Obstetrical Outcome of Young Women with a Past History of Cerebral Venous Thrombosis

2013 ◽  
Vol 36 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Jonathan Ciron ◽  
Gaëlle Godenèche ◽  
Xavier Vandamme ◽  
Marie-Pierre Rosier ◽  
Igor Sharov ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Young Women ◽  
Cerebral Venous Thrombosis ◽  
Past History ◽  
History Of ◽  
Obstetrical Outcome

scholarly journals Isolated cortical venous thrombosis after fetal demise

2019 ◽  
Vol 12 (4) ◽  
pp. e228484
Author(s):  
Mohammad Al-Jundi ◽  
Ghassan Al-Shbool ◽  
Mohamad Muhailan ◽  
Moutasem Aljundi ◽  
Christian J Woods
Keyword(s):  
Family History ◽  
Early Diagnosis ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Clinical Presentation ◽  
Young Patients ◽  
Fetal Demise ◽  
History Of ◽  
Venous Stroke ◽  
Cortical Venous Thrombosis

Isolated cortical venous thrombosis (ICVT) occurring in the absence of dural venous thrombosis, constitutes about 2%–5% of all cerebral venous thrombosis. Its vague, non-specific presentation makes it a difficult and challenging diagnosis that needs an extensive workup especially in young patients. Outcome and prognosis depend mainly on early diagnosis and treatment. Here we discuss the clinical presentation, diagnosis and the treatment of a young woman diagnosed with ICVT with acute ischaemic venous stroke, in the setting of eclampsia and family history of coagulation disease.

scholarly journals Extensive Cerebral Venous Thrombosis Secondary to Recreational Nitrous Oxide Abuse

2021 ◽  
pp. 1-4
Author(s):  
Wassim Farhat ◽  
Aaron Pariente ◽  
Rami Mijahed
Keyword(s):  
Nitrous Oxide ◽  
Venous Thrombosis ◽  
Vitamin B12 ◽  
Cerebral Venous Thrombosis ◽  
Medical Literature ◽  
Homocysteine Level ◽  
Prior History ◽  
Limited Data ◽  
Folate Supplementation ◽  
History Of

Nitrous oxide, colloquially known as “whippets,” is a commonly abused inhalant by adolescents and young adults. There are limited data describing the adverse effects of this abuse. We present a 16-year-old girl with no medical history who presented to the emergency department for confusion, hallucinations, weakness, and headaches. Imaging revealed extensive cerebral thrombosis. She had no prior history of venous or arterial thrombosis. Hypercoagulability workup demonstrated an elevated homocysteine level. She was treated with effective anticoagulation and vitamin B12 folate supplementation. To our knowledge, there are a very few cases in the medical literature of cerebral venous thrombosis following the use of nitrous oxide. The pathophysiology of the disorder appears to be linked to the metabolism of vitamin B12 inducing hyperhomocysteinemia and a procoagulant state.

scholarly journals Clinical features, predisposing factors and radiological study of cerebral venous sinus thrombosis: experience from a tertiary care center in Southern India

2017 ◽  
Vol 5 (7) ◽  
pp. 3023 ◽  
Author(s):  
Aneesh T. ◽  
Hemamalini Gururaj ◽  
Arpitha J. S. ◽  
Anusha Rao ◽  
Vaishnavi Chakravarthy ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Clinical Features ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Tertiary Care ◽  
Disease Process ◽  
Predisposing Factors ◽  
Wide Range ◽  
History Of ◽  
Study Population

