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Sample records for cerebral sinovenous thrombosis

  1. Cerebral sinovenous thrombosis associated with isopropanol ingestion in an infant.

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    Nwosu, Michelle E; Golomb, Meredith R

    2009-03-01

    This report describes a 5-week-old female infant who presented with accidental ingestion of rubbing alcohol (which contains about 70% isopropanol), and was subsequently diagnosed with cerebral sinovenous thrombosis. Isopropanol is a clear, volatile 3-carbon alcohol found in varying concentrations in many solvents. Mislabeled rubbing alcohol was mixed with this patient's formula. After ingesting it, she presented with a 1-day history of uncontrolled fussiness and an episode of deviation of the eyes to the right for 30 minutes, followed by rhythmic movements of the arms and legs for 20 minutes. Cerebral imaging demonstrated sinovenous thrombosis. To our knowledge, there have been no reports describing cerebral sinovenous thrombosis as a complication of isopropanol ingestion. The possible association of isopropanol ingestion and sinovenous thrombosis is discussed.

  2. Cerebral Sinovenous Thrombosis in a Child with Idiopathic Nephrotic Syndrome

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    L. Ghedira Besbes

    2011-01-01

    Full Text Available Nephrotic syndrome (NS is a renal disorder characterized by heavy proteinuria, hypoalbuninemia, edema and hypercholesterolemia. Nephrotic syndrome in children is known to be associated with an hypercoagulable state and thromboembolic complications. However cerebral sinovenous thrombosis (CSVT is very rare. Here we report a seven-year-old child with steroid-dependent idopathic nephrotic syndrome resulting from a minimal change disease, developed multiple cerebral sinovenous thrombosis, presenting with headache, left sixth nerve palsy, and papilledema. The diagnosis of CSVT was established by cranial computed tomography, magnetic resonance imaging, and magnetic resonance angiography. He gradually recovered after anticoagulant therapy. CSVT is very rare in nephrotic children. The diagnosis of CSVT should be considered in any patient with nephrotic syndrome who develops neurologic symptoms. This report highlights the importance of suspecting and recognizing this potentially life threatening complication and initiating early treatment.

  3. Homocystinuria: A Rare Disorder Presenting as Cerebral Sinovenous Thrombosis

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    Hossein ESLAMIYEH

    2015-06-01

    Full Text Available How to Cite This Article: Eslamiyeh H, Ashrafzadeh F, Akhondian J, Beiraghi Toosi M. Homocystinuria: A Rare Disorder Presenting as Cerebral Sinovenous Thrombosis. Iran J Child Neurol. Spring 2015;9(2:53-57.AbstractObjectiveHomocystinuria is an inborn error of amino acid metabolism caused by cystathionine beta-synthase deficiency that affects methionine metabolism. The clinical features are heterogeneous ranging from mental retardation, ectopia lentis, and osteoporosis to vascular events such as deep vein thrombosis,   sagital sinus thrombosis, and myocardial infarction. Cerebral sinovenous thrombosis (CVST is an unusual disorder in children and requires prompt and accurate management. Some causal factors for thedevelopment of CVST differ between children and adults. The majority of cases with CSVT are found to have an underlying cause for thrombosis like dehydration, infections, prothrombotic and hematologic disorders, malignancy and trauma.Although homocystinuria is usually associated with ischemic strokes, CVST as initial clinical presentation of homocystinuria is rare in children.In this article, we presented a 10-year old boy with seizure, hemiparesis, and ataxia due to CSVT caused by homocystinuria.

  4. Contralateral Hypoplastic Venous Draining Sinuses Are Associated with Elevated Intracranial Pressure in Unilateral Cerebral Sinovenous Thrombosis.

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    Farias-Moeller, R; Avery, R; Diab, Y; Carpenter, J; Murnick, J

    2016-12-01

    Variations in cerebral venous development can influence the ability to regulate drainage. In cerebral sinovenous thrombosis, these variations can be associated with elevated intracranial pressure. We present a series of pediatric patients with unilateral cerebral sinovenous thrombosis and investigate whether the contralateral venous sinus size increases the risk of developing elevated intracranial pressure. Patients diagnosed with a unilateral cerebral sinovenous thrombosis were identified by querying our institutional radiology data base. The difference in the occurrence of elevated intracranial pressure in patients with cerebral sinovenous thrombosis with and without hypoplastic venous sinuses was studied. Twelve cases of unilateral cerebral sinovenous thrombosis met the inclusion criteria and had sufficient images. Six patients had hypoplastic contralateral venous sinuses. The presence of hypoplastic contralateral venous sinus in the setting of thrombosis of a dominant sinus was associated with elevation of intracranial pressure (83% versus 0%, P = .015). Patients with cerebral sinovenous thrombosis and contralateral hypoplastic venous sinuses are at higher risk of developing elevated ICP and may benefit from screening with an ophthalmologic examination.

  5. Neonatal Cerebral Sinovenous Thrombosis : Neuroimaging and Long-term Follow-up

    NARCIS (Netherlands)

    Kersbergen, Karina J.; Groenendaal, Floris; Benders, Manon J. N. L.; de Vries, Linda S.

    2011-01-01

    Neonates are known to have a higher risk of cerebral sinovenous thrombosis than children of other age groups. The exact incidence in neonates remains unknown and is likely to be underestimated, as clinical presentation is nonspecific and diagnosis can only be made when dedicated neuroimaging techniq

  6. Anticoagulation Therapy and Imaging in Neonates With a Unilateral Thalamic Hemorrhage Due to Cerebral Sinovenous Thrombosis

    NARCIS (Netherlands)

    Kersbergen, Karina J.; de Vries, Linda S.; van Straaten, H. L. M. (Irma); Benders, Manon J. N. L.; Nievelstein, Ruter A. J.; Groenendaal, Floris

    2009-01-01

    Background and Purpose-Cerebral sinovenous thrombosis is a rare disorder with a high risk of an adverse neurodevelopmental outcome. Until now, anticoagulation therapy has been restricted to neonates without an associated parenchymal hemorrhage. In this study, we describe sequential neuroimaging find

  7. Presentation of Neonatal Sinovenous Thrombosis

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    J Gordon Millichap

    2008-09-01

    Full Text Available Signs, risk factors, comorbidities, and radiographic findings in 59 neonates presenting with sinovenous thrombosis are reported from Indiana University School of Medicine, Indianapolis, IN.

  8. Paediatric arterial ischaemic stroke and cerebral sinovenous thrombosis. First report from the Italian Registry of Pediatric Thrombosis (R. I. T. I., Registro Italiano Trombosi Infantili).

