RESUMEN
BACKGROUND: The clinical epidemiology of cerebral venous thrombosis (CVT) in Sub-Saharan Africa is unknown. Such information may be relevant for service planning, prevention and for adapting existing CVT management guidelines to that zone of the World. AIMS: Systematic review to describe the demography, associated conditions, clinical and neuroimaging features, treatment and outcome of CVT in Sub-Saharan Africa. SUMMARY OF REVIEW: We searched MEDLINE, Cochrane Database of Systematic Reviews, clinicaltrials.gov and reference lists of included studies for studies reporting original data on CVT in sub-Saharan Africa. We included 20 observational studies describing 287 CVT patients, 11 case reports (13 patients) and 9 case series (274 patients). All studies had a high risk of bias. In case series 58.6 % of the patients were female, the most common associated condition was infection (63.1%), followed by oral contraceptives (7.3%), pregnancy/puerperium (6.2 %), and prothrombotic conditions (2.2%). CT was the most common method to diagnose CVT (85%). Ninety-nine percent (101/102) of patients reported in case series after the year 2000 were anticoagulated. In case series, 21/210 with information (10 %) patients died in the acute phase, while 60/129 with information (46.5%) recovered without sequels. CONCLUSIONS: The low number of reported CVT cases from Sub-Saharan Africa suggests that CVT is either infrequent, not diagnosed or not reported. Infection is the most common risk factor. Most CVT cases were confirmed by CT alone. Almost all patients reported after year 2000 received anticoagulation. Death rate was higher than in high income countries.
Asunto(s)
Anticoagulantes/uso terapéutico , Trombosis de los Senos Intracraneales/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Trombosis de la Vena/tratamiento farmacológico , Adolescente , Adulto , África del Sur del Sahara/epidemiología , Anciano , Anticoagulantes/efectos adversos , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Observacionales como Asunto , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de Riesgo , Trombosis de los Senos Intracraneales/diagnóstico por imagen , Trombosis de los Senos Intracraneales/mortalidad , Resultado del Tratamiento , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/mortalidad , Adulto JovenRESUMEN
The risk of stroke due to infective endocarditis is particularly high during the first week. Moreover, in low-resource settings where imaging access is limited, and diagnostic pathways are inaccurate the risk further increases. In addition to antibiotic therapy, treatment may include intravenous thrombolysis, with high risk of hemorrhagic complications in patients with infective endocarditis or mechanical thrombectomy. We report here a case of a 24-year-old male with rheumatic heart disease presenting a septic cardioembolic stroke secondary to infective endocarditis that was successfully treated in a low-resource setting.