Predicting diagnostic factors for cerebral venous sinus thrombosis in Suratthani Hospital
Keywords:
cerebral venous sinus thrombosis, Neurological manifestation, cerebral arterial thrombosisAbstract
Objective : To study the affecting factors for diagnosis of cerebral venous sinus thrombosis (CVST) and treatment.
Methods : A retrospective cross-sectional study was conducted in Suratthani Hospital, Thailand. All cases of CVST stroke patients, diagnosed by magnetic resonance imaging (MRI), MR-venography or computed tomography (CT), CT- venography between January 2013 and December 2018 were included. The sampling of cerebral arterial thrombosis (CAT) stroke cases during the same period as CTSV cases were randomly selected with one-to-one ratio. The key characteristics were abstracted from medical records, and were contrasted between the two groups with multivariable risk regression analyses.
Result : There were a total of 52 CVSTs and 52 random samples of CATs in the study. The median age were 44 years in CVST and 70 years in CAT. The most common sites of thrombosis were transverse sinus (59.62%) and superior sagittal sinus (51.92%). Prothrombotic risk identified were antithrombin III abnormal in 16 patients (40%), Beta2-Glycoprotein antibody in 9 patients (39.13%). In the multivariable risk regression analysis. The predicting factors favoring for CVST were; age <45 years (adjusted risk difference [aRD]) 16%, 95% confidence interval [CI]: 1-32%, p=0.039), headache (aRD 52%, 95%CI: 38-66%, p<0.001) and seizure (aRD 42%, 95%CI: 12-35%, p<0.001). The predicting factors favoring for CAT was history of previous stroke (aRD 22%, 95%CI: 7-37%, p=0.005).
Conclusion : The predicting factors favoring for CVST were; age <45 years, headache and seizure on presentation. The history of previous stroke was the only predicting factor favoring for CAT.
References
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Misra UK, Kalita J, Chandra S, Kumar B, Bansal V. Low molecular weight heparin versus unfractionated heparin in cerebral venous sinus thrombosis: a randomized controlled trial. Eur J Neurol. 2012 Jul;19(7):1030-6.
Servais S, Scholtes F, Roemers S, Martin D. [Cerebral venous thrombosis (CVT)]. Rev Med Liege. 2009 ;64(1):25-31.
Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005 ;352(17):1791-8.
Luo Y, Tian X, Wang X. Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review. Front Aging Neurosci. 2018;10:2.
Anadure RK, Wilson V, Sahu S, Singhal A, Kota S. A study of clinical, radiological and etiological profile of cerebral venous sinus thrombosis at a tertiary care center. Med J Armed Forces India. 2018 ;74(4):326-32.
Lal D, Gujjar AR, Ramachandiran N, Obaidi A, Kumar S, El-Tigani M, et al. Spectrum of Cerebral Venous Thrombosis in Oman. Sultan Qaboos Univ Med J. 2018 ;18(3):e329-e37.
Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012;43(12):3375-7.
Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral Venous Sinus Thrombosis Incidence Is Higher Than Previously Thought: A Retrospective Population-Based Study. Stroke. 2016;47(9):2180-2.
Terni E, Giannini N, Chiti A, Gialdini G, Orlandi G, Montano V, et al. Cerebral sinus venous thrombosis: clinical and pathogenetic perspectives from Tuscany. Blood Coagul Fibrinolysis. 2015 ;26(5):505-8.
Crassard I, Bousser MG. Cerebral venous thrombosis. J Neuroophthalmol. 2004 ;24(2):156-63.
Karadas S, Milanlioglu A, Gonullu H, Sayin R, Aydin MN. Cerebral venous sinus thrombosis presentation in emergency department in Van, Turkey. J Pak Med Assoc. 2014;64(4):370-4.
Zuurbier SM, Middeldorp S, Stam J, Coutinho JM. Sex differences in cerebral venous thrombosis: A systematic analysis of a shift over time. Int J Stroke. 2016;11(2):164-70.
Wasay M, Bakshi R, Bobustuc G, Kojan S, Sheikh Z, Dai A, et al. Cerebral venous thrombosis: analysis of a multicenter cohort from the United States. J Stroke Cerebrovasc Dis. 2008;17(2):49-54.
Sidhom Y, Mansour M, Messelmani M, Derbali H, Fekih-Mrissa N, Zaouali J, et al. Cerebral venous thrombosis: clinical features, risk factors, and long-term outcome in a Tunisian cohort. J Stroke Cerebrovasc Dis. 2014 ;23(6):1291-5.
Kalita J, Chandra S, Kumar B, Bansal V, Misra UK. Cerebral Venous Sinus Thrombosis From a Tertiary Care Teaching Hospital in India. Neurologist. 2016;21(3):35-8.
Venous thromboembolic disease and combined oral contraceptives: results of international multicentre case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet. 1995 ;346(8990):1575-82.
Lidegaard O, Edstrom B, Kreiner S. Oral contraceptives and venous thromboembolism: a five-year national case-control study. Contraception. 2002 ;65(3):187-96.