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    Suppiej, Agnese; Gentilomo, Chiara; Saracco, Paola; Sartori, Stefano; Agostini, Manuela; Bagna, Rossana; Bassi, Bianca; Giordano, Paola; Grassi, Massimo; Guzzetta, Andrea; Lasagni, Donatella; Luciani, Matteo; Molinari, Angelo C; Palmieri, Antonella; Putti, Maria Caterina; Ramenghi, Luca Antonelli; Rota, Lidia Luciana; Sperlì, Domenico; Laverda, Anna Maria; Simioni, Paolo

    2015-06-01

    Data from large case series of children with cerebral thrombotic events are pivotal to improve prevention, early recognition and treatment of these conditions. The Italian Registry of Pediatric Thrombosis (R. I. T. I.) was established in 2007 by a multidisciplinary team, aiming for a better understanding of neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols. We analysed data relative to the paediatric cerebral thrombotic events of the R. I. T. I. which occurred between January 2007 and June 2012. In the study period, 79 arterial ischaemic stroke (AIS) events (49 in males) and 91 cerebral sinovenous thrombosis (CSVT) events (65 in males) were enrolled in the R. I. T. I. Mean age at onset was 4.5 years in AIS, and 7.1 years in CSVT. Most common modes of presentation were hemiparesis, seizures and speech disturbances in AIS, and headache, seizures and lethargy in CSVT. Most common etiologies were underlying chronic diseases, vasculopathy and cardiopathy in AIS, and underlying chronic diseases and infection in CSVT. Time to diagnosis exceeded 24 hours in 46 % AIS and 59 % CSVT. Overall data from the Italian Registry are in substantial agreement with those from the literature, despite small differences. Among these, a longer time to diagnosis compared to other registries and case series poses the accent to the need of an earlier recognition of paediatric cerebrovascular events in Italy, in order to enable prompt and effective treatment strategies.

  9. Cortical sinovenous thrombosis in a child with nephrotic syndrome and iron deficiency anaemia.

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    Meena A

    2000-07-01

    Full Text Available Cortical sinovenous thrombosis in a child with nephrotic syndrome and iron deficiency anaemia is described. The most probable mechanism for the hypercoagulable state was thrombocytosis associated with iron deficiency anaemia. The other possible contributing factor might have been the diuretic therapy during the phase of relapse.

  10. Cerebral venous sinus thrombosis

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    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  11. Cerebral venous thrombosis in childhood

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    Huisman, T.A.G.M.; Martin, E.; Willi, U.V. [Dept. of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich (Switzerland); Holzmann, D. [Dept. of Otorhinolaryngology, University Children' s Hospital Zurich, Zurich (Switzerland)

    2001-09-01

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

  12. Cerebral sinus venous thrombosis

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    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  13. Cerebral sinus venous thrombosis

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    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  14. Contraceptives and cerebral thrombosis: a five-year national case-control study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Kreiner, Svend

    2002-01-01

    Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis......Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis...

  15. Hydrocephalus in cerebral venous thrombosis.

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    Zuurbier, Susanna M; van den Berg, René; Troost, Dirk; Majoie, Charles B; Stam, Jan; Coutinho, Jonathan M

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  16. Cerebral Arterial Thrombosis in Ulcerative Colitis

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    Giovanni Casella

    2013-01-01

    Full Text Available Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD. We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  17. Cerebral venous sinus thrombosis with autoimmune thyroiditis

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    Sameer Aggarwal

    2013-01-01

    Full Text Available Cerebral Venous Thrombosis ( CVT is a multifactorial condition which is described as idiopathic in 12.5% of patients. Hyperthyroidism has been associated with CVT in many case reports, and increased levels of factor VIII and von Willebrand factor (vWF have been proposed as the possible link in this association, but only few rare case reports have described an association of hypothyroidism with CVT. We report here a case of autoimmune thyroiditis presenting with CVT.

  18. Cerebral venous thrombosis: An Indian perspective

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    Deepa Dash

    2015-01-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke with extremely varied clinical presentations, predisposing factors, imaging findings, and outcomes, and thus can be extremely challenging to diagnose. Accurate and prompt diagnosis of CVT is crucial because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long-term squel. In this article, we have reviewed the epidemiology, causative factors, clinical features, diagnosis and treatment of CVT from an Indian perspective. Over the last decade, a change in trends in the causative factors has been noted from India.

  19. Unilateral Pseudotumoral Presentation of Cerebral Venous Thrombosis

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    Leonardo Halley Carvalho Pimentel

    2014-09-01

    Full Text Available Cerebral venous thrombosis (CVT is an unusual cause of stroke. It is more common in middle-aged women and deep CVT lesions are usually bilateral. CVT can have very diverse clinical presentations and mimic other conditions. We report two women with CVT initially diagnosed as tumors (unilateral pseudotumoral presentation of CVT successfully treated with intravenous heparin. Early diagnosis was important and completely reversed the symptoms. The diagnosis of CVT should be remembered when clinical picture is compatible even if brain imaging suggests unilateral tumor.

  20. CEREBRAL VENOUS THROMBOSIS AND TURNER SYNDROME: A RARE REPORTED ASSOCIATION.

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    Guler, A; Alpaydin, S; Bademkiran, F; Sirin, H; Celebisoy, N

    2015-01-01

    Turner Syndrome is the only known viable chromosomal monosomy, characterised by the complete or partial absence of an X chromosome. It's the most common chromosomal abnormality in females. Apart from the well known dysmorphic features of the syndrome, it has been associated with a number of vascular pathologies; mainly involving the cardiovascular, renovascular, peripheral vascular and cerebrovascular system. It seems striking that thromboembolism is not considered as a feature of the syndrome. Most of the thromboembolism cases are related to the arterial vascular system; except for some rare reported portal venous thrombosis cases, peripheral venous thrombosis cases and to the best of our knowledge a single case of cerebral venous thrombosis with Dandy Walker malformation and polymicrogyria. We herein report a cerebral venous thrombosis case with Turner Syndrome. With no other found underlying etiology, we want to highlight that Turner Syndrome, itself, may have a relationship not only with the cerebral arterial vascular system pathologies but also with the cerebral venous thrombosis.

  1. Risk Factors for Cerebral Venous Thrombosis.

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    Silvis, Suzanne M; Middeldorp, Saskia; Zuurbier, Susanna M; Cannegieter, Suzanne C; Coutinho, Jonathan M

    2016-09-01

    Cerebral venous thrombosis (CVT) is a rare thrombotic disorder involving the cerebral veins and dural sinuses. In contrast to more common sites of venous thromboembolism (VTE), such as the legs and lungs, CVT mainly affects young adults and children, and women are affected three times more often than men. Although presenting symptoms are variable, headache is usually the first symptom, often in combination with focal neurologic deficits and epileptic seizures. The primary therapy for CVT consists of heparin followed by oral anticoagulation for at least 3 to 6 months. The mortality in the acute phase is 5 to 10% and a substantial proportion of survivors suffer from long-term disabilities. A large number of risk factors have been linked to CVT, although the scientific evidence for an association varies considerably between risk factors. Some risk factors, such as hereditary thrombophilia, correspond with risk factors for more common sites of VTE, whereas others, such as head trauma, are specific to CVT. In most patients, at least one risk factor can be identified. In this review, we provide an overview of the risk factors for CVT.

