scholarly journals Prevalence of subarachnoid haemorrhage among patients with cranial venous sinus thrombosis in the presence and absence of venous infarcts

2018 ◽  
Vol 31 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Muhammad Azeemuddin ◽  
Muhammad Awais ◽  
Fatima Mubarak ◽  
Abdul Rehman ◽  
Noor Ul-Ain Baloch
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Sinus Thrombosis ◽  
Venous Sinus ◽  
P Value ◽  
Chi Square ◽  
Venous Sinus Thrombosis ◽  
Venous Infarct ◽  
Fluid Attenuated Inversion Recovery ◽  
Chi Square Test ◽  
Venous Infarcts

Introduction In patients with cranial venous sinus thrombosis, the occurrence of subarachnoid haemorrhage in association with haemorrhagic venous infarcts is a well described phenomenon. However, the presence of subarachnoid haemorrhage in patients with cranial venous sinus thrombosis in the absence of a haemorrhagic venous infarct is exceedingly rare. Methods We retrospectively reviewed charts and scans of all patients who had cranial venous sinus thrombosis confirmed by magnetic resonance venography at our hospital between September 2004 and May 2015. The presence of subarachnoid haemorrhage was ascertained on fluid-attenuated inversion recovery, susceptibility-weighted imaging and/or unenhanced computed tomography scans by a single experienced neuroradiologist. Statistical analysis was performed using the Statistical Package for Social Sciences version 20. Differences in the proportion of haemorrhagic venous infarcts among patients with subarachnoid haemorrhage versus those without subarachnoid haemorrhage were compared using the chi-square test. A P value of less than 0.05 was considered significant. Results A total of 138 patients who had cranial venous sinus thrombosis were included in the study. Seventy-three (52.9%) were women and the median age of subjects was 35 (interquartile range 22–47) years. Venous infarcts and haemorrhagic venous infarcts were noted in 20/138 (14.5%) and 62/138 (44.9%) cases, respectively. Subarachnoid haemorrhage was present in 15/138 (10.9%) cases and, in three cases, subarachnoid haemorrhage occurred in the absence of a venous infarct. Haemorrhagic venous infarcts were more prevalent ( P = 0.021) among patients with subarachnoid haemorrhage (11/15) than in those without subarachnoid haemorrhage (51/123). Conclusion In patients with cranial venous sinus thrombosis, subarachnoid haemorrhage can occur even in the absence of a haemorrhagic venous infarct. The recognition of cranial venous sinus thrombosis as the underlying cause of subarachnoid haemorrhage is important to avoid misdiagnosis and inappropriate management.

Sticky Platelet Syndrome: A Cause of Neurovascular Thrombosis and Thrombo-Embolism

1997 ◽  
Vol 3 (2) ◽  
pp. 145-154 ◽  
Author(s):  
E. Berg-Dammer ◽  
H. Henkes ◽  
H. Trobisch ◽  
D. Kühne
Keyword(s):  
Parietal Lobe ◽  
Sinus Thrombosis ◽  
Cerebral Arteries ◽  
Positive Family History ◽  
Adenosine Diphosphate ◽  
Venous Sinus ◽  
Left Vertebral Artery ◽  
Venous Sinus Thrombosis ◽  
Venous Infarct ◽  
Basilar Tip Aneurysm

Increased platelet aggregation induced by adenosine diphosphate and epinephrine and enhanced platelet activation response to surface contact are the key features of the “sticky platelet syndrome”, in which the phenotype is transmitted with an autosomal dominant pattern. Two thirds of the patients with this syndrome have a positive family history of thrombo-embolic disease, which may be triggered by stress. We have seen two patients suffering from intracranial arterial and venous sinus thrombosis due to sticky platelet syndrome. Hyperaggregability of the platelets after stimulation with adenosine diphosphate and epinephrine was found in both. Case 1: A 43 year old man with a superior sagittal and right transverse venous sinus thrombosis developed subdural hygromas and a venous infarct of the parietal lobe. After burr hole evacuation of the hygromas, aspirin and phenoprocumone were prescribed. The patient made a good neurological recovery. Case 2: A 52 year old woman experienced spontaneous occlusion of a right MCA branch. The work-up revealed bilateral MCA and a basilar tip aneurysm. During the attempt to treat the basilar tip aneurysm by endovascular means, a thrombus formed within the left vertebral artery and was dislodged to both posterior cerebral arteries (PCAs). Local intra-arterial fibrinolysis yielded good recanalization of both PCAs. No new neurological deficit occurred. Continuous prophylaxis with aspirin was started. In sticky platelet syndrome stress and adrenaline release can trigger the thrombosis of intracranial arterial or venous vessels in otherwise healthy subjects. This is a potential cause of thromboembolic complications during endovascular procedures. Low-dose aspirin normalizes platelet hyperaggregability.

scholarly journals P.074 Management, timing of anticoagulation and outcomes of patients with cerebral venous sinus thrombosis: a single centre chart review

2021 ◽  
Vol 48 (s3) ◽  
pp. S40-S40
Author(s):  
G Mak ◽  
N Chan ◽  
K Perera
Keyword(s):  
Chart Review ◽  
Sinus Thrombosis ◽  
Anticoagulation Therapy ◽  
Retrospective Chart Review ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Neurosurgical Procedure ◽  
Venous Sinus Thrombosis ◽  
Venous Infarct ◽  
Common Clinical Presentation

