Cerebral venous sinus thrombosis in a 19 year old female with ulcerative colitis: long term follow-up and review from the literature

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.

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Quality of Life in Patients with Cerebral Venous Sinus Thrombosis: A Study on Physical, Psychological, and Social Status of Patients in Long-term

Archives of Iranian Medicine ◽

10.34172/aim.2021.03 ◽

2021 ◽

Vol 24 (1) ◽

pp. 15-21

Author(s):

Danesh Kajbaf ◽

Kamyar Moradi ◽

Hossein Shamshiri ◽

Sayna Bagheri ◽

Reza Rikhtegar ◽

...

Keyword(s):

Quality Of Life ◽

Sinus Thrombosis ◽

Linear Regression Analysis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Time Interval ◽

Residual Symptoms ◽

Venous Sinus Thrombosis

Background: Cerebral venous sinus thrombosis (CVST) causes significant problems for patients in the working age and may therefore negatively affect their quality of life (QOL). In the present study, we sought to evaluate the QOL and its predictors in subjects with CVST. Methods: This observational, prospective study investigated several outcomes of 56 CVST patients after thrombosis onset. Demographic characteristics, medical history, neurological signs and symptoms during hospitalization, and the employment status of the patients were retrospectively collected. Stroke-related functional scales, including the modified Rankin Scale (mRS) and Barthel Index (BI) were employed. For physical and mental aspects of the QOL, we used the validated Persian version of the Stroke Specific Quality of Life (SS-QOL) scale. Results: The physical and functional outcomes in the long-term were promising according to mRS and BI tools, as well as the improved rate of return to work. Mental domains of the SS-QOL, such as energy and personality represented the lowest scores. According to the multiple linear regression analysis, lower mRS score, and longer time interval between CVST onset and interview were associated with higher physical function of the patients while their better mental function was correlated with lower mRS score and thrombosis in merely one cerebral venous. Conclusion: CVST patients experience an acceptable alleviation of the primary physical disabilities, while residual symptoms, mostly in psychologic/mental domains, impair their QOL.

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Unusual presentation of cerebral venous sinus thrombosis in ulcerative colitis

Journal of Marine Medical Society ◽

10.4103/jmms.jmms_41_20 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Adwait Sodani ◽

Manish Manrai ◽

SS Mohakuda

Keyword(s):

Ulcerative Colitis ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Unusual Presentation ◽

Venous Sinus Thrombosis

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

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000362 ◽

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.

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Cerebral venous sinus thrombosis in a young patient with ulcerative colitis

Medicine ◽

10.1097/md.0000000000017428 ◽

2019 ◽

Vol 98 (41) ◽

pp. e17428

Author(s):

Anna Deskur ◽

Iwona Zawada ◽

Wojciech Błogowski ◽

Teresa Starzyńska

Keyword(s):

Ulcerative Colitis ◽

Young Patient ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis

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Cerebral Venous Sinus Thrombosis in a Patient with Ulcerative Colitis Flare

Case Reports in Neurological Medicine ◽

10.1155/2018/5798983 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

L. M. Conners ◽

R. Ahad ◽

P. H. Janda ◽

Z. Mudasir

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Sinus Thrombosis ◽

Rare Complication ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

Increased Risk ◽

Inflammatory Bowel

Inflammatory bowel disease is characterized by a chronic inflammatory state and is therefore associated with abnormalities in coagulation and a hypercoagulable state. Cerebral venous sinus thrombosis is a rare complication of inflammatory bowel disease yet contributes significant morbidity and mortality to those affected. Early diagnosis is critical, as a delay in diagnosis portends a worse prognosis. This paper seeks to highlight the increased risk of venous sinus thrombosis in patients with inflammatory bowel disease. We start by discussing the case of a seventeen-year-old female who presented with ulcerative colitis flare and developed new-onset seizures, found to be caused by a large venous sinus thrombosis.

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Long-term outcome of cognition and functional health after cerebral venous sinus thrombosis

Neurology ◽

10.1212/wnl.54.8.1687 ◽

2000 ◽

Vol 54 (8) ◽

pp. 1687-1689 ◽

Cited By ~ 50

Author(s):

S. F. T. M. de Bruijn ◽

M. Budde ◽

S. Teunisse ◽

R. J. de Haan ◽

J. Stam

Keyword(s):

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Functional Health ◽

Term Outcome ◽

Long Term Outcome ◽

Venous Sinus Thrombosis

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Cerebral Venous Sinus Thrombosis, a Nonenhanced CT Diagnosis?

Radiology Research and Practice ◽

10.1155/2015/581437 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 4

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.

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