  2. Cerebral venous thrombosis presenting with cerebellar ataxia and cortical blindness.

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    Ben Sassi, Samia; Mizouni, Habiba; Nabli, Fatma; Kallel, Lamia; Kefi, Mounir; Hentati, Fayçal

    2010-01-01

    Venous infarction in the cerebellum has been reported only rarely, probably because of the abundant venous collateral drainage in this region. Bilateral occipital infarction is a rare cause of visual loss in cerebral venous thrombosis. We describe a 50-year-old woman with a history of ulcerative colitis who developed acute cerebellar ataxia and cortical blindness. She had bilateral cerebellar and occipital lesions related to sigmoid venous thrombosis and achieved complete recovery with anticoagulation therapy. Cerebral venous thrombosis should be considered in cases of simultaneous cerebellar and occipital vascular lesions.

  3. Cerebral Vein Thrombosis Misdiagnosed and Mismanaged

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    P. K. Sasidharan

    2012-01-01

    Full Text Available Cerebral venous thrombosis (CVT should be considered in the differential diagnosis of all unexplained CNS disorders of sudden onset. Etiological factors are often subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is missed because of the heterogeneity in clinical presentation and etiological factors. In several patients with the so called idiopathic CVT nutritional deficiencies and lifestyle issues are more important factors in pathogenesis, rather than single rarer causes. High index of suspicion is the key to diagnosis. Clinical skill has to be fine tuned to diagnose the problem and to identify all the etiological factors. Radiology is essential for diagnosis but relying on radiology alone will lead to missing several cases and even erroneous diagnosis. It is inappropriate to proceed prematurely to laboratory investigations, forgetting proper clinical evaluation by studying diet, lifestyle, and environment of the patients. Success in managing lies in identifying all the contributory causes and correcting all of them giving excellent outcome almost always. Clinical observations based on case series and sharing of such information alone are the means to arrive at a consensus in diagnosis and management.

  4. Do we have to anticoagulated patients with cerebral venous thrombosis?

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    Feher, G; Illes, Z; Hargroves, D

    2016-01-01

    INTRODUCTION: Cerebral venous thrombosis (CVT) is a rare form of venous thromboembolism (VTE). Although anticoagulation is recommended for the initial and long term treatment with regards to thrombotic risks for patients with CVT, the role of anticogalution has not been fully elucidated. The aim...... and the outcome of a second event as good as that of the first one irrespective of underlying risk factors....

  5. Novel oral anticoagulants in the treatment of cerebral venous thrombosis

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    Feher, G; Illes, Z; Komoly, S;

    2015-01-01

    Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with extremely diverse clinical features, predisposing factors, brain imaging findings, and outcome. Anticoagulation is the cornerstone of CVT management, however, it is not supported by high-quality evicence. Novel oral anticoagulan...

  6. Thrombosis of the great cerebral vein in a hemodialysis patient.

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    Ratkovic, Marina; Basic-Jukic, Nikolina; Gledovic, Branka; Radunovic, Danilo

    2014-01-01

    Cerebral venous thrombosis is a rare condition with various clinical presentations which may delay diagnosis. It is frequently associated with severe consequences. We present the first documented case of thrombosis of the great cerebral vein in a hemodialysis patient. A 29-year-old female patient with end-stage renal disease of unknown etiology was admitted to a hospital with altered consciousness and nausea. Severe headache in the right parietal area had started 2 days before. On examination, she was in the poor overall condition, dysartric, with a severe nystagmus. Urgent brain multislice computerized tomography and magnetic resonance imaging revealed thrombosis of the great cerebral vein with hypodense zones in hypothalamus, thalamus and basal ganglia. She was treated with heparin bolus of 25000 IU with a favorable outcome. Detailed examination demonstrated increased lupus anticoagulant (LA) 1 and LA2 and increased LA1/LA2. Control magnetic resonance imaging performed 1 year later revealed multiple vascular lesions within the brain. Acetylsalicylate was introduced in therapy. Thrombosis of the cerebral veins should be suspected in patients with end-stage renal disease, altered neurological status and signs of increased intracranial pressure.

  7. Cerebral Venous-Sinus Thrombosis: A Case Series Analysis

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    Nahid Ashjazadeh

    2011-09-01

    Full Text Available Background: Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. Methods: We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. Results: The patients' mean age was 34.01±10.25. Eighty seven (70.16% were women and 37 (29.83% were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51% women took oral contraceptive pills. Twenty of 57 women (35.08% took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%. High mortality and morbidity rates (14.51% and 35.48%, respectively were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001 and evidence of hemorrhage in primary CT scan (P=0.005. Conclusion: Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it

  8. Life-threatening Cerebral Venous Thrombosis: a case report

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    Daniel Agustin Godoy

    2016-06-01

    Full Text Available Cerebral venous sinus thrombosis (CVT can compromise dural sinus, cerebral veins or both. It is an uncommon condition and it is more prevalent in young women. Several prothrombotic states are the principal predisposing factors. Clinical spectrum of presentation is wide, so this entity requires a high suspect index for correct and prompt diagnosis. CVT may develop serious complications that can be life-threatening such as hemorrhagic venous infarctions, cerebral edema, and intracranial hypertension. This report describes the case of a woman who was in treatment for unspecific vaginal bleeding with oral contraceptives. Suddenly she deteriorated to coma with severe respiratory compromise. Neuroimaging showed thrombosis of multiple venous sinus. Physiological neuroprotection, osmotherapy, mechanical ventilation and anticoagulation therapy were the keystones of treatment. In a few months, the patient has recovered a good functional status, while maintaining a motor deficit on the right hand.

  9. [Cerebral venous thrombosis in minimal change nephrotic syndrome].

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    Hirata, M; Kuroda, M; Koni, I

    1999-06-01

    A 46-year old man presented with an eight-day history of edema and was found to be nephrotic, with a plasma albumin level of 1.1 g/dl and urine protein excretion of 13.3 g/24 hrs. The level of plasma creatinine was normal at 1.0 mg/dl. A finding of renal biopsy was consistent with minimal change glomerulopathy. On the 6th hospital day, he suddenly developed a severe headache and was noted to have bilateral papilledema. Lumbar puncture revealed an opening pressure of 250 mm of water. Magnetic resonance venography showed an irregular flow in the superior sagittal sinus and right transverse sinus, a finding consistent with thrombus. The diagnosis of cerebral venous thrombosis was made, and the patient was given both Warfarin 2 mg/day and prednisolone 60 mg/day. A complete recovery from nephrotic syndrome was achieved within eight weeks. Nephrotic syndrome causes a hypercoagulable state, leading to both venous and arterial thrombosis. The most common clinical features are renal vein thrombosis, femoral vein thrombosis, and pulmonary embolism, however, cerebral venous sinus thrombosis is rare in patients with nephrotic syndrome. It is important to be aware of this complication, since prompt treatment with anticoagulation and control of nephrotic syndrome can lead to a successful outcome.

