Journal Mobile Options
Table of Contents
Vol. 11, No. 3, 2001
Issue release date: April 2001

Cerebral Vein and Dural Sinus Thrombosis in Portugal: 1980–1998

Ferro J.M. · Correia M. · Pontes C. · Baptista M.V. · Pita F.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

There is insufficient information on the prognosis and safety of anticoagulation in acute cerebral vein and dural sinus thrombosis (CVDST). To describe the clinical aspects and medical management of CVDST in Portuguese hospitals, to evaluate the safety of anticoagulation in this setting, and to identify subgroups of CVDST patients with different prognoses, we registered symptomatic CVDST patients admitted to Portuguese hospitals since 1980. Cases were collected from file review up to 6/95 and from consecutively admitted patients from 6/95 to 6/98. One hundred and forty-two patients were included from 20 centers (51 retrospectively and 91 prospectively). One hundred and twelve patients (79%) were anticoagulated. There were only 6 new intracranial hemorrhages (4 in anticoagulated patients) and 2 systemic hemorrhages. Nine (6%) patients died. At discharge, 96 (68%), had recovered completely and only 6 (4%) were dependent (Rankin ≧3). Significant multivariate predictors of death/dependency were central nervous system infection as a predisposing cause (odds ratio, OR = 15.4; 95% confidence interval CI = 111–1.1), encephalopathy on admission (OR = 5.2; 95% CI = 18.7–1.5) and hemorrhage on admission CT/MR (OR = 3.6; 95% CI = 12.9–1). Significant predictors of complete recovery were no encephalopathy on admission (OR = 5; 95% CI = 12.5–2.1), age <45 years (OR = 3.8; 95% CI = 9.2–1.6) and anticoagulation (OR = 3.8; 95% CI = 9.6–1.5). It is possible to identify CVDST patients with potential bad or good prognosis in the acute phase. Anticoagulation was safe and a predictor of complete recovery in acute CVDST.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Krayenbühl HA: Cerebral vein and sinus thrombosis. Clin Neurosurg 1967;14:1–24.
  2. Srinivasan K: Cerebral venous and arterial thrombosis in pregnancy and puerperium. A study of 135 patients. Angiology 1983;34:731–746.
  3. Bousser MG, Chiras J, Bories J, Castaigne P: Cerebral venous thrombosis – A review of 38 cases. Stroke 1985;16:199–213.
  4. Einhäupl KM, Villringer A, Haberl RL, Pfister H-W, Deckert M, Steinhoff H, Schmiedek P: Clinical spectrum of sinus venous thrombosis; in Einhäupl KM, Kempski O, Baethmann A (eds): Cerebral Sinus Thrombosis: Experimental and Clinical Aspects. New York, Plenum, 1990, pp 149–155.
  5. Kaplan JM, Biller J, Adams HP: Outcome in nonseptic spontaneous superiorsagittal sinus thrombosis in adults. A 14-year experience. Cerebrovasc Dis 1991;1:231–234.
  6. Barinagarrementeria F, Cantu C, Arredondo H: Aseptic cerebral venous thrombosis: Proposed prognostic scale. J Stroke Cerebrovasc Dis 1992;2:34–39.
  7. Cantu C, Barinagarrementeria F: Cerebral venous thrombosis associated with pregnancy and puerperium: Review of 67 cases. Stroke 1993;24:1880–1884.
  8. Daif A, Awada A, Al-Rajeh S, Abduljabbar M, Al Tahan AR, Obeid T, Malibary T: Cerebral venous thrombosis in adults. A study of 40 cases from Saudi Arabia. Stroke 1995;26:1193–1195.
  9. Ben Hamouda-m’rad I, Mrabet A, Hamida MB: Thromboses veineuses et infarctus cérébraux au cours de la grossesse et du post-partum. Rev Neurol 1995;151:563–568.
  10. Rondepierre P, Hamon M, Leys D, Leclerc X, Mounier-Vehier F, Godefroy O, Janssens E, Pruvo JP: Thromboses veineuses cérébrales: étude de l’évolution. Rev Neurol 1995;151:100–104.
  11. Preter M, Tzourio CH, Ameri A, Bousser MG: Long term prognosis in cerebral venous thrombosis. A follow-up of 77 patients. Stroke 1996;27:243–246.
  12. Brucker AB, Vollert-Rogenhofer H, Wagner M, Stieglbauer K, Felber S, Trenkler J, Deisenhammer E, Aichner F: Heparin treatment in acute sinus venous thrombosis: A retrospective clinical and MR analysis of 42 cases. Cerebrovasc Dis 1998;8:331–337.
  13. Wingerchuk DM, Wijdicks EFM, Fulgham JR: Cerebral venous thrombosis complicated by hemorrhagic infarction: Factors affecting the initiation and safety of anticoagulation. Cerebrovasc Dis 1998;8:25–30.
  14. Tehindrazanarivelo A, Evrard S, Schaison M, Mas JL, Rougemont D, Bousser MG: Prospective study of cerebral venous thrombosis in patients presenting with benign intracranial hypertension. Cerebrovasc Dis 1992;2:22–27.
  15. Biousse V, Ameri A, Bousser MG: Isolated intracranial hypertension as the only sign of cerebral venous thrombosis. Neurology 1999;53:1537–1542.
  16. Bousser MG: Cerebral venous thrombosis. Nothing, heparin, or local thrombolysis? Stroke 1999;30:481–483.
  17. Einhäupl KM, Villringer A, Meister W, Mehraein S, Garner C, Pellkofer M, Haberl RL, Pfister HW, Schmiedek P: Heparin treatment in sinus venous thrombosis. Lancet 1991;338:597–600.
  18. De Bruijn SFTM, Stam J, for the Cerebral Venous Sinus Thrombosis Study Group: Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke 1999;30:484–488.
  19. Horowitz M, Purdy P, Unwin H, Carstens G, Greenlee R, Hise J, Kopitnik T, Batjer H, Rollins N, Samson D: Treatment of dural sinus thrombosis using elective catheterization and urokinase. Ann Neurol 1995;38:58–67.
  20. Frey JL, Muro GJ, McDougall CG, Dean BL, Jahnke HK: Cerebral venous thrombosis. Combined intrathrombus rtPA and intravenous heparin. Stroke 1999;30:489–494.
  21. Bousser MG, Russell RR: Cerebral venous thrombosis; in Warlow CP, Van Gijn J (eds): Major Problems in Neurology. London, Saunders, 1997, vol 33, pp 27–29, 104–126.
  22. Rankin J: Cerebral vascular accidents in patients over the age of 60. II. Prognosis. Scott Med J 1957;2:200–215.
  23. Biousse V, Conard J, Brouzes C, Horellou MH, Ameri A, Bousser MG: Frequency of 20210 G→A mutation in the 3′-untranslated region of the prothrombin gene in 35 cases of cerebral venous thrombosis. Stroke 1998;29:1398–1400.
  24. Martinelli I, Sacchi E, Gianluca L, Taioli E, Duca F, Mannucci PM: High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. N Engl J Med 1998;338:1793–1797.
  25. De Bruijn SFTM, de Hoan RJ, Stam J, and the CVST study group: Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients; in De Bruijn SFTM (ed): Cerebral Venous Sinus Thrombosis. Clinical and Epidemiological Studies. Amsterdam, Thesis Publishers, 1998, pp 83–91.
  26. Bousser MG: Cerebral venous thrombosis; in Fisher M, Bogousslavsky J (eds): Current Review of Cerebrovascular Disease, ed 3. Boston, Butterworth Heinemann, 1999, pp 129–135.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50