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Cerebral venous thrombosis in pregnancy

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https://www.readbyqxmd.com/read/28274514/cerebral-venous-sinus-thrombosis-in-pregnancy-and-puerperium-a-pooled-systematic-review
#1
REVIEW
Ahmed I Kashkoush, Henry Ma, Nitin Agarwal, David Panczykowski, Daniel Tonetti, Gregory M Weiner, William Ares, Cynthia Kenmuir, Ashutosh Jadhav, Tudor Jovin, Brian T Jankowitz, Bradley A Gross
Pregnancy and puerperium are risk factors for cerebral venous sinus thrombosis (CVST); however studies describing diagnosis and management in this population are limited. The objective of this study was to amalgamate published case reports and series regarding diagnosis and management of CVST in pregnancy and puerperium. Searches of PubMed and the Cochrane library were performed using search terms "pregnancy"/"puerperium" and "sinus occlusion"/"sinus thrombosis". Studies were included in our pooled analysis if they included individual patient symptoms, management approach and follow-up condition...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28262755/clinical-characteristics-and-prognosis-of-cerebral-venous-thrombosis-in-chinese-women-during-pregnancy-and-puerperium
#2
Zhu-Wei Liang, Wan-Li Gao, Li-Min Feng
Due to the specific physiology associated with pregnancy and puerperium, cerebral venous sinus thrombosis (CVT) may manifest different characteristics. This study aimed to identify the clinical manifestations and prognosis of pregnancy-associated CVT. A total of 43 pregnancy-associated CVT patients were enrolled. We analysed the clinical presentations of the disease and performed a multivariate logistic regression analysis to determine which variables were associated with prognosis. Our descriptive results showed the following: 1) the incidence was 202 per 100,000 deliveries, and the mortality rate was 11...
March 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28208950/cerebral-venous-thrombosis-in-pregnancy-a-poignant-allegory-of-an-unusual-case
#3
Sheeba Marwah, Gaikwad Harsha Shailesh, Sumedha Gupta, Manjula Sharma, Pratima Mittal
Cerebral Venous Thrombosis (CVT), also known as cortical venous, cerebral sinus, cerebral venous sinus, or dural sinus thrombosis, is an infrequent grave condition affecting pregnant females, resulting from clot formation in one of the many outflow tracts of the brain. Although pregnancy-associated stroke or CVT is uncommon, the risk of stroke is greatly increased above the low baseline rate in young patients during late pregnancy and, even more so, during the puerperium. Haemorrhagic infarction can occur in the acute stage of CVT...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208940/neurological-disorders-complicating-pregnancy-focus-on-obstetric-outcome
#4
Sandya Renukesh, Lavanya Rai
INTRODUCTION: Neurological disorders in pregnancy can be pregnancy related or can be caused by exacerbation of a pre-existing neurological condition or sometimes may even be detected for the first time during pregnancy in which it might be an incidental finding. The diagnosis and management of the neurological disorders in pregnancy is always a challenging task due to varied symptomatology and risks to the fetus. The evaluation and management should be performed in a stepwise fashion and requires multidisciplinary approach...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#5
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28024507/-correlation-of-thrombosis-and-prothrombotic-state-with-coagulation-factor-v-gene-polymorphism-and-apcr-hhcy
#6
Li-Xia Gao, Qiu-Lan Ding, Ke-Xiong Wu, Jun Hu, Xue-Feng Wang, Chuan-Ling Dong, Qin Dai, Bing Zhang, Jin Dai, Ping He, Xue-Ping Zhang, Yun-Xia Wang
OBJECTIVE: To investigate the correlation of patients with thrombosis or prothrombotic status with hyperhomocysteinemia (HHcy), activated protein C-resistance(APCR) and gene polymorphism of coagulation factor V. METHODS: Three hundred healthy voluteers were selected as controls, 223 cases of thrombosis (80 cases of cerebral infarction of CT, the MI of 82 cases of myocardial infarction, venous thrombosis of VTE 61 cases), 270 cases of patients with prothrombotic state (76 cases of pregnancy disease of PIH, 62 cases of chronic obstructive pulmonary disease (COPD), 60 cases of diabetes(DM) and 72 cases of cancer) were enrolled in this study...
December 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/27816347/cerebral-venous-thrombosis
#7
José Manuel Ferro, Patrícia Canhão, Diana Aguiar de Sousa
Cerebral venous thrombosis (CVT) has an incidence of 1.32/100,000/years in high-income countries, and higher in middle- and low-income countries. CVT is more frequent in infants and children young adults and females, especially during pregnancy/puerperium. CVT are now being diagnosed with increasing frequency because of the increased awareness and higher use of magnetic resonance imaging (MR) for investigating patients with acute and subacute headaches and new onset seizures. CVT rarely present as a stroke syndrome...