  10. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

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    Fardin Faraji

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

  11. [Cerebral venous thrombosis imagiologic features in a pregnant woman].

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    Ferreira, Maria Madalena; Rios, Ana Cristina; Fragata, Isabel; Baptista, José Tiago; Manaças, Rui; Reis, João

    2011-01-01

    Cerebral venous thrombosis (CVT) is a relatively rare but serious condition potentially reversible upon accurate diagnosis and adequate therapy. The peri-partum state and pregnancy are predisposing factors and TVC accounts for about 6% of maternal deaths. Its clinical symptoms depend on the the thrombus site and extension, and also on the existing collateral vessels network. We present the case of a 33 year-old woman, 13 weeks pregnant, that complained of headaches and whose cranial magnetic resonance imaging revealed a subtotal oclusión of the superior sagittal sinus. We discuss the imaging features of dural venous thrombosis in the acute phase.

  12. Cortical blindness as a rare presentation of cerebral venous thrombosis.

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    Wang, Bonnie; Moon, Seong-Jin; Olivero, William C; Wang, Huan

    2013-05-09

    Cerebral venous thrombosis (CVT) remains a diagnostic and therapeutic challenge for clinicians. Manifesting in a remarkably wide spectrum of symptoms and signs, CVT often presents in a misleading fashion-if unrecognized or misdiagnosed, it carries potentially fatal consequences. Visual loss is quite rare as the initial presentation of CVT and is typically a finding more frequent in chronic cases with associated papilledema on funduscopy Ferro, Lopes, Rosas and Fontes (Delay in Hospital Admission of Patients with Cerebral Vein and Dural Sinus Thrombosis. Cerebrovasc Dis 2005;19: :152-6). We report a rare case of acute cortical blindness as the initial presentation of CVT in an 18-year-old female patient and review the current literature.

  13. Evaluation of Patients with Cerebral Venous Sinus Thrombosis

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    Abdullah Yılgör

    2014-08-01

    Full Text Available OBJECTIVE: The aim of this article is to point out the etiology, risk factors, the rate of recanalization and mortality of cerebral venous sinus thrombosis patients. METHODS: The current study was planned as retrospectively and fifty patients were included. All the patients were analyzed according to the clinical presentation, etiologic causes, risk factors, presence of MR lesion, the involvement of anatomic localization, recanalization and mortality. RESULTS: The most frequent risk factors of the cases were prothrombotic conditions (34%, pregnancy (14% and puerperium (8%. The most frequent involvement was transverse sinus and secondly more than one sinüs thrombosis. As clinical application symptoms we detected headache (68% and then focal neurologic deficiency (30%. On the other hand, at least 3 month’s incidence rate of recanalization in the patients was 70.7%. Except for 2 cases that ended with death, the mortality of the cases was low. We could not find a significant association between risk factors and the presence of cerebral MR lesion or not (p=0.42 and also the presence of recanalization or not in the follow-up MR venography (p=0.625. CONCLUSION: We have concluded that, in the diagnosis and follow-up of cerebral venous sinus thrombosis, MR venography is the best method; through early diagnosis and proper treatment, the rate of recanalization will be fairly high and mortality will be low. In etiology, besides trombotic conditions, pregnancy and puerperium must be considered as one of the frequent risk factors.

  14. Recurrent cerebral thrombosis; With special reference to the neuroradiological study

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    Iwamoto, Toshihiko; Abe, Shin-e; Kubo, Hideki; Hanyu, Haruo; Takasaki, Masaru (Tokyo Medical Coll. (Japan))

    1992-10-01

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.).

  15. Superior Sagittal Sinus Thrombosis Complicating Typhoid Fever in a Teenager

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    P. O. Okunola

    2012-01-01

    Full Text Available Cerebral venous sinus (sinovenous thrombosis (CSVT is a rare life-threatening disorder in childhood that is often misdiagnosed. CSVT encompasses cavernous sinus thrombosis, lateral sinus thrombosis, and superior sagittal sinus thrombosis (SSST. We present an adolescent girl who was well until two weeks earlier when she had a throbbing frontal headache and fever with chills; she later had dyspnoea, jaundice, melena stool, multiple seizures, nuchal rigidity, and monoparesis of the right lower limb a day before admission. Urine test for Salmonella typhi Vi antigen was positive, and Widal reaction was significant. Serial cranial computerized tomography scans revealed an expanding hypodense lesion in the parafalcine region consistent with SSST or a parasagittal abscess. Inadvertent left parietal limited craniectomy confirmed SSST. She recovered completely with subsequent conservative management. Beyond neuropsychiatric complications of Typhoid fever, CSVT should be highly considered when focal neurologic deficits are present.

  16. Risk factors for cerebral venous thrombosis and deep venous thrombosis in patients aged between 15 and 50 years

    NARCIS (Netherlands)

    Koopman, Karen; Uyttenboogaart, Maarten; Vroomen, Patrick C A J; van der Meer, Jannes; De Keyser, Jacques; Luijckx, Gert-Jan

    2009-01-01

    Cerebral venous thrombosis (CVT) and deep vein thrombosis or pulmonary embolism (DVT/PE) are associated with many risk factors. It is unclear why CVT occurs less often than DVT/PE. Age dependent risk factors may play a role. The aim of our study was to compare risk factors in a uniform age group of

  17. Cerebral venous thrombosis: Update on clinical manifestations, diagnosis and management

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    Leys Didier

    2008-01-01

    Full Text Available Cerebral venous thrombosis (CVT has a wide spectrum of clinical manifestations that may mimic many other neurological disorders and lead to misdiagnoses. Headache is the most common symptom and may be associated with other symptoms or remain isolated. The other frequent manifestations are focal neurological deficits and diffuse encephalopathies with seizures. The key to the diagnosis is the imaging of the occluded vessel or of the intravascular thrombus, by a combination of magnetic resonance imaging (MRI and magnetic resonance venography (MRV. Causes and risk factors include medical, surgical and obstetrical causes of deep vein thrombosis, genetic and acquired prothrombotic disorders, cancer and hematological disorders, inflammatory systemic disorders, pregnancy and puerperium, infections and local causes such as tumors, arteriovenous malformations, trauma, central nervous system infections and local infections. The breakdown of causes differs in different parts of the world. A meta-analysis of the most recent prospectively collected series showed an overall 15% case-fatality or dependency rate. Heparin therapy is the standard therapy at the acute stage, followed by 3-6 months of oral anticoagulation. Patients with isolated intracranial hypertension may require a lumbar puncture to remove cerebrospinal fluid before starting heparin when they develop a papilloedema that may threaten the visual acuity or decompressive hemicraniectomy. Patients who develop seizures should receive antiepileptic drugs. Cerebral venous thrombosis - even pregnancy-related - should not contraindicate future pregnancies. The efficacy and safety of local thrombolysis and decompressive hemicraniectomy should be tested

  18. Prevalence of cerebral and pulmonary thrombosis in patients with cyanotic congenital heart disease

    DEFF Research Database (Denmark)

    Jensen, A S; Idorn, L; Thomsen, C;

    2015-01-01

    BACKGROUND: Patients with cyanotic congenital heart disease (CCHD) have a high prevalence of thrombosis, the most frequently described locations being the cerebral and pulmonary vessels. The reported prevalence of both cerebral infarction and pulmonary thrombosis has been highly variable. The aim...

