scholarly journals Acute symptomatic seizures in cerebral venous thrombosis

Neurology ◽  
2020 ◽  
Vol 95 (12) ◽  
pp. e1706-e1715 ◽  
Author(s):  
Erik Lindgren ◽  
Suzanne M. Silvis ◽  
Sini Hiltunen ◽  
Mirjam R. Heldner ◽  
Fabiola Serrano ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Edema ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Sagittal Sinus ◽  
Cortical Vein Thrombosis ◽  
Symptomatic Seizures ◽  
Acute Symptomatic Seizures

ObjectiveTo identify characteristics, predictors, and outcomes of acute symptomatic seizures (ASS) in cerebral venous thrombosis (CVT), we investigated 1,281 consecutive adult patients with CVT included from 12 hospitals within the International CVT Consortium.MethodsWe defined ASS as any seizure between symptom onset and 7 days after diagnosis of CVT. We stratified ASS into prediagnosis and solely postdiagnosis ASS. Status epilepticus (SE) was also analyzed separately. We analyzed predictors for ASS and the association between ASS and clinical outcome (modified Rankin Scale) with multivariable logistic regression.ResultsOf 1,281 eligible patients, 441 (34%) had ASS. Baseline predictors for ASS were intracerebral hemorrhage (ICH; adjusted odds ratio [aOR] 4.1, 95% confidence interval [CI] 3.0–5.5), cerebral edema/infarction without ICH (aOR 2.8, 95% CI 2.0–4.0), cortical vein thrombosis (aOR 2.1, 95% CI 1.5–2.9), superior sagittal sinus thrombosis (aOR 2.0, 95% CI 1.5–2.6), focal neurologic deficit (aOR 1.9, 95% CI 1.4–2.6), sulcal subarachnoid hemorrhage (aOR 1.6, 95% CI 1.1–2.5), and female-specific risk factors (aOR 1.5, 95% CI 1.1–2.1). Ninety-three (7%) patients had solely postdiagnosis ASS, best predicted by cortical vein thrombosis (positive/negative predictive value 22%/92%). Eighty (6%) patients had SE, independently predicted by ICH, focal neurologic deficits, and cerebral edema/infarction. Neither ASS nor SE was independently associated with outcome.ConclusionASS occurred in one-third of patients with CVT and was associated with brain parenchymal lesions and thrombosis of the superficial system. In the absence of prediagnosis ASS, no subgroup was identified with sufficient risk of postdiagnosis ASS to justify prophylactic antiepileptic drug treatment. We found no association between ASS and outcome.

scholarly journals Case Reports of Pregnancy-Related Cerebral Venous Thrombosis in the Neurology Department of the Emergency Clinical Hospital in Constanta

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 90
Author(s):  
Any Docu Axelerad ◽  
Lavinia Alexandra Zlotea ◽  
Carmen Adella Sirbu ◽  
Alina Zorina Stroe ◽  
Silviu Docu Axelerad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Special Treatment ◽  
Lateral Sinus ◽  
Cortical Vein ◽  
Cortical Vein Thrombosis

Cerebral venous thrombosis accounts for 0.5–1% of all cerebrovascular events and is one type of stroke that affects the veins and cerebral sinuses. Females are more affected than males, as they may have risk factors, such as pregnancy, first period after pregnancy, treatment with oral contraceptives treatment with hormonal replacement, or hereditary thrombophilia. This neurological pathology may endanger a patient’s life. However, it must be suspected in its acute phase, when it presents with variable clinical characteristics, so that special treatment can be initiated to achieve a favorable outcome with partial or complete functional recovery. The case study describes the data and the treatment of two patients with confirmed cerebral venous thrombosis with various localizations and associated risk factors, who were admitted to the neurology department of the Sf. Apostol Andrei Emergency Hospital in Constanta. The first patient was 40 years old and affected by sigmoid sinus and right lateral sinus thrombosis, inferior sagittal sinus, and right sinus thrombosis, associated with right temporal subacute cortical and subcortical hemorrhage, which appeared following a voluntary abortion. The second case was a patient aged 25 who was affected by left parietal cortical vein thrombosis, associated with ipsilateral superior parietal subcortical venous infarction, which appeared following labor. The data are strictly observational and offer a perspective on clinical manifestations and clinical and paraclinical investigations, including the treatment of young patients who had been diagnosed with cerebral venous thrombosis and admitted to the neurology department.

scholarly journals Cerebellar venous thrombosis mimicking a cerebellar tumor due to polycythemia vera: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongfeng Wen ◽  
Di Jin ◽  
Yu Chen ◽  
Bin Cui ◽  
Tianyi Xiao
Keyword(s):  
Venous Thrombosis ◽  
Polycythemia Vera ◽  
Delayed Diagnosis ◽  
Janus Kinase ◽  
Cerebellar Hemisphere ◽  
Cerebellar Tumor ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
V617f Mutation

Abstract Background Cerebral venous thrombosis (CVT) occurs rarely in the general population and is frequently associated with confused clinical findings and delayed diagnosis. Isolated cerebellar cortical vein thrombosis is a very rare phenomenon. Case presentation This report describes a case with CVT, which is manifested as space-occupying lesions of the cerebellar hemisphere and mimics a cerebellar tumor at the beginning. The diagnosis of CVT was finalized given the laboratory and brain biopsy findings. The etiology may be related to polycythemia vera with Janus Kinase 2 V617F mutation. Conclusion Isolated cerebellar vein thrombosis should be considered when swelling and enhancing cerebellar lesions are detected. Polycythemia vera, especially with a positive JAK2 V617F mutation, may be a rare risk factor for CVT.