Background: Cerebral venous sinus thrombosis (CVST) accounts for <1% of all strokes. Our objectives were to describe the clinical features and examine the association between timing of anticoagulation therapy and outcomes in CVST patients. Methods: We conducted a retrospective chart review of patients admitted to Hamilton Health Sciences from 2015 – 2020 with imaging confirmed CVST. Results: We included 96 patients, mean age of 47.9 (SD 18.1). The most common clinical presentation was headache (43.8%). Brain trauma was the most common identified risk factor (15.6%), while 27% of individuals had no identified cause. Most patients (57.3%) received anticoagulation within 24hrs of identified CVST, while 26% had a delay (≥48hrs) and 16.7% were not anti-coagulated. The rationale for delaying or not starting anticoagulation included traumatic brain injury (31.8%), neurosurgical procedure (9.1%), presence of venous infarct and/or haemorrhage (27.1%) and unclear rationale (31.8%). At a median of 8 days, more patients without clear indications for delayed or no anticoagulation were disabled (defined by modified Rankin Scale, mRS, score ≥ 2) or dead (mRS 6), compared to those anti-coagulated in 24hrs (87.5% versus 31.8%; RR 2.75; 95% CI 1.74 – 4.35). Conclusions: Unjustified delay in anticoagulation may result in poorer clinical outcomes in CVST patients.

Cerebral venous sinus thrombosis presenting as subarachnoid haemorrhage

2016 ◽  
Vol 117 (1) ◽  
pp. 313-314
Author(s):  
Ravi Uniyal ◽  
Neeraj Kumar ◽  
Hardeep Singh Malhotra ◽  
Ravindra Kumar Garg
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

PO018 Two cases of subarachnoid haemorrhage caused by venous sinus thrombosis

2017 ◽  
Vol 88 (Suppl 1) ◽  
pp. A17.2-A17
Author(s):  
W Owen Pickrell ◽  
Sartaj Ahmed ◽  
Shawn F Halpin ◽  
Mark Wardle ◽  
Khalid Hamandi
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

Cerebral Venous Sinus Thrombosis: Unusual Imaging Appearance

2009 ◽  
Vol 22 (4) ◽  
pp. 413-417
Author(s):  
T.J.E. Muttikkal ◽  
R. Shaikh ◽  
A. Ben Nakhi ◽  
R. Gupta ◽  
M. Sheikh
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Brain Oedema ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Imaging Appearance ◽  
Subdural Hematomas

Cerebral venous sinus thrombosis (CVST) has widely varied clinical and radiological manifestations ranging from asymptomatic minimal brain oedema to severe haemorrhagic infarcts associated with focal deficits, coma and even death. Cerebral venous sinus thrombosis presenting with lobar or subdural hematomas are rare and the cause may easily be overlooked. We present a case of CVST with an atypical radiological picture of intra-arenchymal, subdural and subarachnoid haemorrhage.

scholarly journals Endovascular management of cerebral venous sinus thrombosis

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Omar Choudhri ◽  
Abdullah Feroze ◽  
Michael P. Marks ◽  
Huy M. Do
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Hypertension ◽  
Venous Sinus ◽  
Clinical Deterioration ◽  
Endovascular Management ◽  
Venous Sinus Thrombosis ◽  
Link Type ◽  
Venous Infarcts ◽  
Systemic Anticoagulation

Cerebral venous sinus thrombosis (CVST) is characterized by formation of widespread thrombus within the cerebral venous sinus system. CVST can cause venous hypertension, venous infarcts, hemorrhage and seizures. It is managed in most cases with systemic anticoagulation through the use of heparin to resolve the thrombus. Patients that demonstrate clinical deterioration while on heparin are often treated with endovascular strategies to recanalize the sinuses. We present the case of a patient with widespread CVST, involving his superior sagittal sinuses and bilateral transverse sigmoid sinuses, who was treated with a combination of endovascular therapies.The video can be found here: http://youtu.be/w3wAGlT7h8c.

scholarly journals Isolated headache and its association with characteristics and outcome of cerebral venous sinus thrombosis

2020 ◽  
Vol 3 ◽  
pp. 251581632091996 ◽  
Author(s):  
Banafsheh Shakibajahromi ◽  
Afshin Borhani-Haghighi ◽  
Hossein Molavi Vardanjani ◽  
Mehrnaz Ghaedian ◽  
Farnia Feiz ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Sinus Thrombosis ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
P Value ◽  
Lateral Sinus ◽  
Venous Sinus Thrombosis ◽  
Poor Outcome

We aimed to evaluate the clinical characteristics and outcome, hospital stay, and intracranial hemorrhage (ICH) development of patients with cerebral venous sinus thrombosis (CVST) who presented with isolated headache. In a retrospective study, consecutive patients with a definite diagnosis of CVST referred to Namazi hospital (Shiraz University of Medical Sciences) from 2012 to 2016 were included. Clinical, radiological, and prognostic characteristics and outcome on discharge (using modified Rankin Scale (mRS)) were compared between the CVST patients who presented with isolated headache and other CVST patients through univariate analyses. The associations of isolated headache with poor outcome (mRS > 2), presence or development of ICH, and duration of hospital stay were assessed through multivariable analyses. Of the 174 patients, 45 (26.0%) presented with isolated headache. Presence of isolated headache was more frequent in men ( p value = 0.048) and patients with thrombophilia ( p value = 0.040). Lateral sinus involvement was more common in patients with isolated headache ( p value = 0.005). After adjustment for other variables, the isolated headache was significantly associated with shorter hospital stay (odds ratio (OR): 0.85, confidence interval (CI): 0.73–0.99) and lower risk of early ICH (OR: 0.314, CI: 0.132–0.749). Although poor outcome was significantly less frequent in patients with isolated headache on univariate analysis ( p value < 0.001), this association was not significant in multivariable analysis (OR: 0.324, CI: 0.035–2.985). CVST patients with isolated headache had lower ICH events and shorter hospital stay. CVST should be considered as a possible differential diagnosis in certain patients who present only with headache, particularly those with diffuse progressive headache, or underlying provocative conditions.

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