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.
Subject(s)
Cerebral Veins , Intracranial Thrombosis , Venous Thrombosis , Adult , Aged , Europe , Female , Humans , Intracranial Hemorrhages/complications , Intracranial Hemorrhages/diagnostic imaging , Intracranial Hemorrhages/epidemiology , Intracranial Thrombosis/complications , Intracranial Thrombosis/diagnostic imaging , Intracranial Thrombosis/epidemiology , Male , Mexico , Retrospective Studies , Venous Thrombosis/complications , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/epidemiologyABSTRACT
It could be shown that MRI has capability of demostrating parenchymal damage due to cerebrovascular disease even in asymptomatic individuals. In ischemic stroke MRI is superior to CT because of the earlier detection of the lesion, a More precise delineation of lacunes, of brainstem infarcts, and of hemorrhagic components. Evidence of confluent white matter damage is helpful in differentiating vascualr dementia from degenerative forms. Is hemorrhagic stroke CT remains the preferred imaging technique during the acute phase but MRI will detect remnants of a cerebral hemorrhage for lifetime
Subject(s)
Cerebral Hemorrhage/diagnosis , Intracranial Embolism and Thrombosis/diagnosis , Magnetic Resonance Spectroscopy/diagnosis , Tomography, X-Ray Computed , Cerebral Hemorrhage/diagnostic imaging , Intracranial Embolism and Thrombosis/diagnostic imaging , Cerebral Infarction/diagnosis , Cerebral Infarction/diagnostic imaging , Brain Ischemia/diagnosis , Brain Ischemia/diagnostic imaging , Dementia, Vascular/diagnosis , Dementia, Vascular/diagnostic imaging , Evaluation StudyABSTRACT
It could be shown that MRI has capability of demostrating parenchymal damage due to cerebrovascular disease even in asymptomatic individuals. In ischemic stroke MRI is superior to CT because of the earlier detection of the lesion, a More precise delineation of lacunes, of brainstem infarcts, and of hemorrhagic components. Evidence of confluent white matter damage is helpful in differentiating vascualr dementia from degenerative forms. Is hemorrhagic stroke CT remains the preferred imaging technique during the acute phase but MRI will detect remnants of a cerebral hemorrhage for lifetime
Subject(s)
Intracranial Embolism and Thrombosis/diagnosis , Cerebral Hemorrhage/diagnosis , Magnetic Resonance Spectroscopy , Tomography, X-Ray Computed , Dementia, Vascular/diagnosis , Dementia, Vascular , Intracranial Embolism and Thrombosis , Cerebral Hemorrhage , Cerebral Infarction/diagnosis , Cerebral Infarction , Brain Ischemia/diagnosis , Brain Ischemia , Evaluation StudyABSTRACT
Dentro de los pacientes con enfermedad de Parkinson existen algunos que tienen especial frecuencia de factores de riesgo hemodinámico (hipertensión, diabetes, hipertrigliceridemia, agregación plaquetaria aumentada, disminución del flujo sanguíneo cerebral y anormalidades tomográficas). Estos pacientes tienen iguales síntomas que los demás, salvo en que los síntomas progresan más rápidamente. Es posible que una mejoría terapéutica de su estado vascular les sea útil (AU)
Subject(s)
Humans , Male , Female , Parkinson Disease/complications , Vascular Diseases/complications , Hypertension/physiopathology , Diabetes Mellitus/physiopathology , Levodopa/therapeutic use , Regional Blood Flow , Cerebrum/blood supply , RiskABSTRACT
Dentro de los pacientes con enfermedad de Parkinson existen algunos que tienen especial frecuencia de factores de riesgo hemodinámico (hipertensión, diabetes, hipertrigliceridemia, agregación plaquetaria aumentada, disminución del flujo sanguíneo cerebral y anormalidades tomográficas). Estos pacientes tienen iguales síntomas que los demás, salvo en que los síntomas progresan más rápidamente. Es posible que una mejoría terapéutica de su estado vascular les sea útil