December 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27775757/risk-of-pregnancy-associated-stroke-across-age-groups-in-new-york-state
#8
Eliza C Miller, Hajere J Gatollari, Gloria Too, Amelia K Boehme, Lisa Leffert, Mitchell S V Elkind, Joshua Z Willey
Importance: Older age is associated with increased risk of pregnancy-associated stroke (PAS). Data are limited on age-specific incidence ratios of PAS compared with stroke risk in nonpregnant women. Objectives: To assess the risk of stroke by age group in pregnant and postpartum women compared with their nonpregnant contemporaries and to compare risk factors across age groups in the exposed (pregnant/postpartum) and unexposed (nonpregnant) populations. Design, Setting, and Participants: International Classification of Diseases, Ninth Revision, billing codes from the calendar year 2003-2012 New York State Department of Health inpatient database and population data were used to identify all women aged 12 to 55 years with cerebrovascular events, including transient ischemic attack, ischemic and hemorrhagic stroke, cerebral venous thrombosis, and nonspecified PAS...
December 1, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27695595/international-classification-of-diseases-ninth-revision-icd-9-diagnosis-codes-can-identify-cerebral-venous-thrombosis-in-hospitalized-adults
#9
Ava L Liberman, Hooman Kamel, Michael T Mullen, Steven R Messé
BACKGROUND: Cerebral venous thrombosis (CVT) is a relatively rare and understudied disease. We sought to determine the accuracy of International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes to identify CVT. METHODS: Retrospective chart review using the electronic medical record (EMR) to identify all patients discharged with CVT following admission or emergency department visit from May 1, 2010 to May 1, 2015 at our center. RESULTS: We identified 111 patients with an ICD-9 discharge diagnosis code of 325...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27598406/pregnancy-outcome-after-a-first-episode-of-cerebral-vein-thrombosis
#10
I Martinelli, S M Passamonti, A Maino, M Abbattista, P Bucciarelli, E Somigliana, A Artoni, F Gianniello, F Peyvandi
Essentials Little is known about recurrences and pregnancy outcome after cerebral vein thrombosis (CVT). We studied a cohort of pregnant women with CVT. Women with CVT appear at increased risk of late obstetrical complications despite prophylaxis. Risks of recurrent thrombosis and bleeding in women on heparin prophylaxis while pregnant are low. SUMMARY: Background The risk of recurrent thrombosis and bleeding episodes in women with previous cerebral vein thrombosis (CVT) on antithrombotic prophylaxis with low-molecular-weight heparin (LMWH) during pregnancy is not established and little information is available on pregnancy outcome...
December 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27582021/cerebral-venous-thrombosis
#11
Samia Ben Sassi, Nahla Touati, Hela Baccouche, Cyrine Drissi, Neila Ben Romdhane, Fayçal Hentati
OBJECTIVE: Data regarding cerebral venous thrombosis in North Africa are scarce. This study aims to identify the clinical features, risk factors, outcome, and prognosis of cerebral venous thrombosis in Tunisia. METHODS: Data of 160 patients with radiologically confirmed cerebral venous thrombosis, hospitalized in Mongi Ben Hmida National Institute of Neurology (Tunis, Tunisia), were retrospectively collected and analyzed. RESULTS: The mean age was 37...
January 1, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27504325/a-prospective-study-of-the-clinical-profile-outcome-and-evaluation-of-d-dimer-in-cerebral-venous-thrombosis
#12
Venkatesh Thammishetti, Subrahmanyam Dharanipragada, Debdatta Basu, Ramesh Ananthakrishnan, Deepanjali Surendiran
INTRODUCTION: Cerebral Venous Thrombosis (CVT) is a well known disease with diverse clinical presentation and causes. With advances in neuroimaging and changing lifestyles, the clinical profile and causes of CVT are changing. D-dimer has been studied in early diagnosis of CVT with variable results. This prospective study was carried out to assess the clinical profile of CVT and role of D-dimer in diagnosis of CVT. AIM: To study various aspects of CVT and role of D-dimer...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27393078/seizures-in-the-peripartum-period-epidemiology-diagnosis-and-management
#13
REVIEW
A G M Aya, B Ondze, J Ripart, P Cuvillon
The occurrence of seizures in the peripartum period is a rare but particularly challenging situation. Seizures in the peripartum period could result from three categories of conditions: first and most frequent is the exacerbation of a known pre-existing seizure disorder, mainly epilepsy. A therapeutic evaluation is needed; second is the new onset of seizures due to a non-pregnancy-related problem. An accurate diagnosis and a specific treatment are required; third is range of pregnancy-related conditions. The present review focuses on this third category, with a special attention to disorders occurring in the peripartum period...