Background: Cerebral venous thrombosis (CVT) is a less common cause of stroke with a wide range of clinical presentations, predisposing factors, radiological features and outcomes. A high index of suspicion is absolutely essential to diagnose cerebral venous thrombosis. In this article, we have reviewed the clinical spectrum and radiological profile of patients with cerebral venous thrombosis and attempted to identify the specific predisposing factors for developing cerebral venous thrombosis particularly in this region of India.Methods: 116 patients hospitalized from January 2015 to March 2017 with a final diagnosis of Cerebral Venous Thrombosis which was confirmed by imaging (MRI/MRV or CT angiography) were included. Patients who were initially diagnosed as CVT but imaging were not suggestive of the same were excluded.Results: The mean age of the study population was 35.21 years, with most patients aged between 21-30 years. 18.1% of the study population were puerperal women, much lower than earlier series. 54.54% of the men had a significant history of alcohol consumption and 10.34% of the non-puerperal women revealed a history of consuming oral contraceptive pills. Among men, seizures were the most common presenting symptom followed by headache. Women presented with headache followed by vomiting. Superior sagittal sinus, transverse sinus, cortical veins and sigmoid sinus involvement were quite common in comparison to the other sinuses.Conclusions: Accurate and prompt diagnosis of CVT is crucial because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long-term sequelae. In this article, we have reviewed the epidemiology, causative factors, clinical features and as well as radiological pattern of CVT from an Indian perspective. Over the last decade, a relatively high incidence of CVT in fairly young individuals warrants further evaluation towards genetic predisposition for pro-thrombotic states particularly in this region of India.

scholarly journals Cerebral Venous Thrombosis in the Superior Sagittal Sinus as a Rare Cause of a Paroxysmal Kinetic Tremor

2017 ◽  
Vol 8 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Kei Murao ◽  
Shuji Arakawa ◽  
Yoshihiko Furuta ◽  
Masahiro Shijo ◽  
Tetsuro Ago ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Clinical Presentation ◽  
Superior Sagittal Sinus ◽  
Epileptic Seizures ◽  
Repetitive Movement ◽  
Sagittal Sinus ◽  
Kinetic Tremor ◽  
History Of ◽  
The Common

Cerebral venous thrombosis (CVT) has a broad spectrum of clinical presentation compared to arterial etiology. Seizure is one of the common symptoms and is more frequent than in other stroke types. Hence, transient neurological symptoms in CVT patients are usually due to epileptic seizures, while transient repetitive movement disorder is extremely rare except as a complication of epilepsy. We report a case of CVT in the superior sagittal sinus with a 1-year history of paroxysmal kinetic tremor without evident epilepsy.

scholarly journals Postpartum Period Is a Risk Factor for Cerebral Venous Thrombosis

Stroke ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 501-503 ◽  
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.

Assessing diagnostic error in cerebral venous thrombosis via detailed chart review

Diagnosis ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 361-367
Author(s):  
Ava L. Liberman ◽  
Ekaterina Bakradze ◽  
Daryl C. Mchugh ◽  
Charles C. Esenwa ◽  
Richard B. Lipton
Keyword(s):  
Venous Thrombosis ◽  
Medical Records ◽  
Cerebral Venous Thrombosis ◽  
Diagnostic Errors ◽  
Diagnostic Error ◽  
Categorical Variables ◽  
Prior History ◽  
Continuous Variables ◽  
Clinical Factor ◽  
History Of

Abstract Background Diagnostic error in cerebral venous thrombosis (CVT) has been understudied despite the harm associated with misdiagnosis of other cerebrovascular diseases as well as the known challenges of evaluating non-specific neurological symptoms in clinical practice. Methods We conducted a retrospective cohort study of CVT patients hospitalized at a single center. Two independent reviewers used a medical record review tool, the Safer Dx Instrument, to identify diagnostic errors. Demographic and clinical factors were abstracted. We compared subjects with and without a diagnostic error using the t-test for continuous variables and the chi-square (χ2) test or Fisher’s exact test for categorical variables; an alpha of 0.05 was the cutoff for significance. Results A total of 72 CVT patients initially met study inclusion criteria; 19 were excluded due to incomplete medical records. Of the 53 patients included in the final analysis, the mean age was 48 years and 32 (60.4%) were women. Diagnostic error occurred in 11 cases [20.8%; 95% confidence interval (CI) 11.8–33.6%]. Subjects with diagnostic errors were younger (42 vs. 49 years, p = 0.13), more often women (81.8% vs. 54.8%, p = 0.17), and were significantly more likely to have a past medical history of a headache disorder prior to the index CVT visit (7.1% vs. 36.4%, p = 0.03). Conclusions Nearly one in five patients with complete medical records experienced a diagnostic error. Prior history of headache was the only evaluated clinical factor that was more common among those with an error in diagnosis. Future work on distinguishing primary from secondary headaches to improve diagnostic accuracy in acute neurological disease is warranted.