Headache in cerebral venous sinus thrombosis revisited: Exploring the role of vascular congestion and cortical vein thrombosis

Cephalalgia ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 503-510 ◽  
Author(s):  
Ravinder-Jeet Singh ◽  
Jitender Saini ◽  
Shriram Varadharajan ◽  
Girish Baburao Kulkarni ◽  
Mustare Veerendrakumar
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Dural Sinus ◽  
Dural Sinus Thrombosis ◽  
Venous Sinus Thrombosis ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
Vascular Congestion

Background and purpose Headache constitutes the most common symptom of cerebral venous sinus thrombosis (CVST), but its pathophysiology is unclear. We sought to investigate the potential mechanism for headache genesis in patients with CVST based on its imaging correlates. Methods A subgroup of CVST patients having headache as the predominant symptom without significant parenchymal lesion were retrospectively analysed for imaging features of vascular congestion (VC), in addition to cortical venous (CVT) and dural sinus thrombosis (DST) on magnetic resonance imaging. Headache and imaging patterns were classified into lateralized and nonlateralized phenotypes and their correlation was sought. Results Among 41 patients included, 28 had lateralized headache (LH group; 15 males; mean age 32.25 ± 9.19 years) while 13 had nonlateralized headache (non-LH group; six males; mean age 27.15 ± 8.65 years). Headache characteristics in both the groups were quite similar. Imaging showed VC in 39 of 41 and CVT among 35 of 41 patients, which were lateralized in 23 of 39 and 18 of 35 patients, respectively. Nearly all lateralized imaging patterns (21 of 23 for VC and 17 of 18 for CVT) occurred in the LH group and ipsilateral to (concordant) headache, while the non-LH group showed lateralized VC and CVT in only two and one patient respectively. Sinus thrombosis was lateralized in both groups irrespective of headache laterality. Whole cohort headache-imaging laterality (including patients with nonlateralized headache and nonlateralized imaging) concordance was 31 of 39, 24 of 35 and 18 of 41 for vascular congestion, cortical vein thrombosis and dural sinus thrombosis respectively. Conclusion Co-localization of VC and CVT with overlying headache might provide a possible explanation of headache and its laterality in patients with CVST.

scholarly journals Specific Polymorphism 4G/5G Gene for PAI-1 as a Possible Cause of Cerebral Venous Thrombosis: A Case Report

2017 ◽  
Vol 18 (2) ◽  
pp. 169-173
Author(s):  
Tatjana Boskovic Matic ◽  
Aleksandar Gavrilovic ◽  
Snezana Simovic ◽  
Dejan Aleksic ◽  
Katarina Vesic ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Plasminogen Activator ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Plasminogen Activator Inhibitor ◽  
Plasminogen Activator Inhibitor 1 ◽  
Sagittal Sinus ◽  
Clinical Center ◽  
The Impact ◽  
Activator Inhibitor

AbstractThrombosis of veins and venous sinus (CVT) is the rare cerebral vascular disorder which makes less than 1% of all strokes. Thrombosis of veins and venous sinuses is picturesquely called “мајоr neurological forger” since it is characterized by very varied clinical picture. Among the various causes of CVT, which can be of infective or non-infective nature, the congenital hyper coagulations especially stand out, diagnosis is based on highly sophisticated diagnostic tests.We present the case of a female patient, 36 years old, who was hospitalized at the Clinic for Neurology in Clinical Center because of the diffuse headache she had for the last few days, with milder right-sided hemiparesis and one generalized tonic-clonic epileptic seizure. With nuclear magnetic resonance (MR/2D venography) the thrombosis of the upper and lower sagittal sinuses is confirmed. By appropriate laboratory tests, as well as by confirmatory immunological and genetic analyses, the impact of the most of the factors is excluded which can contribute to the occurrence of venous thrombosis. The only pathological findings which indicated the possible congenital thrombophilia as the cause of the sagittal sinus thrombosis was the determination of the specific polymorphism of the 4G/5G gene for plasminogen activator inhibitor 1.According to our knowledge, this is the first decribed case of the possible impact of the specific polymorphism of the 4G/5G gene for plasminogen activator inhibitor of 1 on the development of cerebral venous thrombosis.