  19. Incidental Diagnosis of Cerebral Cortical Venous Thrombosis in Postdural Puncture Headache on Brain Computed Tomography.

    Science.gov (United States)

    Humbertjean, Lisa; Ducrocq, Xavier; Lacour, Jean-Christophe; Mione, Gioia; Richard, Sébastien

    2015-01-01

    Diagnosis of cerebral cortical venous thrombosis in patients with postdural puncture headache (PDPH) is usually secondary to changes in headache pattern or cerebral infarctions. Nevertheless, incidental discovery of asymptomatic forms on brain imaging has never been reported before and its management thus remains ill-defined. We describe 2 cases of patients with asymptomatic cortical vein thrombosis in the context of PDPH. In both cases, brain computed tomography (CT) scans showed an isolated cortical vein thrombosis without cerebral damage. Neurological examination revealed the typical orthostatic feature of PDPH, independently of cortical vein thrombosis which was considered as a radiological incidental finding. Clinical and radiological signs resolved after bed rest, oral caffeine, and anticoagulation therapy. Asymptomatic cortical vein thrombosis may be found on radiological exploration, even basic like brain CT scan without contrast, of PDPH. Utility of anticoagulation therapy, which could increase the risk of cerebral hemorrhagic complications in this specific context, has to be assessed.

  20. Hereditary thrombophilia in cerebral venous thrombosis: a study from India.

    Science.gov (United States)

    Pai, Navin; Ghosh, Kanjaksha; Shetty, Shrimati

    2013-07-01

    A systematic study of thrombophilia markers in a large series of patients with cerebral venous thrombosis (CVT) from India is scarce. The present study was undertaken to know the prevalence of common hereditary thrombophilia in a large series of CVT patients from India. Six hundred and twelve (354 men, 219 women and 39 children) consecutive patients with CVT admitted to various hospitals in Mumbai between 2001 and 2010 were investigated for the common thrombophilia markers, that is, protein C (PC), protein S, antithrombin (AT), and factor V Leiden (FVL) mutation. The main presenting clinical manifestations included papilledema (62%), headache (62%), hemiparesis (48%), seizures (31%), and cranial nerve palsy (7%). All the patients were managed with heparin followed by warfarin during the succeeding 6 months. Superior sagittal sinus thrombosis was the commonest site (74%) followed by cortical venous thrombosis (15%). Associated clinical pathologies were dehydration, sepsis, pregnancy and puerperium, malaria, and tuberculosis; but in the majority of patients, there was no obvious cause. Eighteen percent of the patients had any of the thrombophilia markers studied; PC deficiency was the commonest thrombophilia marker followed by deficiency of protein S, FVL mutation and AT deficiency. The men below 45 years with PC deficiency (P=0.03) and women with protein S deficiency were significantly higher (P=0.04). In conclusion, CVT is not an uncommon cause of neurological deficit as was presented in earlier reports. Pregnancy and puerperium-related CVT was much less common. Thrombophilia markers accounted for approximately one-fifth of the patients. Death due to CVT has shown remarkable reduction (13%) because of early diagnosis and appropriate anticoagulation.

  1. Contribution of multiple thrombophilic and transient risk factors in the development of cerebral venous thrombosis

    NARCIS (Netherlands)

    Libourel, Eduard J.; ten Kate, Min Ki; Brouwer, Jan-Leendert P.; Veeger, Nic J. G. M.; van der Meer, Jan

    2007-01-01

    introduction: Cerebral venous thrombosis (CVT), deep vein thrombosis (DVT) and/or pulmonary embolism (PE) have been associated with thrombophilic defects. However, in contrast to DVT or PE, CVT is a rare disease. We performed a study to identify differences in thrombotic risk profile, predisposing t

  2. Antiphospholipid syndrome presenting as cerebral venous sinus thrombosis: a case series and a review.

    Science.gov (United States)

    Shlebak, Abdul

    2016-04-01

    The cerebral venous sinus system is a rare site for venous thrombosis except in patients with antiphospholipid syndrome. We describe three patients presenting with cerebral venous thrombosis in association with other thrombotic sites in two patients and as an only site in one patient. Antiphospholipid syndrome has varied clinical manifestations but the defining feature is the persistent presence of antiphospholipid antibodies. In this report we will review the clinical and laboratory diagnostic criteria and the management of patients with antiphospholipid syndrome.

  3. Norethisterone induced cerebral venous sinus thrombosis (CVST): a rare case report and review of literature

    OpenAIRE

    Ramya T; Prakash B; Devi B

    2014-01-01

    The association between the progestin only pill used for treatment of menstrual disorders and cerebral venous sinus thrombosis (CVST) has rarely been reported in the literature. This report describes a case of cerebral venous thrombosis following intake of norethisterone for menorrhagia secondary to polycystic ovary syndrome in a young woman with undiagnosed underlying hyperhomocysteinemia. A 24 year old married woman presented with acute onset of headache, vomiting and right focal seizures. ...

  4. Cerebral venous sinus thrombosis presenting with diplopia in pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Munira Yusoff

    2012-10-01

    Full Text Available Abstract Introduction Cerebral venous sinus thrombosis is a rare condition. The most frequent symptoms and signs are headache, focal seizures with or without secondary generalization, unilateral or bilateral paresis and papilledema. We report a case of transverse sinus and superior sagittal sinus thrombosis that presented with diplopia in a pregnant woman. Case presentation A 34-year-old Malay woman, gravida 3 para 2 at 8 weeks of pregnancy, was admitted for hyperemesis gravidarum, presented with sudden onset of diplopia, blurring of vision and headache. A magnetic resonance scan of her brain showed the presence of cerebral edema with no space occupying lesion, but magnetic resonance venography ultimately revealed right transverse sinus and superior sagittal sinus thrombosis. The patient was treated with anticoagulation for 1 year, after which the patient recovered fully. Conclusion Due to its diverse and varied neurological presentation, cerebral venous sinus thrombosis should be considered in almost any brain syndrome.

