Postpartum Cerebral Venous Thrombosis—A Single-Center Experience

Background: Cerebral venous thrombosis (CVT) is a rare variant of stroke in the general population, but an important subtype among pregnancy- and puerperium-related cases. Studies describing its risk factors and clinical characteristics are limited. The aim of our study is to disclose these aspects and compare with cases unrelated to pregnancy and puerperium. Materials and Methods: We performed a retrospective analysis including 88 consecutive cases from a tertiary neurology clinic with a diagnosis of CVT. Ten of the 88 cases (11.3%) appeared during the postpartum period. Results: The mean age of the puerperal CVT cases was 26.5 years. The main pregnancy-related risk factors besides puerperium were cesarean delivery (5/10), preeclampsia (2/10), and stillbirth (1/10). General risk factors for thrombosis, i.e., infection, smoking, and primary hypercoagulability, were identified in 50% of cases. Onset was in the first 3 weeks after delivery, with a mean value of 9.6 ± 5.6 days. Headache was present in 90% of postpartum CVT cases and in 76.1% of non-postpartum female cases. Seizures were more frequent in the postpartum group (60% vs. 34.8%). Onset was acute (<48 h) in 50% of postpartum cases and in 30.4% of the non-postpartum female group. The Rankin score at discharge was significantly lower in the postpartum group (0.22 vs. 0.7, p = 0.02), suggesting a more favorable short-term outcome. Conclusions: The early postpartum period represents an important risk for the development of CVT. Cesarean delivery and preeclampsia, besides general risk factors such as infection, smoking, and primary thrombophilia, contribute to enhanced risk. Puerperium-related CVT presents a more favorable outcome compared with CVT with other etiologies.

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Gender Differences in Risk Factor Profile and Clinical Characteristics in 89 Consecutive Cases of Cerebral Venous Thrombosis

Journal of Clinical Medicine ◽

10.3390/jcm10071382 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1382

Author(s):

Zoltan Bajko ◽

Anca Motataianu ◽

Adina Stoian ◽

Laura Barcutean ◽

Sebastian Andone ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Clinical Manifestations ◽

Important Variable ◽

Term Outcome ◽

Hematological Disorders ◽

Risk Factor Profile ◽

Male Patients

Gender has been shown to be an important variable in cerebral venous thrombosis (CVT) risk and significantly influences its clinical manifestations and outcome. The aim of our study was to investigate the gender-specific risk factor profile and clinical picture of this rare cerebrovascular disorder. Materials and methods: We retrospectively reviewed the medical records of 89 consecutive cases of CVT at a tertiary neurology clinic in Târgu Mures, Romania, between June 2009 and January 2021 to analyze the gender-related differences in etiology, clinical presentation, and outcome. Results: Women comprised 62.5% of the cohort. Females were significantly younger than males (37.3 years versus 48.8 years, respectively, p = 0.001), and the main risk factors were hormone related in 37.9% of the cases, followed by primary thrombophilia (34.4%), smoking (25.8%), obesity (17.2%), infections (17.2%), mechanical factors (17.2%), cancer (8.6%), systemic autoimmune disorders (8.6%), and hematological disorders (8.6%). In male patients, the main risk factors were smoking (41.9%), primary thrombophilia (29%), infections (22.6%), heavy alcohol consumption (16.1%), and venous thromboembolism in the medical history (12.9%). Frequency of headache was higher in females than in males (75.9% versus 67.7%), whereas frequency of coma (6.5% in males versus 1.7% in females) and dizziness (19.4% in males versus 10.3% in females) was higher in males. CVT onset was acute in 41.4% of females and 38.7% of males. The Rankin score at discharge was significantly lower in females compared with males (0.6 versus 1.6), reflecting a more favorable short-term outcome. Mortality was 6.4% in males and 1.7% in females. Conclusions: CVT is a multifactorial disorder that has a broad spectrum of risk factors with important gender-related differences in clinical manifestation and prognosis. Female patients, especially those with hormone-related risk factors, have a more favorable outcome than male patients.