Realini JP, Encarnacion CE, Chintapalli KN, Rees CR. Oral contraceptives and venous thromboembolism: a case-control study designed to minimize detection bias. J Am Board Fam Pract. 1997;10(5):315-21.
Wang Y, Meng R, Duan J, Liu G, Chen J, Li S, et al. Nephrotic Syndrome May Be One of the Important Etiologies of Cerebral Venous Sinus Thrombosis. J Stroke Cerebrovasc Dis. 2016 ;25(10):2415-22.
Park SJ, Shin JI. Complications of nephrotic syndrome. Korean J Pediatr. 2011 ;54(8):322-8.
Al Fakeeh KN, Al Rasheed SA. Cerebral venous thrombosis in the nephrotic syndrome. Saudi J Kidney Dis Transpl. 2000;11(1):59-63.
Fluss J, Geary D, deVeber G. Cerebral sinovenous thrombosis and idiopathic nephrotic syndrome in childhood: report of four new cases and review of the literature. Eur J Pediatr. 2006 ;165(10):709-16.
Heller C, Heinecke A, Junker R, Knofler R, Kosch A, Kurnik K, et al. Cerebral venous thrombosis in children: a multifactorial origin. Circulation. 2003;108(11):1362-7.
Boehme AK, Esenwa C, Elkind MS. Stroke Risk Factors, Genetics, and Prevention. Circ Res. 2017 ;120(3):472-95.
Guzik A, Bushnell C. Stroke Epidemiology and Risk Factor Management. Continuum (Minneap Minn). 2017 ;23(1, Cerebrovascular Disease):15-39.
Turin TC, Okamura T, Afzal AR, Rumana N, Watanabe M, Higashiyama A, et al. Hypertension and lifetime risk of stroke. J Hypertens. 2016 ;34(1):116-22.
Sparaco M, Feleppa M, Bigal ME. Cerebral Venous Thrombosis and Headache--A Case-Series. Headache. 2015 ;55(6):806-14.
Iurlaro S, Beghi E, Massetto N, Guccione A, Autunno M, Colombo B, et al. Does headache represent a clinical marker in early diagnosis of cerebral venous thrombosis? A prospective multicentric study. Neurol Sci. 2004 ;25 Suppl 3:S298-9.
Wasay M, Kojan S, Dai AI, Bobustuc G, Sheikh Z. Headache in Cerebral Venous Thrombosis: incidence, pattern and location in 200 consecutive patients. J Headache Pain. 2010;11(2):137-9.
Laborit H, Wermuth CG, Weber B, Ornellas RM, Baron C. [3,4-Dihydroxy)-4-phenyl-2-aminothiazole (Ag310)]. Agressologie. 1967;8(4):341-77.
Masuhr F, Busch M, Amberger N, Ortwein H, Weih M, Neumann K, et al. Risk and predictors of early epileptic seizures in acute cerebral venous and sinus thrombosis. Eur J Neurol. 2006;13(8):852-6.
Ferro JM, Canhao P, Bousser MG, Stam J, Barinagarrementeria F. Early seizures in cerebral vein and dural sinus thrombosis: risk factors and role of antiepileptics. Stroke. 2008;39(4):1152-8.
Mahale R, Mehta A, John AA, Buddaraju K, Shankar AK, Javali M, et al. Acute seizures in cerebral venous sinus thrombosis: What predicts it? Epilepsy Res. 2016;123:1-5.
Paciaroni M, Palmerini F, Bogousslavsky J. Clinical presentations of cerebral vein and sinus thrombosis. Front Neurol Neurosci. 2008;23:77-88.
Chang DI, Yoon SS, Chung KC. Superior sagittal sinus thrombosis and transient ischemic attacks: possible mechanism. J Korean Med Sci. 1998;13(5):566-8.
Uzar E, Ekici F, Acar A, Yucel Y, Bakir S, Tekbas G, et al. Cerebral venous sinus thrombosis: an analyses of 47 patients. Eur Rev Med Pharmacol Sci. 2012;16(11):1499-505.
Sassi SB, Touati N, Baccouche H, Drissi C, Romdhane NB, Hentati F. Cerebral Venous Thrombosis: A Tunisian Monocenter Study on 160 Patients. Clin Appl Thromb Hemost. 2017 ;23(8):1005-9.
Sasidharan PK. Cerebral vein thrombosis misdiagnosed and mismanaged. Thrombosis. 2012;2012:210676.
Einhaupl K, Stam J, Bousser MG, De Bruijn SF, Ferro JM, Martinelli I, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. Eur J Neurol. 2010 ;17(10):1229-35.
Misra UK, Kalita J, Chandra S, Kumar B, Bansal V. Low molecular weight heparin versus unfractionated heparin in cerebral venous sinus thrombosis: a randomized controlled trial. Eur J Neurol. 2012 Jul;19(7):1030-6.
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2019-05-10
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โรจนพิทยากร พ. (2019). Predicting diagnostic factors for cerebral venous sinus thrombosis in Suratthani Hospital. Region 11 Medical Journal, 33(1), 155–170. Retrieved from https://he02.tci-thaijo.org/index.php/Reg11MedJ/article/view/188700
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