scholarly journals Prevalence and predictors of alternative diagnoses on whole-leg ultrasound negative for acute deep venous thrombosis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ebba Beller ◽  
Mattes Becher ◽  
Felix G. Meinel ◽  
Jens-Christian Kröger ◽  
Rengarajan Rajagopal ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Chart Review ◽  
Venous Insufficiency ◽  
Past History ◽  
Clinical Information ◽  
Ultrasound Evaluation ◽  
Electronic Chart ◽  
History Of ◽  
One Year

Abstract Background To investigate the prevalence, spectrum, and predictors of alternative diagnoses explaining leg symptoms in patients negative for suspected acute deep venous thrombosis (DVT), which can be detected with whole-leg ultrasound. Methods We retrospectively analyzed a cohort of 789 patients (median age 70 years, 50.6% women) evaluated with a whole-leg ultrasound examination for suspected acute DVT within one year. All findings in the radiology report were analyzed and electronic chart review was performed to collect clinical information. Results Ultrasound was negative for acute DVT in 531 patients (67.3%). Among these, alternative diagnoses explaining leg symptoms were seen in 349 patients (65.7%). The most frequent alternative diagnoses were chronic venous insufficiency (147 patients, 27.7%), followed by lymphedema (48 patients, 9.0%) and chronic post-thrombotic changes (41 patients, 7.7%). Patients with alternative diagnoses were older (median 71 vs. 66 years, p = 0.0226), as well as more likely to present with leg swelling (39.5% vs. 23.1%, p = 0.0002), difference in leg circumference (25.5% vs. 14.8%, p = 0.0055) and redness (7.7% vs. 2.7%, p = 0.0213) than patients without alternative diagnosis. Independent predictors of finding alternative diagnoses on whole-leg ultrasound were older age (odds ratio 1.014 per year, p = 0.0119), leg swelling (OR 1.949, p = 0.0020) and history of previous DVT (OR 2.235, p = 0.0154). Conclusions Alternative diagnoses explaining leg symptoms can be detected on whole-leg ultrasound in two thirds of patients with no evidence of acute DVT. Our data supports performing a comprehensive ultrasound evaluation beyond the venous system, particularly, in older patients, who present with leg swelling and a past history of DVT.

scholarly journals The use of new anticoagulants in cerebral venous thrombosis

2021 ◽  
Author(s):  
Letícia Luísa Mattos ◽  
Amanda Mendes Clemente Vilella
Keyword(s):  
Venous Thrombosis ◽  
Young Women ◽  
Cerebral Venous Thrombosis ◽  
Lower Risk ◽  
Case Reports ◽  
High Recovery ◽  
Risk Of Bleeding ◽  
New Anticoagulants ◽  
Hemorrhagic Complications ◽  
Primary Focus

