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Cerebral vein thrombosis

Paul Monagle, Fiona Newall
Venous thrombosis (VTE) in children and neonates presents numerous management challenges. Although increasing in frequency, VTE in children and neonates is still uncommon compared with adults. The epidemiology of VTE is vastly different in neonates vs children vs adolescents vs adults. In reality, pediatric thrombosis should be viewed as a multitude of rare diseases (eg, renal vein thrombosis, spontaneous thrombosis, catheter-related thrombosis, cerebral sinovenous thrombosis), all requiring different approaches to diagnosis and with different short- and long-term consequences, but linked by the use of common therapeutic agents...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
I D Stulin, O A Podgornaia, F A Seleznev, S A Trukhanov, D S Solonskii, N A Shamalov, S V Prikazchikov, I S Tagirov, O N Kudriakov, M G Selezneva, G A Baranov, L E Dobrovolskaia, A V Dobriakov, I A Skliar, N D Sorokina
AIM: To assess the efficacy of intermittent pneumatic compression (IPC) in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurological patients. MATERIAL AND METHODS: The study included 101 patients with acute disorders of cerebral circulation: 52 patients underwent IPC for prevention of DVT of the lower extremities, 49 patients received only basic treatment. Clinical examination, venous duplex scan of the lower extremities and telethermography were performed...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Giacomo Emmi, Alessandra Bettiol, Elena Silvestri, Gerardo Di Scala, Matteo Becatti, Claudia Fiorillo, Domenico Prisco
Behçet's syndrome (BS) is a complex vasculitis, characterised by peculiar histological, pathogenetic and clinical features. Superficial venous thrombosis (SVT) and deep vein thrombosis (DVT) are the most frequent vascular involvements, affecting altogether 15-40% of BS patients. Atypical thrombosis is also an important clinical feature of BS, involving the vascular districts of the inferior and superior vena cava, suprahepatic veins with Budd-Chiari syndrome, portal vein, cerebral sinuses and right ventricle...
November 29, 2018: Internal and Emergency Medicine
Yumeho Sugahara, Natsuki Ono, Eriko Morishita, Hiroshi Takashima
We reported a 31-year-old man with recurrent cerebral venous thrombosis caused by congenital protein C deficiency. He was diagnosed with cerebral venous thrombosis before 7 months. He was transferred to our hospital with numbness of right hand and right side of face, and dysarthria. The blood examination showed that his protein C antigen level and protein C activity were decreased than the lower limits of normal. Brain magnetic resonance venography showed poor visualization of the superior sagittal sinus and cortical veins...
November 29, 2018: Rinshō Shinkeigaku, Clinical Neurology
Paul Monagle, Carlos A Cuello, Caitlin Augustine, Mariana Bonduel, Leonardo R Brandão, Tammy Capman, Anthony K C Chan, Sheila Hanson, Christoph Male, Joerg Meerpohl, Fiona Newall, Sarah H O'Brien, Leslie Raffini, Heleen van Ommen, John Wiernikowski, Suzan Williams, Meha Bhatt, John J Riva, Yetiani Roldan, Nicole Schwab, Reem A Mustafa, Sara K Vesely
BACKGROUND: Despite an increasing incidence of venous thromboembolism (VTE) in pediatric patients in tertiary care settings, relatively few pediatric physicians have experience with antithrombotic interventions. OBJECTIVE: These guidelines of the American Society of Hematology (ASH), based on the best available evidence, are intended to support patients, clinicians, and other health care professionals in their decisions about management of pediatric VTE. METHODS: ASH formed a multidisciplinary guideline panel that included 2 patient representatives and was balanced to minimize potential bias from conflicts of interest...
November 27, 2018: Blood Advances
Hikaru Kamo, Yuji Ueno, Mizuho Sugiyama, Nobukazu Miyamoto, Kazuo Yamashiro, Ryota Tanaka, Nobutaka Hattori
Deep cerebral venous system thrombosis (DCVST) is an uncommon variety of thrombosis that accounts for 11% of cases of cerebral venous thrombosis. Thalamostriate vein (TSV) thrombosis is further rare among patients with DCVST. Although patients with cerebral venous thrombosis commonly have characteristic neurological deficits including headache, deterioration of consciousness, and seizures, patients with DCVST do not necessarily show such symptoms. Therefore, diagnose of DCVST is sometimes difficult. Here we report a case of TSV thrombosis with a unilateral basal ganglion lesion presenting with right-sided hemiparesis...