  5. Cerebral sinodural thrombosis following minor head injury in children.

    Science.gov (United States)

    Pikis, Stylianos; Moscovici, Samuel; Itshayek, Eyal; Cohen, José E

    2013-04-01

    Cerebral sinodural thrombosis (CSDT) is a rare complication of minor head trauma in children. Despite recommendations, anticoagulation is frequently withheld. We aimed to evaluate the etiology, clinical presentation, risk factors, diagnosis, treatment, and outcome of pediatric CSDT following minor head trauma, and specifically to evaluate factors associated with anticoagulation use following minor head trauma in pediatric patients with CSDT. A literature search from 1990 to 2012 identified manuscripts discussing epidemiology, risk factors, clinical presentation, management, and outcome in pediatric patients with CSDT subsequent to minor head trauma. One pediatric patient diagnosed with CSDT following minor head trauma in our institution was also included in the study. There were 18 pediatric patients with CSDT following minor trauma, including the current patient. Mean patient age was 7.8years (range 23months-15years). There was a strong female predominance (2.4:1). Vomiting and headache were the most common symptoms. Five patients had pre-existing risk factors (gastroenteritis, protein S deficiency, estroprogestenic medication, elevated antiphospholipid antibodies, malnutrition). Anticoagulation was administered to six patients with additional risk factors, severe symptoms, or deterioration. There was no mortality, 12 patients recovered fully, and four patients improved with residual symptoms. One patient required lumboperitoneal shunt placement. Pediatric CSDT is a rare complication of minor head trauma, with variable presentation. Anticoagulation has generally been reserved for patients suffering from severe symptoms, for those who deteriorate neurologically during observation, and for those who suffer from a concomitant prothrombotic disorder.

  6. Controversies of Treatment Modalities for Cerebral Venous Thrombosis

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    Maria Khan

    2010-01-01

    Full Text Available Cerebral vein thrombosis has been well recognized for nearly two centuries. However, therapeutic options for the condition are limited due to lack of large randomized trials. The various modalities reportedly used include antiplatelets, anticoagulation, fibrinolysis, and mechanical thrombectomy. Of these, antiplatelets are the least studied, and there are only anecdotal reports of aspirin use. Anticoagulation is the most widely used and accepted modality with favorable outcomes documented in two randomized controlled trials. Various fibrinolytic agents have also been tried. Local infusions have shown more promise compared to systemic agents. Similarly, mechanical thrombectomy has been used to augment the effects of chemical thrombolysis. However, in the absence of randomized controlled trials; there is no concrete evidence of the safety and efficacy of either of these modalities. Limited study series disclosed that decompression surgery in malignant CVT can be life saving and provides good neurological outcome in some cases. Conclusion. Overall therapeutics for CVT need larger randomized controlled trials. Anticoagulaion with heparin is the only modality with a reasonable evidence to support its use in CVT. Endovascular thrombolysis and mechanical thrombectomy are reserved for selected cases who fail anticoagulation and decompression surgery for malignant CVT with impending herniation.

  7. Dural puncture: an overlooked cause of cerebral venous thrombosis.

    Science.gov (United States)

    Guner, Derya; Tiftikcioglu, Bedile Irem; Uludag, Irem Fatma; Oncel, Dilek; Zorlu, Yasar

    2015-03-01

    Cerebral venous thrombosis (CVT) accounts for 0.5-1 % of all strokes. Although dural puncture is proposed as one of the rare risk factors, this association has only been mentioned in anecdotal reports. Headache, i.e., usually the first and the most frequent clinical symptom on admission, is often attributed to the dural puncture itself. We investigated the frequency of CVT following a recent dural puncture in our stroke database, together with the other risk factors. The computerized medical records of patients (n = 10,740) registered in our tertiary-care neurology clinic stroke database were reviewed retrospectively. Patients diagnosed with CVT were reanalyzed. Patients who had a dural puncture in the preceding 7 days were included in the study. A total of 46 patients were diagnosed with CVT. Nine patients (19.6 %) had a recent dural puncture before the onset of the symptoms. Patients were younger than 45 years and had at least one more predisposing condition for thromboembolism other than the dural puncture. All patients have received either spinal anesthesia or intrathecal chemotherapy. Dural puncture seems to trigger CVT particularly in patients with predisposing disorders. Although reported as an extremely rare complication, our data indicate a much higher association. This case series emphasize the importance of reevaluation of patients with persistent/progressive headache following dural puncture. The effect of change in the biochemical composition of CSF due to intrathecal drug administration in pathogenesis is not known. Larger controlled trials are warranted to clarify the causal relationship between lumbar puncture and/or intrathecal drug administration and CVT.

  8. An unusual cause of cerebral venous sinus thrombosis: prothrombin G20210A gene mutation.

    Science.gov (United States)

    Porres-Aguilar, Mateo; Square, Jaime H; Storey, Raul; Rodriguez-Dunn, Simon; Mohamed-Aly, Mohamed S

    2007-09-01

    Cerebral venous sinus thrombosis represents less than 1% of all strokes, being an uncommon entity with a wide spectrum of clinical scenarios. We present a 45-year-old Hispanic female with a history of long-term oral contraceptive use who was diagnosed with cerebral venous sinus thrombosis due to a heterozygous carrier mutation in the prothrombin G20210A gene. The patient was successfully managed with intravenous heparin with favorable clinical results without adverse effects. The prevalence of inherited primary thrombophilia increases with additional risk factors such as the use of oral contraceptives that can trigger or prothrombotic events in any vascular bed. An increased prevalence in the prothrombin G20210 gene mutation has been demonstrated in the Mexican-Mestizo population. Controversy exists regarding therapy of cerebral venous sinus thrombosis; according to experts, heparin remains the cornerstone of therapy with acceptable outcomes. More clinical trials are required to evaluate long-term outcomes in this subgroup of patients.

  9. Cerebral sinus thrombosis in patients with inflammatory bowel disease: A case report

    Institute of Scientific and Technical Information of China (English)

    Hasan Umit; Talip Asil; Yahya Celik; Ahmet Tezel; Gulbin Dokmeci; Nermin Tuncbilek; Ufuk Utku; Ali Riza Soylu

    2005-01-01

    Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease of the gastrointestinal tract. The pathophysiology of IBD is probably the result of the complex interaction of genetic susceptibility and environmental influences. There is a well-known risk of thrombosis in patients with IBD. We present the case of a 53-year-old man with ulcerative colitis, who spontaneously developed intracranial sinus thrombosis that was treated with low molecular weight heparin. Literature was searched to assess the frequency and characteristics of cerebral sinus thrombosis in IBD and the role of certain etiopathological factors in such thrombotic patients.

  10. Good clinical outcome after combined endovascular and neurosurgical treatment of cerebral venous sinus thrombosis

    DEFF Research Database (Denmark)

    Poulsen, Frantz Rom; Høgedal, Lisbeth; Stilling, Margit V;

    2013-01-01

    A subgroup of patients suffering from cerebral venous sinus thrombosis (CVST) has a poor prognosis with standard anticoagulant treatment alone. Over a five-year period, we treated nine patients with aggressive endovascular therapy and neurosurgical/neurointensive treatment. In this study, the eff......A subgroup of patients suffering from cerebral venous sinus thrombosis (CVST) has a poor prognosis with standard anticoagulant treatment alone. Over a five-year period, we treated nine patients with aggressive endovascular therapy and neurosurgical/neurointensive treatment. In this study...