October 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27377498/quality-of-anticoagulation-therapy-in-neurological-patients-in-a-tertiary-care-hospital-in-north-india
#14
Prabhat Singh, J Kalita, U K Misra
BACKGROUND & OBJECTIVES: There is paucity of studies on the quality of anticoagulation in neurological patients from India. This study evaluates the quality of oral anticoagulation therapy in neurology patients. METHODS: Consecutive patients attending a tertiary care neurology service in north India who were prescribed oral anticoagulant (OAC), were included. Their international normalized ratio (INR) values were prospectively monitored and the earlier INR values of the patients who were already on OAC were retrospectively analyzed...
April 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27230113/neurological-complications-of-pregnancy
#15
REVIEW
H Steven Block
Physiologic alterations during pregnancy create an environment for the occurrence of disease states that are either unique to pregnancy, occur more frequently in pregnancy, or require special management considerations that may be different from the nonpregnancy state. In the realm of cerebrovascular disease, preeclampsia, eclampsia, reversible cerebral vasoconstriction syndrome, sources of cardiogenic embolization including peripartum cardiomyopathy, cerebral venous thrombosis, pituitary apoplexy, subarachnoid hemorrhage, intracerebral hemorrhage, and special considerations for anticoagulation during pregnancy will be discussed...
July 2016: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/27116537/status-epilepticus-associated-with-pregnancy-a-cohort-study
#16
Yan-Ting Lu, Che-Wei Hsu, Wan-Chen Tsai, Mei-Yun Cheng, Fu-Yuan Shih, Ting-Ying Fu, Yao-Chung Chuang, Meng-Han Tsai
BACKGROUND: Status epilepticus (SE) is a neurological emergency associated with a high mortality rate and long-term cognitive sequelae. Status epilepticus in pregnancy poses a tremendous threat to both mother and fetus, making a correct diagnosis and treatment a challenging task for clinicians. The prevalence, underlying etiology, and outcomes of pregnancy-related SE remain largely unknown. METHODS: We retrospectively studied all SE episodes (n=366) in patients admitted to our neurological ICU over a period of 8...
June 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/26993845/thrombophilia-testing-has-limited-usefulness-in-clinical-decision-making-and-should-be-used-selectively
#17
Elna M Masuda, Raymond W Lee, Ian J Okazaki, Pouya Benyamini, Robert L Kistner
Management of venous thromboembolism (VTE) includes evaluation for hypercoagulable state, especially if the VTE occurs in young patients, is recurrent, or is associated with a positive family history. These laboratory tests are costly, and surprisingly, there is little evidence showing that testing leads to improved clinical outcomes. Evidence based on observational prospective studies suggests that optimal duration of anticoagulation should be based on clinical risks resulting in VTE, such as transient, permanent, and idiopathic or unprovoked risks, and less on abnormal thrombophilia values...
April 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26918201/mechanisms-and-outcomes-of-stroke-during-pregnancy-and-the-postpartum-period-a-cross-sectional-study
#18
Eliza C Miller, Shadi Yaghi, Amelia K Boehme, Joshua Z Willey, Mitchell S V Elkind, Randolph S Marshall
BACKGROUND: Pregnancy-associated stroke remains incompletely characterized because of the rarity of these potentially devastating events. We investigated whether mechanism and outcome of ischemic pathophysiology stroke differ between young pregnant and nonpregnant women. METHODS: We identified 135 consecutive women ages 18-40 years admitted to our center from January 2008 through June 2014 with ischemic stroke, TIA, cerebral venous thrombosis, or nonaneurysmal subarachnoid hemorrhage due to reversible cerebral vasoconstriction syndrome (RCVS)...
February 2016: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/26797665/safety-of-pregnancy-after-cerebral-venous-thrombosis-a-systematic-review
#19
REVIEW
Diana Aguiar de Sousa, Patrícia Canhão, José M Ferro
BACKGROUND AND PURPOSE: Pregnancy and puerperium are associated with an increased risk of venous thrombotic events (VTEs), including cerebral venous thrombosis (CVT). We aimed to systematically review, in pregnant woman with previous CVT, (1) the risk of recurrence of CVT or other VTE; (2) the result of pregnancy; and (3) the association of antithrombotic prophylaxis with these outcomes. METHODS: We searched MEDLINE, Cochrane Database of Systematic Reviews, clinicaltrials...
March 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/26783307/sex-differences-in-cerebral-venous-thrombosis-a-systematic-analysis-of-a-shift-over-time
#20
REVIEW
Susanna M Zuurbier, Saskia Middeldorp, Jan Stam, Jonathan M Coutinho
BACKGROUND: In contemporary studies, cerebral venous thrombosis is three times more common in adult women than in men. AIM: To study the change in sex ratio over time in cerebral venous thrombosis. SUMMARY OF REVIEW: We systematically reviewed the literature. Any type of study with at least 40 patients with cerebral venous thrombosis that reported sex ratio was eligible. We ranked studies according to the year halfway the period of patient recruitment...
February 2016: International Journal of Stroke: Official Journal of the International Stroke Society
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