November 24, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Wakoto Matsuda, Shozo Noguchi, Fumino Fujiyama
A 71-year-old male appeared at the facility complaining of disturbance of consciousness and bilateral papilledema. The laboratory test revealed anemia and coagulation abnormality. A physical examination and magnetic resonance imaging (MRI) of the brain with and without gadolinium showed no abnormalities. A lumbar puncture showed a high pressure, but a normal cerebrospinal fluid (CSF) cell count. Cerebral angiography showed no morphological abnormalities, but it revealed an asymmetric right dominant type of confluence of the sinuses with the partially-communicating left transverse sinus in the late phase...
December 2018: ENeurologicalSci
Hiromitsu Ohmori, Yasushi Kanaoka, Masami Yamasaki, Hiroko Takesue, Ryo Sumimoto
Sudden death associated with patients with severe motor and intellectual disabilities (SMID) have been thought to be caused in part by venous thromboembolism (VTE), but actual situation of VTE in SMID is not clear. We examined the prevalence and location of deep venous thrombosis (DVT), and the relation of the development of crural veins in 16 patients with SMID, using ultrasonography. The maximum diameter of soleal vein was 1.6±0.5 mm. In most cases, DVT was found in the femoral veins. We could not detect thrombus in the soleal veins...
September 25, 2018: Annals of Vascular Diseases
Myungah Lee, Youngjae Heo, Taewon Kim
Our objective is to present a case of Vernet's syndrome (cranial nerve (CN) IX, X, and XI palsy) associated with cerebral venous thrombosis (CVT) in an internal jugular vein. The patient presented with acutely developed dysphagia. The weakness of the left sternocleidomastoid and trapezius muscles was observed. The initial magnetic resonance imaging and computed tomography (CT) with contrast enhancement showed contrast-filling defect in the left internal jugular vein inside the jugular foramen. The magnetic resonance venography with contrast enhancement revealed a partial filling defect in the left sigmoid sinus and total occlusion of the left internal jugular vein...
November 2, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Mohammad Selim, Amandeep Rakhra, Thamer Kassim, Rouhin Sen, Javaneh Jabbari, Carrie Valenta
A case of 43-year-old female presented to the emergency department (ED) with a new onset grand mal tonic-clonic seizure lasting at least two minutes with post-ictal confusion. Imaging was consistent with cerebral sinus venous thrombosis (CSVT) associated with intracranial hemorrhage. After ruling out most common causes of thrombosis, the etiology was attributed to estrogen vaginal ring. The patient was treated with anticoagulation therapy and had increasing hemorrhagic changes in the first few days, which eventually improved...
August 5, 2018: Curēus
Y Liu, D C Han, Y L Hu, L M Chen, J C Li, Y W Su, C X Hu
Objective: To summarize the clinical presentations and imaging features of cerebral venous sinus thrombosis (CVST) in 5 newborns. Methods: The clinical data of 5 newborns with CVST admitted to Department of Neonatology of Maternal and Children Hospital of Hubei Province from February 2017 to April 2018 were analyzed retrospectively. The risk factors, clinical presentations, imaging manifestations and treatment of CVST were investigated. Results: Of the 5 full term neonates, 4 were males and 1 female, with 4 aged less than 7 days and 1 more than 7 days; one with the history of maternal gestational diabetes mellitus, one with maternal gestational hypertension...
October 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Sara Degl'Innocenti, Nicola Della Camera, Cristian Falzone, Carlo Cantile
Intravascular lymphoma (IVL) is a rare angiotropic large-cell lymphoma in which neoplastic lymphocytes proliferate within the lumina of small blood vessels in the absence of a primary extravascular mass or leukemia. This study included 10 cases of canine IVL restricted to the CNS. Dogs had an average age of 8 years and neurological signs mainly referred to brain involvement such as depression, seizures, and ambulatory deficits. Gross examination at necropsy showed focal extensive or multiple hemorrhagic areas mainly distributed in the telencephalon and diencephalon...
October 5, 2018: Veterinary Pathology
Kyle H Cichos, Eva J Lehtonen, Gerald McGwin, Brent A Ponce, Elie S Ghanem
INTRODUCTION: Orthopaedic surgeons are wary of patients with neuromuscular (NM) diseases as a result of perceived poor outcomes and lack of data regarding complication risks. We determined the prevalence of patients with NM disease undergoing total joint arthroplasty (TJA) and characterized its relationship with in-hospital complications, prolonged length of stay, and total charges. METHODS: Data from the Nationwide Inpatient Sample from 2005 to 2014 was used for this retrospective cohort study to identify 8,028,435 discharges with total joint arthroplasty...
October 2, 2018: Journal of the American Academy of Orthopaedic Surgeons
Anne Kuitunen, Marjatta Sinisalo, Annukka Vahtera, Leena Hiltunen, Kaija Javela, Outi Laine
BACKGROUND: Heparin-induced thrombocytopenia (HIT) usually appears at 5 to 10 days after initiation of heparin. Autoimmune HIT can arise after discontinuation of heparin treatment (delayed-onset HIT) or without any preceding heparin exposure (spontaneous HIT syndrome). CASE REPORT: This case presents a course of autoimmune HIT with delayed onset. The patient was hospitalized due to influenza pneumonia and received low-molecular-weight heparin thromboprophylaxis for 9 days...