  11. Cerebral venous thrombosis presenting with intracerebral hemorrhage in a patient with paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Gentle Sunder Shrestha

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke. Paroxysmal nocturnal hemoglobinuria (PNH is a rare type of hemolytic anemia, frequently associated with thrombophilia. PNH may rarely present with CVT. Approximately, one-third of the patients with CVT develop cerebral hemorrhage. Here, we present a rare combination of CVT presenting with intracerebral hemorrhage in a patient with PNH. High index of suspicion is needed to avoid misdiagnosis. Patient was successfully managed with anticoagulation therapy.

  12. Antiphospholipid Antibody Syndrome: Raised Intracranial Pressure Without Cerebral Venous Sinus Thrombosis.

    Science.gov (United States)

    Rudich, Danielle S; Yun, Samuel H; Liebling, Anne; Silbert, Jonathan E; Moeckel, Gilbert W; Lesser, Robert L

    2015-12-01

    Antiphospholipid antibody syndrome (APS) has been reported to cause elevated intracranial pressure, but usually this is due to cerebral venous sinus thrombosis (CVST). We present a 36-year old man with APS with elevated intracranial pressure with neuro-ophthalmic, renal and hematological involvement without identifiable CVST.

  13. Unfractionated or Low-Molecular Weight Heparin for the Treatment of Cerebral Venous Thrombosis

    NARCIS (Netherlands)

    J.M. Coutinho; J.M. Ferro; P. Canhão; F. Barinagarrementeria; M.G. Bousser; J. Stam

    2010-01-01

    Background and Purpose-There is no consensus whether to use unfractionated heparin or low-molecular weight heparin for the treatment of cerebral venous thrombosis. We examined the effect on clinical outcome of each type of heparin. Methods-A nonrandomized comparison of a prospective cohort study (th

  14. Cerebral venous thrombosis and secondary polycythemia in a case of nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Shankar Prasad Nagaraju

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT and polycythemia are considered as rare and life threatening complications of nephrotic syndrome. We report an unusual combination of both these complications in a case of nephrotic syndrome due to minimal change disease that was treated successfully. There was prompt and complete remission of nephrotic syndrome with steroid therapy, concurrent with complete resolution of polycythemia and CVT.

  15. Differentiating the headache of cerebral venous thrombosis from post-dural puncture: A headache for anaesthesiologists

    Directory of Open Access Journals (Sweden)

    Khaja Mohideen Sherfudeen

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT is a rare complication of lumbar puncture. Occasionally, the clinical picture of CVT may mimic post-dural puncture headache (PDPH resulting in delayed diagnosis. A case of PDPH progressing to CVT is presented and the pathophysiology, diagnostic challenges and management options discussed in this article.

  16. Plasmodium vivax cerebral malaria complicated with venous sinus thrombosis in Colombia

    Institute of Scientific and Technical Information of China (English)

    Miguel A Pinzn; Juan C Pineda; Fernando Rosso; Masaru Shinchi; Fabio Bonilla-Abada

    2013-01-01

    Complicated malaria is usually due to Plasmodium falciparum. Nevertheless, Plasmodium vivax is infrequently related with life-threatening complications. Few cases have been reported of severe Plasmodium vivax infection, and most of them from Southeast Asia and India. We report the first case of cerebral malaria due to Plasmodium vivax in Latin America, complicated with sagittal sinus thrombosis and confirmed by a molecular method.

  17. Development and validation of a predictive outcome score of cerebral venous thrombosis

    NARCIS (Netherlands)

    Koopman, K; Uyttenboogaart, M; Vroomen, P C; van der Meer, J; De Keyser, J; Luijckx, G J

    2009-01-01

    Background and purpose: Cerebral venous thrombosis (CVT) is a rare disease with a Variable outcome. The aim of this study was to develop and validate a predictive outcome score for CVT patients. Methods: The score was based on the 8 predictive variables of poor Outcome (modified Rankin Scale score>2

  18. Norethisterone induced cerebral venous sinus thrombosis (CVST: a rare case report and review of literature

    Directory of Open Access Journals (Sweden)

    Ramya T

    2014-02-01

    Full Text Available The association between the progestin only pill used for treatment of menstrual disorders and cerebral venous sinus thrombosis (CVST has rarely been reported in the literature. This report describes a case of cerebral venous thrombosis following intake of norethisterone for menorrhagia secondary to polycystic ovary syndrome in a young woman with undiagnosed underlying hyperhomocysteinemia. A 24 year old married woman presented with acute onset of headache, vomiting and right focal seizures. MRI Cerebral venogram and CT Brain revealed thrombosed anterosuperior segment of superior sagittal sinus and haemorrhagic infarct in right frontoparietal region. The risk factors were acquired hyperhomocysteinemia, polycystic ovary syndrome and norethisterone for menorrhagia. The patient was treated with low molecular weight heparin, followed by warfarin, vitamin B12, vitamin B6 and folic acid. She made a total recovery. Although venous thrombosis is usually linked to the ingestion of estrogen, rather than progestogen, this case illustrates that patients who are prescribed progestogen only pills for gynaecological disorders may develop thrombosis, especially if they have predisposing metabolic disorders. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 231-235

  19. A case-series study of cerebral venous thrombosis in women using short course oral contraceptive

    OpenAIRE

    Payam Khomand; Kambiz Hassanzadeh

    2016-01-01

    Background: We report a case series of cerebral vein thrombosis (CVT) in women who used oral contraceptive pill (OCP) in the Muslims Ramadan and fasting month.Methods: This study was a retrospective case series of 9 patients with diagnosis of CVT, who admitted in the neurology ward of Tohid Hospital of Sanandaj, Iran, in July-August 2014-2015.Results: Patients had no history of thrombosis before. They were treated with oral contraceptive more than 1 month to be able to fast during Ramadan. Th...

  20. HELLP Syndrome and Cerebral Venous Sinus Thrombosis Associated with Factor V Leiden Mutation during Pregnancy

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    Zeynep Ozcan Dag

    2014-01-01

    Full Text Available Preeclampsia is a leading cause of maternal mortality and morbidity worldwide. The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality for women and their infants alike. Hormonal changes during pregnancy and the puerperium carry an increased risk of venous thromboembolism including cerebral venous sinus thrombosis (CVST. Factor 5 leiden (FVL is a procoagulant mutation associated primarily with venous thrombosis and pregnancy complications. We report a patient with FVL mutation who presented with CVST at 24th week of pregnancy and was diagnosed as HELLP syndrome at 34th week of pregnancy.

  1. HELLP Syndrome and Cerebral Venous Sinus Thrombosis Associated with Factor V Leiden Mutation during Pregnancy.

    Science.gov (United States)

    Dag, Zeynep Ozcan; Işik, Yuksel; Simsek, Yavuz; Tulmac, Ozlem Banu; Demiray, Demet

    2014-01-01

    Preeclampsia is a leading cause of maternal mortality and morbidity worldwide. The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality for women and their infants alike. Hormonal changes during pregnancy and the puerperium carry an increased risk of venous thromboembolism including cerebral venous sinus thrombosis (CVST). Factor 5 leiden (FVL) is a procoagulant mutation associated primarily with venous thrombosis and pregnancy complications. We report a patient with FVL mutation who presented with CVST at 24th week of pregnancy and was diagnosed as HELLP syndrome at 34th week of pregnancy.