Superior sagittal sinus thrombosis as a focal point of pulmonary embolism

2021 ◽  
Vol 26 (1) ◽  
pp. 39-44
Author(s):  
G. R. Ramazanov ◽  
A. E. Talypov ◽  
A. A. Kanibolotskiy ◽  
Kh. V. Korigova ◽  
V. N. Stepanov ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cerebrovascular Disease ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Superior Sagittal Sinus ◽  
Focal Point ◽  
Sinus Thrombosis ◽  
Sagittal Sinus ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

This article represents the discussion of a clinical case of superior sagittal sinus thrombosis as a focal point of fatal pulmonary embolism. Pulmonary embolism is a life-threatening condition, with a mortality rate of up to 40%. The direct source of pulmonary embolism is deep vein thrombosis of the lower extremities and pelvis in 80–90% of all cases. The veins of the upper extremities and venous heart cause it less often. Pulmonary embolism in patients with cerebral venous thrombosis is observed in 1.4% of patients.Cerebral venous thrombosis is a cerebrovascular disease manifested by venous outflow disorders due to acute occlusion of the sinuses and veins of the brain. It requires immediate treatment in order to prevent the development of intracranial hemorrhage, venous infarction, disability and death. Cerebral venous thrombosis accounts for approximately 0.5% of all cases of cerebrovascular disease worldwide. In contrast to ischemic stroke, cerebral venous thrombosis is more common in younger patients. Currently, the diagnosis of cerebral venous thrombosis is based on neuroimaging data, and timely treatment leads to a decrease in disability and mortality.

Acquired pial arteriovenous fistula secondary to cerebral cortical vein thrombosis: A case report and review of the literature

2021 ◽  
pp. 197140092110490
Author(s):  
Skander Sammoud ◽  
Nadia Hammami ◽  
Dhaker Turki ◽  
Fatma Nabli ◽  
Samia Ben Sassi ◽  
...  
Keyword(s):  
Low Flow ◽  
Left Middle Cerebral Artery ◽  
Cerebral Vein ◽  
Cortical Vein ◽  
Arteriovenous Fistulas ◽  
Vein Thrombosis ◽  
Sagittal Sinus ◽  
Venous Circulation ◽  
First Case ◽  
Cortical Vein Thrombosis

Pial arteriovenous fistulas (AVFs) are rare neurovascular malformations. They differ from arteriovenous malformations (AVMs) in that they involve single or multiple feeding arteries, draining directly into a dilated cortical vein with no intervening nidus. Pial and dural AVFs differ in blood supply, as the first originate from pial or cortical arteries and the latter from outside the dural leaflets. Unlike dural AVFs, most of the pial AVFs are supratentorial. The vast majority are congenital, manifesting during infancy. Acquired pial AVFs are significantly rarer and occur after vasculopathy, head trauma, brain surgery, or cerebral vein thrombosis. We describe a unique case of an acquired pial AVF in a 50-year-old man secondary to a cortical vein thrombosis manifesting as a focal-onset seizure with secondary generalization. A cerebral digital subtraction angiography revealed a low-flow pial AVF fed by a postcentral branch of the left middle cerebral artery draining to the superior sagittal sinus via a cortical vein. It also showed a collateral venous circulation adjacent to the previously thrombosed left parietal vein. There was no evidence of an associated dural AVF or venous varix. Endovascular treatment was scheduled three months later, but the angiogram preceding the embolization showed spontaneous and complete closure of the malformation. To our knowledge, this is the first case illustrating acquired pure pial AVF unaccompanied by a dural component following cortical vein thrombosis, eventually resulting in an unprompted closure.

scholarly journals Cerebral Sinus Thrombosis: A Fatal Neurological Complication of Ulcerative Colitis

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Rodolfo Jose Nudelman ◽  
Daniel Gustavo Rosen ◽  
Emilie Rouah ◽  
Gordana Verstovsek
Keyword(s):  
Ulcerative Colitis ◽  
Early Recognition ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Neurological Complication ◽  
Cortical Vein ◽  
Sagittal Sinus ◽  
Cerebral Sinus Thrombosis ◽  
Cortical Vein Thrombosis ◽  
Cerebral Sinus

Cerebral sinus thrombosis has been reported as an uncommon complication of ulcerative colitis (UC), occurring in up to 7.5% of cases. It is suspected to be a consequence of genetic predisposition and the hypercoagulable state occurring during disease relapse. We report a case of a 23-year-old male patient with one-year history of UC. He presented to the Emergency Room with left-sided progressive hemiparesis, numbness, hemiparesthesia, and pain, which followed a recent exacerbation of UC. The patient died 3 days after admission and an autopsy revealed superior and inferior sagittal sinus and cortical vein thrombosis with associated cerebral edema, hemorrhagic infarction, and herniation. The gastrointestinal tract had continuous cobblestone appearance extending from rectum to cecum, with hemorrhage and ulceration, consistent with active UC. Awareness of this rare complication of UC can contribute to early recognition and attempts at treatment of this serious and often fatal condition.

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