TY - JOUR
T1 - Cerebral venous thrombosis
T2 - Influence of risk factors and imaging findings on prognosis
AU - Appenzeller, Simone
AU - Zeller, Carlos Borelli
AU - Annichino-Bizzachi, Joyce M.
AU - Costallat, Lilian T.L.
AU - Deus-Silva, Leonardo
AU - Voetsch, Barbara
AU - Faria, Andreia V.
AU - Zanardi, Verônica A.
AU - Damasceno, Benito P.
AU - Cendes, Fernando
PY - 2005/8
Y1 - 2005/8
N2 - Purpose: To investigate imaging findings, risk factors and outcome in patients with cerebral venous thrombosis (CVT). Methods: Records of all patients with diagnosis of CVT between 1992 and 2002 were reviewed. Patients with CNS infection and with CVT secondary to invasive procedures were excluded. Inherited and acquired thrombophilia were searched in all patients. Results: Twenty-four patients (18 women, 6 men) with mean age of 29.5 years (range 3-48 years) were identified. Mean follow-up was 44 months (range 11-145 months). The most common symptoms were headache (75%), vomiting (33%) and impairment of consciousness (21%). Probable causes of CVT could be determined in 21 (88%) patients: pregnancy or puerperium in six (25%), oral contraceptive use in four (17%), head trauma in two (8%), mastoiditis in one (4%), nephrotic syndrome in one (4%), systemic disease in three (13%), and inherited thrombotic risk factors in four (17%) patients. CVT associated with pregnancy, puerperium and use of oral contraceptives had a significant better outcome than CVT caused by inherited thrombophilia or systemic disease (OR = 14.4; p = 0.02). CT scans were abnormal in 15 (62.5%) patients and MRI with gadolinium was abnormal in all. Those with parenchymal involvement had neurological sequelae during follow-up. All were treated with heparin followed by oral anticoagulants, and none had new or worsening of pre-existing intracerebral hemorrhage. Conclusion: MRI is superior to conventional CT for diagnosing CVT. Patients with parenchymal lesions, thrombophilia and antiphospholipid syndrome had greater risk to be left with neurological sequelae. Anticoagulant therapy did not predispose to further intracerebral hemorrhage.
AB - Purpose: To investigate imaging findings, risk factors and outcome in patients with cerebral venous thrombosis (CVT). Methods: Records of all patients with diagnosis of CVT between 1992 and 2002 were reviewed. Patients with CNS infection and with CVT secondary to invasive procedures were excluded. Inherited and acquired thrombophilia were searched in all patients. Results: Twenty-four patients (18 women, 6 men) with mean age of 29.5 years (range 3-48 years) were identified. Mean follow-up was 44 months (range 11-145 months). The most common symptoms were headache (75%), vomiting (33%) and impairment of consciousness (21%). Probable causes of CVT could be determined in 21 (88%) patients: pregnancy or puerperium in six (25%), oral contraceptive use in four (17%), head trauma in two (8%), mastoiditis in one (4%), nephrotic syndrome in one (4%), systemic disease in three (13%), and inherited thrombotic risk factors in four (17%) patients. CVT associated with pregnancy, puerperium and use of oral contraceptives had a significant better outcome than CVT caused by inherited thrombophilia or systemic disease (OR = 14.4; p = 0.02). CT scans were abnormal in 15 (62.5%) patients and MRI with gadolinium was abnormal in all. Those with parenchymal involvement had neurological sequelae during follow-up. All were treated with heparin followed by oral anticoagulants, and none had new or worsening of pre-existing intracerebral hemorrhage. Conclusion: MRI is superior to conventional CT for diagnosing CVT. Patients with parenchymal lesions, thrombophilia and antiphospholipid syndrome had greater risk to be left with neurological sequelae. Anticoagulant therapy did not predispose to further intracerebral hemorrhage.
KW - Cerebral venous thrombosis
KW - Inherited thrombophilia
KW - Magnetic resonance imaging
KW - Outcome
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U2 - 10.1016/j.clineuro.2004.10.004
DO - 10.1016/j.clineuro.2004.10.004
M3 - Article
C2 - 16023530
AN - SCOPUS:22144484142
SN - 0303-8467
VL - 107
SP - 371
EP - 378
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
IS - 5
ER -