Afifi, K., Bellanger, G., Buyck, P. J., Zuurbier, S. M., Esperon, C. G., Barboza, M. A., Costa, P., Escudero, I, Renard, D., Lemmens, R., Hinteregger, N., Fazekas, F., Jimenez Conde, J., Giralt-Steinhauer, E., Hiltunen, S., Arauz, A., Pezzini, A., Montaner, J., Putaala, J., Weimar, C., Schlamann, Marc, Gattringer, T., Tatlisumak, T., Coutinho, J. M., Demaerel, P. and Thijs, V (2020). Features of intracranial hemorrhage in cerebral venous thrombosis. J. Neurol., 267 (11). S. 3292 - 3299. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1459

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Abstract

Background Cerebral venous thrombosis (CVT) is associated with intracranial hemorrhage. Aim To identify clinical and imaging features of CVT-associated intracranial hemorrhage. We hypothesized that higher clot burden would be associated with a higher risk of intracranial hemorrhage. Methods We performed a retrospective analysis of an international, multicenter cohort of patients with confirmed cerebral venous thrombosis who underwent computed tomography within 2 weeks of symptom onset. Clinical and imaging features were compared between patients with and without intracranial hemorrhage. Clot burden was assessed by counting the number of thrombosed venous sinuses and veins on confirmatory imaging. Results We enrolled 260 patients from 10 institutions in Europe and Mexico. The mean age was 42 years and 74% were female. Intracranial hemorrhage was found in 102 (39%). Among them parenchymal hemorrhage occurred in 64 (63%), in addition, small juxta-cortical hemorrhage was found in 30 (29%), subarachnoid hemorrhage in 24 (24%) and subdural hemorrhage in 11 (11%). Multiple concomitant types of hemorrhage occurred in 23 (23%). Older age and superior sagittal thrombosis involvement were associated with presence of hemorrhage. The number of thrombosed venous sinuses was not associated with intracranial hemorrhage (median number IQRInterquartile ratio] of sinuses/veins involved with hemorrhage 2 (1-3) vs. 2 (1-3) without hemorrhage,p = 0.4). Conclusion The high rate of intracranial hemorrhage in cerebral venous thrombosis is not explained by widespread involvement of the venous sinuses. Superior sagittal sinus involvement is associated with higher bleeding risk.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Afifi, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bellanger, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buyck, P. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zuurbier, S. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Esperon, C. G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barboza, M. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Costa, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Escudero, IUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Renard, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lemmens, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hinteregger, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fazekas, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jimenez Conde, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giralt-Steinhauer, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hiltunen, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arauz, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pezzini, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montaner, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Putaala, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weimar, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlamann, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gattringer, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tatlisumak, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Coutinho, J. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Demaerel, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thijs, VUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-329374
DOI: 10.1007/s00415-020-10008-0
Journal or Publication Title: J. Neurol.
Volume: 267
Number: 11
Page Range: S. 3292 - 3299
Date: 2020
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1432-1459
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SUPERIOR SAGITTAL SINUS; SUBARACHNOID HEMORRHAGE; ANTICOAGULATION; OCCLUSION; PROGNOSIS; DISEASE; STROKE; VEINMultiple languages
Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32937

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