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Cerebral Venous Thrombosis after a Cesarean Delivery

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.68 ◽

2010 ◽

Vol 53 (2) ◽

pp. 109-113 ◽

Cited By ~ 2

Author(s):

Edvard Ehler ◽

Aleš Kopal ◽

Milan Mrklovský ◽

Milan Košťál

Keyword(s):

Risk Factors ◽

Molecular Weight ◽

Venous Thrombosis ◽

Cesarean Delivery ◽

Cerebral Venous Thrombosis ◽

Low Molecular Weight Heparin ◽

Methylenetetrahydrofolate Reductase ◽

Low Molecular Weight ◽

Viii Level ◽

Risk Patients

Cerebral venous thrombosis (CVT) is a serious condition affecting mostly women. This report concerns two cases of women who developed CVT within 14 days of cesarean delivery. Magnetic resonance angiography of the brain (venous phase) is the best modality to diagnose the condition, and parenteral application of low-molecular-weight heparin is the most beneficial treatment. The first patient was found to have an elevated factor VIII level. In the second patient, homozygosity of the C677T mutation in the 5,10-methylenetetrahydrofolate reductase gene was found. The puerperal period and Cesarean Section (CS) are risk factors for thrombotic complications, including CVT. It is necessary to search for risk factors in a patient’s history and within the group of at-risk patients to prolong preventive administration of low molecular weight heparin (LMWH). CVT (including puerperium related) is not a detrimental to future pregnancies.

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Postpartum Period Is a Risk Factor for Cerebral Venous Thrombosis

Stroke ◽

10.1161/strokeaha.118.023017 ◽

2019 ◽

Vol 50 (2) ◽

pp. 501-503 ◽

Cited By ~ 13

Author(s):

Suzanne M. Silvis ◽

Erik Lindgren ◽

Sini Hiltunen ◽

Sharon Devasagayam ◽

Luuk J. Scheres ◽

...

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Postpartum Period ◽

Cerebral Venous Thrombosis ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Increased Risk ◽

History Of ◽

Using Data ◽

History Of Cancer

Background and Purpose— Pregnancy and the postpartum period are generally considered to be risk factors for cerebral venous thrombosis (CVT), but no controlled studies have quantified the risk. Methods— Case-control study using data of consecutive adult patients with CVT from 5 academic hospitals and controls from the Dutch MEGA study (Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis). Men, women over the age of 50, women using oral contraceptives or with a recent abortion or miscarriage were excluded. We adjusted for age and history of cancer, and stratified for pregnancy versus postpartum, and 0 to 6 versus 7 to 12 weeks postpartum. Results— In total 163/813 cases and 1230/6296 controls were included. Cases were younger (median 38 versus 41 years) and more often had a history of cancer (14% versus 4%) than controls. In total 41/163 (25%) cases and 82/1230 (7%) controls were pregnant or postpartum (adjusted odds ratio, 3.8; 95% CI, 2.4–6.0). The association was fully attributable to an increased risk of CVT during the postpartum period (adjusted odds ratio, 10.6; 95% CI, 5.6–20.0). We found no association between pregnancy and CVT (adjusted odds ratio, 1.2; 95% CI, 0.6–2.3). The risk was highest during the first 6 weeks postpartum (adjusted odds ratio, 18.7; 95% CI, 8.3–41.9). Conclusions— Women who have recently delivered are at increased risk of developing CVT, while there does not seem to be an increased risk of CVT during pregnancy.

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Cerebral Venous Thrombosis: Clinical Features, Risk Factors, and Long-term Outcome in a Tunisian Cohort

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2013.10.025 ◽

2014 ◽

Vol 23 (6) ◽

pp. 1291-1295 ◽

Cited By ~ 27

Author(s):

Youssef Sidhom ◽

Malek Mansour ◽

Mariem Messelmani ◽

Hajer Derbali ◽

Nejiba Fekih-Mrissa ◽

...