Background: Cerebral venous thrombosis (CVT) is still documented as a rare disease that affects less than 1% of the population, mainly young women. Symptoms are nonspecific, easily confused with less severe pathologies, with a primary focus on headache, which requires attention and knowledge from professionals. The diagnosis is made possible by the use of complementary exams, when the diagnosis is made early, it is of high recovery. In case of late diagnosis or incorrect treatment, the sequelae may be irreversible. Objectives and methodology: to analyze the use of new anticoagulants (NOACs) in relation to treatment with warfarin in cases of CVT, through narrative review. Studies from the years 2015-2020 were used in the following databases: Pubmed, Scielo and Medline. Results: Studies from the last 5 years, composed mainly of case reports and multicentric analyzes, report non-inferiority of the outcome when treatments are compared or better outcome with NOACs due to the lower risk of bleeding. However, the European Stroke Organization in its last guideline (2017) does not recommend the use, especially during the acute phase. Conclusions: CVT can affect patients of various ages, so knowledge of the best therapy is essential. Currently, the use of warfarin and heparin is still recommended for acute cases, assessing the risk of complications such as bleeding. In view of the possible safety of new anticoagulants in view of the risk of hemorrhagic complications, further studies of non-inferiority in relation to warfarin are necessary so that the best approach is employed for these patients.

scholarly journals Diagnostic and Therapeutic Challenges of Cerebral Venous Thrombosis in SARS-CoV-2 Infection: A Case Report and Review of Literature

2021 ◽  
Vol 11 (3) ◽  
pp. 598-606
Author(s):  
Faisal Khan ◽  
Neha Sharma ◽  
Moin Ud Din ◽  
Ryan Chetram
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Transverse Sinus ◽  
Prodromal Symptom ◽  
History Of ◽  
Subcutaneous Enoxaparin ◽  
Polymerase Chain ◽  
Neurovascular Imaging

Headache, a common prodromal symptom of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, can also be a manifestation of cerebral venous thrombosis (CVT), secondary to COVID-19. CVT management continues to evolve, with direct oral anticoagulants (DOACs) emerging as an alternative to warfarin. A 44-year-old Asian female, with no past medical history, presented to the emergency room (ER) with complaints of nonproductive cough and left-sided headache. She denied a history of COVID-19 vaccination, and SARS-CoV-2 testing (with reverse transcriptase-polymerase chain reaction) was positive. Non-contrast computed tomography (CT) of the head revealed left transverse sinus hyperdensity, consistent with dense vein sign, and magnetic resonance venography (MRV) confirmed the presence of thrombus. The initial treatment included subcutaneous enoxaparin with headache resolution, and she was discharged on apixaban. Five weeks later, a non-contrast head CT showed resolution of the dense vein sign and recanalisation of left transverse sinus was seen on MRV. This report has highlighted the need for increased awareness of coagulopathy and thrombotic events, including cerebral venous thrombosis, in patients infected with SARS-CoV-2. Unremitting headache, in context of SARS-CoV-2 infection, should be evaluated with appropriate neurovascular imaging. Controlled studies are required to compare the safety and efficacy of DOACs with warfarin for management of cerebral venous thrombosis.

scholarly journals Cerebral venous thrombosis in women of childbearing age: diagnosis, treatment, and prophylaxis during a future pregnancy

2020 ◽  
Vol 13 ◽  
pp. 175628642094516
Author(s):  
Büșra Durmuș ◽  
Laetitia Yperzeele ◽  
Susanna M Zuurbier
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Hormone Replacement ◽  
Thrombosis Prophylaxis ◽  
Low Molecular Weight ◽  
Optimal Dosage ◽  
Childbearing Age ◽  
History Of

Sex-specific risk factors for cerebral venous thrombosis (CVT) in women include oral contraceptives, pregnancy, puerperium, and hormone replacement therapy. The acute treatment of CVT is anticoagulation using therapeutic doses of low molecular weight heparin, which is also the preferred treatment in the post-acute phase in pregnancy and during breastfeeding. In patients with imminent brain herniation decompressive surgery is probably life-saving. A medical history of CVT alone is not a contraindication for future pregnancies. The optimal dosage of low molecular weight heparin as thrombosis prophylaxis during future pregnancies after a history of venous thrombosis including CVT is the topic of an ongoing trial.

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