was worse in males (0.41) than females (0.14). Conclusions: Majority of childhood CSVT survivors (males > females) have detectable cognitive deficits on detailed NPT on long term follow-up. NPT is useful in accurate assessment of CSVT outcome & could guide academic interventions. Larger studies are needed to replicate these findings.

Abstract WP383: Neuropsychological Outcomes Following Pediatric Cerebral Sinovenous Thrombosis

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Emily C Maxwell ◽  
Kathleen Hassara ◽  
Timothy J Bernard ◽  
Richard Boada
Keyword(s):  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis ◽  
Neuropsychological Outcomes

Long‐term cognitive outcomes after cerebral sinovenous thrombosis in childhood

2020 ◽  
Vol 62 (12) ◽  
pp. 1437-1443
Author(s):  
Mahmoud Slim ◽  
Aly Shah Aziz ◽  
Robyn Westmacott ◽  
Nomazulu Dlamini ◽  
Gabrielle Deveber ◽  
...  
Keyword(s):  
Cognitive Outcomes ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis

Recognition performance differentiates between elderly patients in the long term course of secondary progressive multiple sclerosis and amnestic mild cognitive impairment

2012 ◽  
Vol 19 (6) ◽  
pp. 799-805 ◽  
Author(s):  
Stephan Müller ◽  
Ralf Saur ◽  
Bernhard Greve ◽  
Arthur Melms ◽  
Martin Hautzinger ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Elderly Patients ◽  
Memory Impairment ◽  
Neuropsychological Testing ◽  
Amnestic Mild Cognitive Impairment ◽  
Secondary Progressive

Background: Cognitive impairment is a common symptom of multiple sclerosis (MS), but little is known about cognitive decline in patients in the long-term course of progressive MS. Because advancing age is the most significant risk factor for Alzheimer’s Disease (AD), AD-related pathology must be considered in elderly patients with MS. Amnestic mild cognitive impairment (aMCI) represents the prodromal phase of AD with subjects showing memory impairment that does not improve with recognition testing. Objective: We sought to identify disease-dependent deterioration patterns by comparing elderly patients with secondary progressive MS (SPMS) and with aMCI using the Consortium to Establish a Registry for Alzheimer’s Disease test battery. Methods: This study included 120 age-, education- and gender-matched participants, including healthy controls ( n=40), SPMS patients ( n=40), and aMCI patients ( n=40). Results: Episodic memory deficits appeared in the long-term course of SPMS. Deficits were associated with deterioration of executive function, but not impairment of memory storage as recognition was preserved in SPMS in contrast to the patients with aMCI. Conclusion: Through neuropsychological testing, MS-related episodic memory impairment due to deteriorated executive function can be distinguished from AD-related encoding and storage deficits. Hence, neuropsychological testing may help to identify AD-related pathology in SPMS patients.

scholarly journals P.116 Cerebral Sinovenous Thrombosis in Preterm Infants

2021 ◽  
Vol 48 (s3) ◽  
pp. S52-S52
Author(s):  
R Christensen ◽  
P Krishnan ◽  
G deVeber ◽  
N Dlamini ◽  
D MacGregor ◽  
...  
Keyword(s):  
Brain Injury ◽  
Preterm Infants ◽  
Treatment Guidelines ◽  
Sinus Thrombosis ◽  
Transverse Sinus ◽  
Distinct Pattern ◽  
Term Infants ◽  
Radiological Features ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis

Background: Neonatal cerebral sinovenous thrombosis (CSVT) can lead to severe brain injury and long-term neurodevelopmental impairments. Previous studies of neonatal CSVT have mainly included term infants. In this study, we examined the clinical and radiological features, treatment and outcome of CSVT in preterm infants. Methods: This was a retrospective cohort study of preterm infants born <37 weeks with radiologically confirmed CSVT. All MRI/MRV and CT/CTV scans were re-reviewed. Clinical and radiological data were analysed using descriptive statistics, ANOVA and chi-square tests. Results: A total of 26 preterm infants with CSVT were included. Of these, 65% were late preterm, 27% very preterm and 8% extreme preterm. Most were symptomatic (seizures 50%, abnormal exam 50%). Radiological features included transverse sinus (85%) and sagittal sinus thrombosis (42%), intraventricular hemorrhage (42%) and venous infarction (19%). Most preterm infants with CSVT (69%) were treated with anticoagulation. Anticoagulation was not associated with new or worsening intracranial hemorrhage. Outcome at follow-up ranged from no impairment (39%), mild impairment (19%), severe impairment (19%) and death (23%). Conclusions: Preterm infants with CSVT are often symptomatic and present with a distinct pattern of brain injury. Anticoagulation treatment of preterm CSVT appeared to be safe. Further studies and treatment guidelines for preterm CSVT are needed.

