2009, Number 3
<< Back Next >>
Rev Mex Neuroci 2009; 10 (3)
Cerebral venous thrombosis at the Hospital Civil de Guadalajara “Fray Antonio Alcalde”
Rodríguez-Rubio LR, Medina-Córdova LL, Andrade-Ramos MA, González-Padilla C, Bañuelos-Becerra LJ, Chiquete E, Coronado-Magaña H, Pérez-Flores G, Rojas-Andrews A, González-Cornejo S, Ruiz-Sandoval JL
Language: Spanish
References: 28
Page: 177-183
PDF size: 114.72 Kb.
ABSTRACT
Introduction: Cerebral venous thrombosis (CVT) is the least common among all sorts of acute cerebrovascular disease, with
a hospital frequency reported of 0.43 to 8% in Mexico. CVT has been studied mainly in concentration hospitals in Mexico City;
however, its features in other scenarios of the rest of the country are unknown.
Objective: To describe the main clinical,
therapeutic and radiological features as well as the prognosis of CVT at the Hospital Civil de Guadalajara “Fray Antonio
Alcalde”.
Material and methods: All consecutive patients with diagnosis of CVT between 1999 and 2008, complete data about
clinical and radiological characteristics at hospital admittance, as well as the in-hospital evolution and outcome at discharge
and during long-term follow-up were registered.
Results: A total of 24 patients with mean age of 30 years were included; 20 of
them (83%) were women. The course of the CVT was mainly sub-acute with a delay in diagnosis of eleven days. Headache, motor
focal signs and cognitive and behavioral disturbances were the most common manifestations. Longitudinal superior sinus was
the most affected. Puerperium was the most frequently associated condition to CVT (46%). Hospital stay was 22 days in average
and during this lapse, one fourth of patients received anticoagulation. At discharge, mortality rate was 8% with a bad outcome
in 50% of cases; however, during a follow-up (17 months in average), 70% observed a good outcome, without CVT recurrence.
Conclusion: CVT in our hospital is not different to what has been previously reported in other hospitals in Mexico. The mortality
observed was low and the long term prognosis was good.
REFERENCES
Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005; 352: 1791-8.
Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004; 35: 664-70.
Barinagarrementería F, Ruiz-Sandoval JL, Arauz A, Amaya L, Cantú C. A Hospital Stroke Register in Mexico City: analysis of 2,045 patients. Neurology 1999; 52(Suppl. 2): 442 [Abstract].
Nieto de-Pascual RH, Guizar-Bermúdez C, Ortiz-Trejo JF. Epidemiología de la enfermedad vascular cerebral en el Hospital General de México. Rev Med Hosp Gen Mex 2003; 66: 7-12.
Ruiz-Sandoval JL, Ortega LA, García-Navarro V, Romero-Vargas S, González-Cornejo S. Hemorragia intracerebral en un hospital de referencia de la región centro-occidente de México. Rev Neurol 2005; 40: 656-60.
Barinagarrementeria F, Cantu C, Arredondo H. Aseptic cerebral venous thrombosis: proposed prognostic scale. J Stroke Cerebrovasc Dis 1992; 2: 34-9.
Cantú C, Barinagarrementeria F. Cerebral venous thrombosis associated with pregnancy and puerperium. Review of 67 cases. Stroke 1993;24:1880-1884.
Cantu C, Alonso E, Jara A, Martínez L, Ríos C, Fernández Mde L, Garcia I, Barinagarrementeria F. Hyperhomocysteinemia, low folate and vitamin B12 concentrations, and methylene tetrahydrofolate reductase mutation in cerebral venous thrombosis. Stroke 2004; 35: 1790-4.
Ruiz-Sandoval JL, Cantú C, Chiquete E, León-Jiménez C, Arauz A, Murillo-Bonilla LM, Villarreal-Careaga J, Barinagarrementería F. RENAMEVASC Investigators. Aneurysmal subarachnoid hemorrhage in a Mexican multicenter registry of cerebrovascular disease: the RENAMEVASC study. J Stroke Cerebrovasc Dis 2009; 18: 48-55.
Ribes F. Des recherchés faites sur la phlebite. Rev Medical Francais et Etrangere er Journal de Clinique del “Hotel Dieu et de la Charite de Paris 1825.
Abercrombie J. Pathological and practical researches on diseases of the brain and spinal cord. Edinburgh; 1828, p. 83-5.
Ameri A, Bousser MG. Cerebral venous sinus thrombosis. Neurol Clin 1992; 10: 87-111.
Ferro JM, Canhão P, Bousser MG, Stam J, Barinagarrementeria F. ISCVT Investigators. Cerebral vein and dural sinus thrombosis in elderly patients. Stroke 2005; 36: 1927-32.
Benabu Y, Mark L, Daniel S, Glikstein R. Cerebral venous thrombosis presenting with subarachnoid hemorrhage. Case report and review. Am J Emerg Med 2009; 27: 96-106.
Ferro JM, Canhão P, Bousser MG, Stam J, Barinagarrementeria F; ISCVT Investigators. Early seizures in cerebral vein and dural sinus thrombosis: risk factors and role of antiepileptics. Stroke 2008; 39: 1152-8.
Bousser MG. Cerebral venous thrombosis: an update. Lancet Neurol 2007; 6: 162-70.
Wasay M, Azeemuddin M. Neuroimaging of cerebral venous thrombosis. J Neuroimaging 2005; 15: 118-28.
Lalive P, Moerloose P. Is measurement of D-dimer useful in the diagnosis of cerebral venous thrombosis. Neurology 2003; 61: 1057-60.
Crassard I, Soria C, Tzourio C, Woimant F, Drouet L, Ducros A, Bousser MG. A negative D-dimer assay does not rule out cerebral venous thrombosis: a series of seventy-three patients. Stroke 2005; 36: 1716-9.
Canhão P, Cortesão A, Cabral M, Ferro JM, Stam J, Bousser MG, Barinagarrementeria F. ISCVT Investigators. Are steroids useful to treat cerebral venous thrombosis? Stroke 2008; 39: 105-10.
Einhäupl KM, Villringer A, Meister W, Mehraein S, Garner C, Pellkofer M, et al. Heparin treatment in sinus venous thrombosis. Lancet 1991; 338: 597-600.
de Bruijn SF, 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: 484-8.
Stam J, de Bruijn SFTM, DeVeber G. Anticoagulation for cerebral sinus thrombosis (Cochrane review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update software. Stroke 2003; 34: 1054-5.
Einhäupl K, Bousser MG, de Bruijn SF, Ferro JM, Martinelli I, Masuhr F, Stam J. EFNS guideline on the treatment of cerebral venous and sinus thrombosis. Eur J Neurol 2006; 13: 553-9.
Canhão P, Falcão F, Ferro JM. Thrombolytics for cerebral sinus thrombosis. A systematic review. Cerebrovasc Dis 2003; 15: 159-66.
Canhao P, Ferro JM, Lindgren AG, Bousser MG, Stam J, Barinagarrementeria F. for the ISCVT Investigators. Causes and predictors of death in cerebral venous thrombosis. Stroke 2005; 36: 1720-5.
Koopman K, Uyttenboogaart M, Vroomen PC, van der Meer J, De Keyser J, Luijckx GJ. Development and validation of a predictive outcome score of cerebral venous thrombosis. J Neurol Sci 2009; 276: 66-8.
Preter N, Tzourio C, Ameri A, Bousser MG. Long-term prognosis in cerebral venous thrombosis – Follow-up of 77 patients. Stroke 1996; 27: 243-6.