October 4, 2018: Transfusion
Ylenia Ingrasciotta, Salvatore Crisafulli, Valeria Pizzimenti, Ilaria Marcianò, Anna Mancuso, Giuseppe Andò, Salvatore Corrao, Piera Capranzano, Gianluca Trifirò
Since 2008, new oral anticoagulants (NOACs) have been approved for the prevention of venous thromboembolism (VTE) in patients receiving hip or knee replacement surgery, prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF), treatment of deep vein thrombosis (DVT), and pulmonary embolism (PE). Premarketing randomized clinical trials (RCTs) of NOACs demonstrated their non-inferiority in terms of efficacy vs. warfarin (traditional oral anticoagulant - TOA), with lower risk of serious adverse drug reactions, especially cerebral hemorrhages...
October 2018: Expert Opinion on Drug Metabolism & Toxicology
Joseph J Shatzel, Matthew O'Donnell, Sven R Olson, Matthew R Kearney, Molly M Daughety, Justine Hum, Khanh P Nguyen, Thomas G DeLoughery
Thrombosis of unusual venous sites encompasses a large part of consultative hematology and is encountered routinely by practicing hematologists. Contrary to the more commonly encountered lower extremity venous thrombosis and common cardiovascular disorders, the various thromboses outlined in this review have unique presentations, pathophysiology, workup, and treatments that all hematologists should be aware of. This review attempts to outline the most up to date literature on cerebral, retinal, upper extremity, hepatic, portal, splenic, mesenteric, and renal vein thrombosis, focusing on the incidence, pathophysiology, provoking factors, and current recommended treatments for each type of unusual thrombosis to provide a useful and practical review for the hematologist...
September 28, 2018: European Journal of Haematology
Gourav Goyal, Abhishek Charan, Rambir Singh
Introduction: Cerebral venous sinus thrombosis (CVST) is an unusual cause of stroke with potentially serious consequences. This study was designed to investigate the clinical and neuroimaging features in patients with CVST and to analyze the predictors of brain parenchymal lesions. Materials and Methods: A retrospective study of 181 patients with CVST was conducted in a tertiary care hospital. Results: Of 181 patients (age range 14-96 years, mean age: 34...
July 2018: Annals of Indian Academy of Neurology
Sadegh Izadi, Afshin Borhani-Haghighi, Kamal Bastani, Bahareh Kardeh, Golnaz Yadollahi-Khales, Mojtaba Neydavoodi
BACKGROUND: Cerebral sinovenous thrombosis (CSVT) is a neurovascular disorder that occurs when a blood clot develops in a vein near the brain. Evaluating the subsequent changes in inflammatory cytokines can better reveal the underlying pathogeneses. OBJECTIVE: To assess the serum levels of interleukin-10 (an anti-inflammatory cytokine) and IL-17 (a pro-inflammatory cytokine) in patients with aseptic non-vasculitic CSVT. METHODS: In this prospective case-control study, 31 patients with aseptic non-vasculitic CSVT (admitted in Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran) were enrolled...
September 2018: Iranian Journal of Immunology: IJI
Prasert Iampreechakul, Wuttipong Tirakotai, Adisak Tanpun, Yodkhwan Wattanasen, Punjama Lertbusayanukul, Somkiet Siriwimonmas
Spontaneous regression of direct carotid-cavernous fistulas (CCFs) is extremely rare. Most of the patients with direct CCFs are usually treated using endovascular techniques. Spontaneous obliteration of the direct fistulas probably results from thrombosis of the venous drainage and/or cavernous sinus. We report spontaneous closure of nine direct CCFs in nine patients. From literature review, we found another 37 patients with 43 fistulas due to spontaneous obliteration of bilateral lesions in six cases. There was no spontaneous closure in large-sized fistula...
September 23, 2018: Interventional Neuroradiology
Małgorzata K Mimier, Dawid T Janczak, Robert D McBane, Damon E Houghton, Waldemar E Wysokinski
In 4% of cases, venous thromboembolism (VTE) involves organ‑related venous territories such as splanchnic, renal, gonadal, and cerebral venous segments, and is often called venous thromboembolism of atypical location (VTE‑AL). Recommendations regarding the method, intensity, and duration of anticoagulant therapy for VTE‑AL are not well established. Direct oral anticoagulants (DOACs) have been a promising alternative to vitamin K antagonists in the treatment of acute VTE. However, all major clinical trials on DOACs excluded patients with VTE‑AL...
October 31, 2018: Polish Archives of Internal Medicine
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