scholarly journals Perinatal thrombosis: implications for mothers and neonates

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Sarah H. O'Brien
Keyword(s):  
Ischemic Stroke ◽  
Treatment Strategies ◽  
Perinatal Period ◽  
Clinical Equipoise ◽  
Arterial Ischemic Stroke ◽  
Perinatal Stroke ◽  
Behavioral Challenges ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis

Abstract Stroke is more likely to occur in the perinatal period than any other time in childhood, and these events can lead to a lifetime of intellectual and motor disabilities, epilepsy, and behavioral challenges. This review describes the epidemiology and natural history of perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT), risk factors for these complications, recent evidence regarding treatment strategies, and current gaps in knowledge. Existing evidence demonstrates the multifactorial etiology of symptomatic ischemic stroke in neonates, which includes a combination of maternal, delivery, and neonatal factors. The importance of inherited thrombophilia in the pathophysiology and long-term outcomes of perinatal stroke requires additional study. At this time, there is no evidence to support routine extensive thrombophilia screening outside of a research setting. Despite the frequency of perinatal stroke and its association with substantial morbidity, treatment strategies are currently limited, and prevention strategies are nonexistent. Anticoagulation is rarely indicated in PAIS, and more work needs to focus on neuroprotective prevention and alternate treatment strategies. Anticoagulation does appear to be safe in CSVT and may prevent thrombus progression but clinical equipoise remains, and clinical trials are needed to obtain evidence regarding short- and long-term efficacy outcomes.

Long-term prognosis of cerebral venous sinus thrombosis in childhood

2004 ◽  
Vol 46 (08) ◽  
Author(s):  
Els LLM De Schryver ◽  
Ingrid Blom ◽  
Kees PJ Braun ◽  
L Jaap Kappelle ◽  
Gabriël JE Rinkel ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Long Term Prognosis

Cerebral sinovenous thrombosis during asparaginase treatment

2003 ◽  
Vol 23 (03) ◽  
pp. 109-112
Author(s):  
A. Hirt ◽  
C. Zwicky ◽  
W.A. Wuillemin ◽  
K. Leibundgut
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Induction Treatment ◽  
Pathogenic Mechanisms ◽  
Cerebral Sinovenous Thrombosis ◽  
Haemorrhagic Infarction ◽  
Sinovenous Thrombosis

SummaryA boy (age: 71/12 years) with acute lymphoblastic leukaemia developed thrombosis of the sinus sagitalis superior with secondary haemorrhagic infarction while on induction treatment with vincristine, prednisone, and asparaginase. Based on this report, the potential pathogenic mechanisms are discussed with respect to congenital prothrombotic defects as well as to the role of antileukaemic treatment. Current hypotheses on mechanisms for thromboembolism in children and proposed prophylactic strategies are briefly summarized.

High-dose glucocorticoid therapy impairs long-term memory, but not executive function

2005 ◽  
Vol 113 (08) ◽  
Author(s):  
R Brunner ◽  
D Schaefer ◽  
K Hess ◽  
P Parzer ◽  
F Resch ◽  
...  
Keyword(s):  
Executive Function ◽  
Glucocorticoid Therapy ◽  
Long Term Memory ◽  
High Dose ◽  
Term Memory

Improvement Of Curvilinear Diagrams Of Concrete Deformation

2019 ◽  
pp. 99-104
Keyword(s):  
Reinforced Concrete ◽  
Peak Load ◽  
Experimental Studies ◽  
Concrete Structures ◽  
Deformation Model ◽  
Reinforced Concrete Structures ◽  
Significant Difference ◽  
Deformation Diagrams

Problems when calculating reinforced concrete structures based on the concrete deformation under compression diagram, which is presented both in Russian and foreign regulatory documents on the design of concrete and reinforced concrete structures are considered. The correctness of their compliance for all classes of concrete remains very approximate, especially a significant difference occurs when using Euronorm due to the different shape and sizes of the samples. At present, there are no methodical recommendations for determining the ultimate relative deformations of concrete under axial compression and the construction of curvilinear deformation diagrams, which leads to limited experimental data and, as a result, does not make it possible to enter more detailed ultimate strain values into domestic standards. The results of experimental studies to determine the ultimate relative deformations of concrete under compression for different classes of concrete, which allowed to make analytical dependences for the evaluation of the ultimate relative deformations and description of curvilinear deformation diagrams, are presented. The article discusses various options for using the deformation model to assess the stress-strain state of the structure, it is concluded that it is necessary to use not only the finite values of the ultimate deformations, but also their intermediate values. This requires reliable diagrams "s–e” for all classes of concrete. The difficulties of measuring deformations in concrete subjected to peak load, corresponding to the prismatic strength, as well as main cracks that appeared under conditions of long-term step loading are highlighted. Variants of more accurate measurements are proposed. Development and implementation of the new standard GOST "Concretes. Methods for determination of complete diagrams" on the basis of the developed method for obtaining complete diagrams of concrete deformation under compression for the evaluation of ultimate deformability of concrete under compression are necessary.

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