scholarly journals Cerebral Venous Sinus Thrombosis (CVST) in a Middle-Aged Female with Clustering of Risk Factors

2021 ◽  
Vol 10 (34) ◽  
pp. 2960-2963
Author(s):  
Maria Prothasis ◽  
Yash Gupte ◽  
Sourya Acharya ◽  
Samarth Shukla ◽  
Neema Acharya
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Factor V ◽  
Venous Sinus Thrombosis

Thrombosis of cerebral venous channel is a known complication of hypercoagulable states. Hyperhomocysteinaemia is a known hypercoagulable state. Obesity is a modern-day global epidemic. Disorders such as myocardial infarction (MI), stroke, and venous thromboembolism are on the rising trend and its increased morbidity and mortality is being associated with obesity. To date, however, the knowledge about the association between obesity and adult cerebral venous thrombosis (CVT) is sparse. We report a 44-year-old young morbidly obese metabolically unhealthy female who presented with headache, nausea, vomiting and giddiness. On evaluation, magnetic resonance venogram showed cerebral venous sinus thrombosis. On investigations, she had concomitant hyperhomocysteinaemia and metabolic syndrome. Cerebral venous sinus thrombosis causing stroke in young adults is uncommon with various conditions precipitating it.1,2,3 Severe headache (70 - 90 %), focal lateralized signs (25 % - 75 %), seizures (30 – 40 %) as well as behavioural symptoms such as delirium, amnesia, and disturbances in consciousness are the various associated clinical symptoms. The known inherited hypercoagulable risk factors that cause CVST are gain of function mutations in the genes encoding factor V (factor V Leiden) and prothrombin, Protein C, S and antithrombin III deficiency. Hyperhomocysteinaemia, is a known risk factor for causing venous thrombosis of the lower limbs. However, till date there is no data available showing its role in causing cerebral venous thrombosis. The interaction between genetic and acquired determinants result in high plasma levels of total homocysteine (tHcy).4,5,6 Vitamins such as folic acid, pyridoxine, and cobalamin are involved in the metabolic pathways of homocysteine and its deficiencies represent the acquired determinants. Venous thromboembolism (VTE) comprises of deep vein thrombosis of the leg and pulmonary embolism and obesity is now being recognised as one of the risk factors causing it. The risk of VTE is approximately increased to 2-fold in an individual with a body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) of 30 or more compared with a normal BMI (< 25), and higher BMIs increase more risk with approximately 3 times higher risk in individuals with a BMI greater than 40.7, 8,9 Again obesity as a risk factor for CVST is less known.

scholarly journals Chronic headache as a clinical manifestation of cerebral venous sinus thrombosis

2021 ◽  
Vol 17 (1) ◽  
pp. 50-54
Author(s):  
O. Sayko ◽  
A. Bohdan ◽  
J. Malankevich
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Secondary Brain Injury ◽  
Venous Sinus Thrombosis ◽  
Dural Sinuses ◽  
Cerebral Mri ◽  
Compensation Mechanisms

Patients with cerebral venous thrombosis (CVT) pre-sent with a range of symptoms, which varies widely from headache to coma. Chronic occlusion of venous dural sinuses leads to the initiation of compensation processes, such as vascular collatera-lization, recanalization of the organized thrombus. Consequently, their efficacy determines disease course and severity. The purpose of our study was to highlight the clinical challenges while managing a patient with subcompensated CVT. Taking into account the fact that mild severity is observed in 20 % of cases, eventually, about a quarter of patients presenting with the headache of unclear etio-logy becomes unnoticed and results in low quality of life. To analyze the disease outcome and prognosis, we accurately studied compensation mechanisms, which occur in a patient due to cerebral venous sinus thrombosis, notably venous collateral circulation and thrombus recanalization. However, the most important “pitfall” of chronic dural sinuses occlusion, when not appropriately treated, is the fact that hemodynamic compensation also leads to a high risk of cerebrovascular events, which may lead to death or disabi-lity. The patient with cerebral venous thrombosis of the transverse and sigmoid sinuses manifested migraine-like headache with a vegetative issue and signs of increased intracranial pressure. Due to the absence of anticoagulant therapy, venous drainage through collateral pathways and recanalization of thrombosed sinuses were insufficient to maintain a cerebral blood supply, resulting in diffuse cerebral edema, secondary brain injury. After an accurate survey, diagnostic procedures, prescribing of individualized treatment, and long-term follow-up with correction of therapy the patient experienced regression of CVT symptoms. Cerebral MRI venography is an important tool for the diagnosis and prediction of the prognosis of this condition. Thus, patients with a long history of untreatable headache and signs of intracranial hypertension should undergo this procedure. To consider intracranial vascular events and outcomes, the venous hemodynamics should be evaluated. Moreover, it is often necessary to examine cerebral veins and sinuses, when hemorrhagic stroke does not correspond to cerebral arterial territories and has unclear etiology.

scholarly journals Cerebral Venous Sinus Thrombosis: Incidence and Hyperhomocysteinemia as a Risk Factor in Japanese Patients

2017 ◽  
Vol 08 (05) ◽  
Author(s):  
Makoto Takemaru ◽  
Masaru Kuriyama ◽  
Takahiro Himeno ◽  
Yuji Shiga ◽  
Yuhei Kanaya ◽  
...  
Keyword(s):  
Risk Factor ◽  
Sinus Thrombosis ◽  
Japanese Patients ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

scholarly journals Cerebral venous sinus thrombosis associated with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection

2021 ◽  
pp. 104-104
Author(s):  
Dragan Nikolic ◽  
Marijana Basta-Nikolic ◽  
Vladimir Manojlovic ◽  
Zeljko Zivanovic ◽  
Sanja Vickovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Neurological Symptoms ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

Introduction/Objective. Coagulopathy induced by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) can be an underlying cause of cerebral venous sinus thrombosis (CVST), a less common type of stroke with a variable clinical presentation and high mortality rate. Objective: to present a series of CVST cases associated with SARS-CoV-2 infection. Methods. This retrospective study evaluated clinical, laboratory and radiological presentation, risk factors, barriers to diagnosis, treatment and outcome of patients with SARS-CoV-2 infection induced CVST. Results. The study comprised 6 patients diagnosed with COVID-19 induced CVST during the 18 months period. Majority (66.7%) had no significant risk factors for developing CVST. Median time from initial COVID-19 diagnosis to onset of neurologic deficit was 7 days (interquartile range 0.5-7 days). Clinical presentation comprised non specific neurological symptoms: headache (83.3%) and decreased consciousness (33.3%), together with elevated levels of D-dimer and inflammatory biomarkers. The transverse (n = 4 or 66.7%), superior sagittal sinuses (n = 3 or 50%) and sigmoid sinus (n = 2 or 33.3%) were most commonly affected. Five patients (83.3%) had minimal to no symptoms at discharge (mRS ? 2). In-hospital mortality in our current series was relatively high (16.7%). Conclusion. The high mortality rate of SARS-CoV-2-associated CVST urges clinicians to suspect CVST in patients with a history of COVID-19 infection presenting with non-specific neurological symptoms in order to provide proper treatment and prevent complications.

scholarly journals Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Derya Uluduz ◽  
Sevki Sahin ◽  
Taskin Duman ◽  
Serefnur Ozturk ◽  
Vildan Yayla ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Previous History ◽  
Epileptic Seizures ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
History Of ◽  
The Mean

Background. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results. The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34±9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38±9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

Cerebral venous sinus thrombosis in a neonate due to factor V Leiden deficiency

2007 ◽  
Vol 91 (2) ◽  
pp. 243-245 ◽  
Author(s):  
M Abrantes ◽  
AF Lacerda ◽  
CR Abreu ◽  
A Levy ◽  
A Azevedo ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Factor V Leiden ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Factor V ◽  
Venous Sinus Thrombosis

scholarly journals Clinical characteristics of cerebral venous sinus thrombosis patients with new-onset of headache

2020 ◽  
Author(s):  
Yugang Wang ◽  
Qi Fang
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Sinus Thrombosis ◽  
Chloride Ion ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Younger Age ◽  
Headache Patients ◽  
New Onset

Abstract Objective : This study aimed to assess the clinical characteristics of cerebral venous sinus thrombosis (CVT) patients with new-onset headache and to identify the risk factors for headache in this population.Methods : We retrospectively reviewed the demographic and clinical data of 69 CVT patients recruited between September 2017 and September 2019. Patients were classified into two groups, the headache group and the non-headache group, according to the presence or absence of new-onset headache symptoms at admission. The following characteristics and parameters were measured and analyzed, including gender, age, Diseased sinus amount(DSA), and so on.Results : The incidence of headache was 75% in this cohort. The proportion of female patients in the headache group was higher than that in the non-headache group. Patients in the headache group were younger than those without headache. CVT patients of headache group showed higher LR, BUN, and (ICP)compared to the non-headache group, whereas MCV and levels of protein (CSF) and LDH (CSF) were lower in headache patients. The data also revealed younger age and the increased level of chloride ion CL - (CSF) were the risk factors for the occurrence of headache in CVT patients.Conclusions: The age, LR, MCV, BUN levels, ICP, protein (CSF), and LDH (CSF) in patients with headache were significantly different from those in the non-headache group at admission. Younger age and a level of CL - (CSF) were risk factors for headache in CVT patients. These findings may provide guidance for clinical diagnosis and treatment of CVT.

scholarly journals Case Report: Cerebral Venous Sinus Thrombosis and COVID-19 Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Manasa Anipindi ◽  
Amanda Scott ◽  
Li Joyce ◽  
Salman Wali ◽  
Mark Morginstin
Keyword(s):  
Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Oral Anticoagulants ◽  
Endothelial Activation ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Initial Symptom ◽  
Venous Sinus Thrombosis ◽  
High Index Of Suspicion ◽  
The Brain

Coronavirus disease-2019 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus). Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020 and has changed our lives in many ways. This infection induces a hypercoagulable state leading to arterial and venous thrombosis, but the exact pathophysiology of thrombosis is unknown. However, various theories have been postulated including excessive cytokine release, endothelial activation, and disseminated intravascular coagulation (DIC). We present a patient diagnosed with cerebral venous sinus thrombosis (CVST) with COVID-19 infection. A 66-year-old man presented to a hospital for evaluation of persistent headaches. He tested positive for COVID-19, and MRI of the brain and CT venogram revealed CVST. He was started on heparin drip in the hospital and transitioned to oral anticoagulants at the time of discharge. His headaches improved with treatment. Even though headache is the most frequent and initial symptom of cerebral venous thrombosis, it is rarely the only symptom. A high index of suspicion is therefore required to diagnose CVST especially if the patient presents with a simple complaint like a headache. Common complaints can delay the diagnosis leading to disease progression. Considering the high mortality rates in patients diagnosed with CVST, we suggest the importance of knowing the association between COVID-19 infection and CVST, especially in susceptible patients.

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