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Cerebral vein thrombosis

Yu Shimizu, Katsuhiro Tsuchiya, Hironori Fujisawa
BACKGROUND: Cerebral venous thrombosis is rare and an uncommon cause of stroke and has diverse etiologies and varied clinical presentations. Here, we report 2 cases of deep cerebral venous thrombosis. CASE DESCRIPTION: A 64-year-old woman presented with cerebral venous thrombosis due to a hypercoagulable state associated with ovarian tumor. On initial fluid-attenuated inversion recovery and diffusion-weighted imaging, there was a diffuse high-intensity lesion in the bilateral thalamus...
February 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Dian He, YunLi Yu, Shan Wu, ShuFen Tian, Hui Yu, Shu Xu, Lan Chu
BACKGROUND: Mixed cerebrovascular disease is a diagnostic entity that presents with hemorrhagic and ischemic stroke clinically and/or subclinically. Here, we report a patient with mixed vascular risk factors, who presented with multiple intracerebral hemorrhages and a simultaneously occurring cerebral infarction with hemorrhagic transformation. CASE PRESENTATION: A 63-year-old male with no history of trauma or prior neurological disease presented with a sudden onset of weakness in his right limbs, followed by an episode of focal seizure without impaired awareness...
February 12, 2019: BMC Neurology
Wenyu Hu, Yanguo Xin, Xin Chen, Zhuyin Song, Zhiyi He, Yinan Zhao
BACKGROUND: Tranexamic acid functions as an antifibrinolytic medication and is widely used to treat or prevent excessive blood loss in menorrhagia and during the perioperative period. The efficacy of tranexamic acid in reducing mortaligy and disability, and the occurrence of complications during treatment of cerebral hemorrhage remains controversial. OBJECTIVE: The objective of this systematic literature review and meta-analysis was to evaluate the efficacy and safety of tranexamic acid in patients with cerebral hemorrhage, aiming to improve the evidence-based medical knowledge of treatment options for such patients...
February 11, 2019: CNS Drugs
R Russell, C Laxton, D N Lucas, J Niewiarowski, M Scrutton, G Stocks
The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. One woman received an epidural blood patch, the other did not, but both suffered with chronic headaches following discharge from hospital. Neither woman was adequately followed-up. Death resulted from a cerebral vein thrombosis in one case and a subdural haematoma in the other. Surveys of clinical practice in the UK have revealed significant variation in anaesthetic practice in the management of obstetric post-dural puncture headache...
December 21, 2018: International Journal of Obstetric Anesthesia
R Russell, C Laxton, D N Lucas, J Niewiarowski, M Scrutton, G Stocks
The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. Despite suffering long-term headaches, neither woman was adequately followed-up after discharge from hospital. Death resulted from a cerebral vein thrombosis in one case and a subdural haematoma in the other. Due to significant variation in the treatment of obstetric post-dural puncture headache, an Obstetric Anaesthetists' Association working group was set up to produce evidence-based guidelines to guide clinicians...
December 22, 2018: International Journal of Obstetric Anesthesia
Shinya Sonobe, Masahiro Yoshida, Kuniyasu Niizuma, Teiji Tominaga
Pulmonary vein thrombosis is a rare disease but can cause severe complications. However, pathophysiology of this entity is not fully understood. We report a case of mechanical thrombectomy for acute ischemic stroke arising from thrombus of the left superior pulmonary vein stump after left pneumonectomy. A 67-year-old male without atrial fibrillation presented with middle cerebral artery occlusion 11 days after left pneumonectomy. Contrast-enhanced computed tomography showed thrombus in the left superior pulmonary vein stump...
January 2019: NMC Case Report Journal
Martina Orfei, Marco Gasparetto, Franco Torrente
Cerebral vein thrombosis is a severe complication of inflammatory bowel disease, can cause non-specific symptoms and hence lead to delay in diagnosis. We report the case of an adolescent with inflammatory bowel disease who developed extensive cerebral vein thrombosis requiring a ventriculoperitoneal shunt. Diagnosis was markedly delayed due to repeated misinterpretation of clinical signs and laboratory findings and the lack of reconsidering the working diagnosis despite the involvement of several medical subspecialties...
January 29, 2019: BMJ Case Reports
Razaz Mageid, Yuchuan Ding, Paul Fu
Emergency department visits for a headache are relatively common, and in most cases, the etiologies of the headache are typically benign. We present a case of a patient who presented to the emergency room for new onset of unremitting unilateral headache. She subsequently had two hospital visits and three separate imaging modalities to identify vein of Labbe thrombosis. The vein of Labbe is a relatively smaller vein which runs superficially and laterally. In our patient, a cerebral venous thrombosis (CTV) was unable to identify vein of Labbe thrombosis, requiring eventually a magnetic resonance imaging (MRI) with and without contrast to identify the culprit etiology...
October 2018: Brain Circulation
Pouya Entezami, Alan Boulos, Junichi Yamamoto, Matthew Adamo
Developmental venous anomalies (DVAs) are the most commonly encountered cerebral malformations. While generally asymptomatic and discovered as incidental findings, there is a small number that can cause intracranial haemorrhage, usually attributed to associated cavernomas; however, venous thrombosis of the draining vein is a rare cause. A 10-year-old woman presented with seizure episodes. Angiographic evaluation revealed a collection of vessels draining into the superior sagittal sinus via the vein of Trolard, concerning for a DVA...