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Clinical Features ◽

Cerebral Venous Thrombosis ◽

Term Outcome ◽

Long Term Outcome

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Clinical presentation, risk factors and factors affecting short term outcome in patients with cerebral venous thrombosis

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20202574 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1100

Author(s):

Josy J. Vallippalam ◽

Balakrishnan R. ◽

Saloni Krishna ◽

Karthik Thamaraikannan ◽

Nitya Suresh

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Clinical Presentation ◽

Tertiary Care ◽

P Value ◽

Short Term ◽

Term Outcome ◽

Factors Influencing ◽

Short Term Outcome

Background: Cerebral venous thrombosis is a rare cause of stroke, with a predilection to females. Since the past two decades its morbidity and mortality had decreased because of the new effective diagnostic and therapeutic interventions. This study mainly intends to assess, the clinical and aetiological factors of cerebral venous thrombosis and the factors predicting its short-term outcome. Objective was to study the factors influencing the short-term outcome of CVT and to study the pattern of clinical presentation and risk factors for CVT.Methods: It was a cross-sectional study done at a tertiary care Centre in Tamil Nadu, in adult CVT patients from august 2018 to august 2019. Clinical, aetiological and radiological data were collected from patients and assessed and factors influencing the short-term outcome at discharge and at 15 days after discharge were studied. Data was analysed using SPSS16 software. Analysis of the descriptive data was performed and independent factors influencing the short-term outcome were analysed subsequently.Results: Males predominated in the study with a mean age of 38yrs. Most common presentation was headache. Infarct was present in 61 (56.5%). The most common site of venous involvement was superior sagittal sinus 81 (75%). Short term outcome had shown a significant association with hypertension (p value -0.019 and odds ratio-65.439) and baseline MRS (p value- 0.000, OR - 0.004) only.Conclusions: Nowadays, the mortality and morbidity of CVT has decreased. Hypertension has emerged as an independent predictive factor in the short -term outcome of CVT.

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CEREBRAL VENOUS THROMBOSIS IN A YOUNG FEMALE PATIENT IN POSTPARTUM PERIOD

10.26226/morressier.5ab8f55ad462b8029238d3df ◽

2018 ◽

Author(s):

Sabina Medukhanova

Keyword(s):

Venous Thrombosis ◽

Female Patient ◽

Postpartum Period ◽

Cerebral Venous Thrombosis ◽

Young Female

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Rivaroxaban for the treatment of cerebral venous thrombosis: a single-center experience

Acta Neurologica Belgica ◽

10.1007/s13760-021-01651-z ◽

2021 ◽

Author(s):

Zoltan Bajko ◽

Smaranda Maier ◽

Anca Motataianu ◽

Rares Cristian Filep ◽

Adina Stoian ◽

...

Keyword(s):

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Single Center ◽

Single Center Experience

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Cerebral venous thrombosis in a patient with Down syndrome and coronavirus disease 2019: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02908-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Henry Robayo-Amortegui ◽

Natalia Valenzuela-Faccini ◽

Cesar Quecano-Rosas ◽

Darlyng Zabala-Muñoz ◽

Michel Perez-Garzon

Keyword(s):

Risk Factors ◽

Down Syndrome ◽

Case Report ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Epidemiological Data ◽

Thromboembolic Disease ◽

Hispanic Woman ◽

Case Presentation ◽

The World

Abstract Background The new coronavirus disease 2019 pandemic has spread throughout most of the world. Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. Case presentation We report the case of a Hispanic woman with Down syndrome who has coronavirus disease 2019 and presents as a complication extensive cerebral venous thrombosis. Conclusions Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. In the absence of clinical and epidemiological data, it is important to carry out further investigation of the risk factors and pathophysiological causes related to the development of cerebrovascular thrombotic events in patients with Down syndrome with coronavirus disease 2019 infection.

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