January 17, 2019: BMJ Case Reports
Amna Bibi, Chathuri Liyanapthirana, Sajjad Khan
This is a case of a female patient presented with a mild headache associated with recurrent episodes of nausea and vomiting, confusion and right-sided hemiparesis, diagnosed of haemorrhagic venous infarction from the thrombosis of left transverse and sigmoid sinus and probably the left vein of Labbe. She had severe microcytic hypochromic anaemia due to iron deficiency, without any other risk factors for cerebral venous thrombosis such as trauma history, infections, coagulation disorders or autoimmune diseases...
January 17, 2019: BMJ Case Reports
K L Benninger, N L Maitre, L Ruess, J A Rusin
BACKGROUND AND PURPOSE: Advanced imaging techniques have allowed earlier and more accurate detection of cerebral deep medullary vein thrombosis and infarction. Our objective was to develop an MR imaging scoring system to evaluate the severity of white matter injury in neonates with deep medullary vein thrombosis and infarction. MATERIALS AND METHODS: This was a retrospective study of infants born ≥32 weeks' gestation (2000-2016) diagnosed with deep medullary vein thrombosis and infarction on neuroimaging in the first 30 days of life...
January 17, 2019: AJNR. American Journal of Neuroradiology
David Roh, Jason Carroll, Kara Melmed, Mitchell S V Elkind, Andrew Eisenberger, Richard Francis, Soojin Park, Sachin Agarwal, Jan Claassen, Philip M Meyers
Cerebral venous sinus thrombosis (CVST) requires anticoagulation to promote vessel recanalization. Current anticoagulation paradigms utilize plasma tests from peripheral venous/arterial samples for therapeutic monitoring. We describe a medically-refractory case of CVST in a 35-year-old woman later found to have JAK2 mutation and essential thrombocytosis. Despite therapeutic anticoagulation levels, worsening cerebral edema and progression to coma prompted endovascular treatment. Failed endovascular thrombectomy attempts led to placement of 2 separate indwelling microcatheters for continuous infusion of tissue plasminogen activator (tPA)...
January 8, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sarkis Morales Vidal, Geeta Verma, Carolyn Goldschmidt, José Biller
Stroke in young women is commonly cryptogenic or associated with an underlying hypercoagulable state (e.g., hormonal contraception). Paradoxical embolization has been postulated as a potential risk factor for stroke in young adults. Many sources of venous thrombosis leading to paradoxical embolization have been described. There have been few reported cases of uterine enlargement leading to iliac vein compression and paradoxical embolization. We present the case of a young adult woman who had a left middle cerebral artery infarction related to patent foramen ovale and right common iliac vein compression from an enlarged fibroid uterus...
September 2018: Case Reports in Neurology
Junko Yamaguchi, Akihiro Noda, Akira Utagawa, Atsushi Sakurai, Kosaku Kinoshita
Herein, we report a pediatric case of acute paradoxical cerebral embolism complicated by serious acute pulmonary embolism that was caused by an extremely small patent foramen ovale (PFO). The patient had no medical history suggestive of any other reason. Paradoxical cerebral embolism may occur even with an extremely small PFO because of the increased right-side pressure of the heart and a resulting right-to-left shunt from the acute pulmonary embolism. Although pediatric cases of pulmonary embolism are rare, when diagnosed, clinicians should consider the risk of a concurrent paradoxical cerebral embolism resulting from a latent PFO...
2019: Open Medicine (Warsaw, Poland)
Vanessa Helena Brait, Francesc Miro-Mur, Isabel Pérez de Puig, Laura Notario, Begoña Hurtado, Jordi Pedragosa, Mattia Gallizioli, Francesc Jimenez-Altayo, Maria Arbaizar-Rovirosa, Amaia Otxoa-de-Amezaga, Juan Monteagudo, Maura Ferrer-Ferrer, Xavier de la Rosa, Ester Bonfill-Teixidor, Angelica Salas-Perdomo, Alba Hernandez-Vidal, Pablo García de Frutos, Pilar Lauzurica, Anna M Planas
RATIONALE: CD69 is an immunomodulatory molecule induced during lymphocyte activation. Following stroke, T lymphocytes upregulate CD69 but its function is unknown. OBJECTIVE: We investigated whether CD69 was involved in brain damage following ischemic stroke. METHODS AND RESULTS: We used adult male mice on the C57BL/6 or BALB/c backgrounds, including wild type mice and CD69-/- mice, and CD69+/+ and CD69-/- lymphocyte-deficient Rag2-/- mice, and generated chimeric mice...
December 3, 2018: Circulation Research
Min Kyoung Kang, Young-Dae Cho, Hyun-Seung Kang, Keun-Hwa Jung
Dural arteriovenous fistulas (dAVF) refer to an aberrant connection between an artery and a vein within the dura. Although the pathogenesis of dAVF is unclear, a link to cerebral venous thrombosis (CVT) has been posited though not fully identified. The current case is the first report demonstrating dAVF formation following CVT according to dynamic changes in the intracranial pressure and venous drainage pattern. This observation provides insight into the pathophysiological association between dAVF and CVT. A 60-year-old woman presented with acute onset of a severe headache and first-onset seizure...
March 2019: ENeurologicalSci
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
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