  2. From presentation to follow-up: diagnosis and treatment of cerebral venous thrombosis.

    Science.gov (United States)

    Bentley, J Nicole; Figueroa, Ramón E; Vender, John R

    2009-11-01

    Cerebral venous thrombosis is an uncommon cause of stroke but remains a challenge for physicians faced with this diagnosis largely due to the variability in presentation. Anticoagulation, typically with intravenous heparin, remains the mainstay of treatment for stable patients and is sufficient in the majority of cases. However, a significant mortality rate exists for cerebral venous thrombosis due to patients who deteriorate or do not adequately respond to initial treatments. It is in these patients that more aggressive interventions must be undertaken. The neurosurgeon is often called on, either acutely for initial evaluation of the stroke or venous hemorrhage or after the failure of initial therapy for clot evacuation, hemicraniectomy, or thrombectomy. A proper workup must include a search for an underlying, correctable cause as well as thorough follow-up with correction of identified risk factors to decrease the risk of recurrent disease.

  3. Local thrombolysis for patients of severe cerebral venous sinus thrombosis during puerperium

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Xin-bin, E-mail: gxb3906080@sina.com [Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Fu, Zhenqiang, E-mail: fuzhenqiang1005@163.com [Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Song, Lai-jun, E-mail: laijunsong@sina.com [Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Guan, Sheng, E-mail: gsradio@126.com [Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China)

    2013-01-15

    Objective: To explore and evaluate the efficacy of intrasinus thrombolysis (IST) in patients with cerebral venous sinus thrombosis (CVST) during postpartum period. Methods: 11 patients during postpartum period with CVST who received IST during July 2007–November 2011 were included. Urokinase was infused into the sinuses via a microcatheter. Magnetic resonance venography (MRV) was performed to assess the recanalization of venous sinuses. Results: Before discharge, the intracranial pressure in 11 patients was under 200 mmH{sub 2}O. MRV confirmed that venous sinus of 9 patients were smooth. The cortex venous and deep venous recovered to normal. Venous sinus of 2 patients recanalized partly, and cortex venous and deep venous had compensation. 9 patients had good outcome and 2 patients had only mild deficits. Conclusion: Intrasinus thrombolysis is safe and effective in patients with severe cerebral venous sinus thrombosis during postpartum period.

  4. Two Cases of Cerebral Sinus Venous Thrombosis Following Chemotherapy for Non-Seminomatous Germ Cell Tumor

    OpenAIRE

    Papet, C.; Gutzeit, A.; Pless, M.

    2011-01-01

    We report on two patients with cerebral sinus venous thrombosis following chemotherapy with cisplatin, bleomycin and etoposide for non-seminomatous germ cell tumor. Headache and neurological deficits were the leading symptoms. Cancer and cisplatin chemotherapy are well-known risk factors for thromboembolic events. The therapeutic strategy is an anticoagulant therapy. Symptoms are usually reversible within weeks under this therapy. Therefore, in patients with testicular cancer and chemotherapy...

  5. Cerebral venous sinus thrombosis complicated by subdural hematomas: Case series and literature review

    OpenAIRE

    Akins, Paul T.; Axelrod, Yekaterina K; Ji, Cheng; Ciporen, Jeremy N.; Arshad, Syed T.; Hawk, Mark W.; Guppy, Kern H.

    2013-01-01

    Background: Cerebral venous sinus thrombosis (CVST) can cause elevated intracranial pressure, hemorrhagic venous infarct, and cortical subarachnoid hemorrhage. We present a case series and literature review to illustrate that CVST can also present with subdural hematoma (SDH). Case Description: Chart review was completed on a retrospective case series of CVST with spontaneous SDH. We also conducted a literature search. Over a 6 year interval, three patients with CVST and SDH were admitted to ...

  6. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases

    Energy Technology Data Exchange (ETDEWEB)

    Boukobza, Monique [APHP - Paris-Diderot University, Department of Neuroradiology and Therapeutic Angiography, Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, Paris (France); Crassard, Isabelle; Bousser, Marie-Germaine [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); Chabriat, Hugues [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); INSERM UMR 1161 and DHU NeuroVasc, Paris (France)

    2016-01-15

    The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it. (orig.)

  7. DIAGNOSTIC VALUE OF D-DIMER MEASUREMENT IN PATIENTS SUSPECTED TO HAVE CEREBRAL VENOUS THROMBOSIS

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    M Ghaffarpour

    2008-12-01

    Full Text Available "nAmong the causes of headache, cerebral venous and/or dural sinus thrombosis (CVT is an important challenge because of its variable clinical presentation, having negative brain CT in up to 30% of cases and unavailability of MRI in some situations. On the other hand as D-Dimer (DD test has been reported to be a sensitive test for the exclusion of venous thromboembolism, we sought whether it could be useful in the diagnosis of cerebral venous thrombosis. A prospective study of 104 consecutive patients with headache or unusual ischemic stroke (infarction in brain CT, but not compatible with any brunch of cerebral arteries, suggesting CVT was conducted between 2003 and 2005. D-Dimer test determined for all patients in the emergency ward before MRI or MRV was performed. Titers above 500 ng/ml were regarded as positive test. From a total 104 patients, 21 cases (20.2% were confirmed (by MRI and/or MRV to have CVT, 20/21 (95.7% of whom had positive DD test. In the remainder 83 (without CVT it was only positive in 16.8% (14/83, which was statistically meaningful (P < 0.001. Specificity, sensitivity, negative and positive predictive values of DD test were 83.1, 95.2, 98.6 and 58.8%, respectively, so application of this test would be useful in the diagnosis of CVT and values below 500 ng/ml make acute thrombosis unlikely.

  8. Cerebral venous thrombosis: treatment with local fibrinolysis plus alteplase; Trombosis venosa cerebral. Tratamiento mediante fibrinolisis local con alteplasa

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    Asis Bravo, F. de; Delgado, F.; Cano, A.; Bautista, D.

    2002-07-01

    Cerebral venous thrombosis is a rare entity with widely variable clinical signs: thus, a high degree of suspicion is required for diagnosis. It affects the dural sinuses and may or may not invade cerebral veins. The diagnosis has usually been based on an angiographic study although, at the present time, new noninvasive imaging techniques, such as computed tomography, magnetic resonance and magnetic resonance angiography are being employed in a growing number of cases. Treatment should involve symptomatic and etiologic therapy. Although anti coagulation would appear to be a reasonable option in these patients, it remains controversial. As in other processes such as pulmonary embolism and coronary thrombosis, the introduction of novel and increasingly safe fibrinolytic drugs, together with technical innovations in the field of interventional neuroradiology, is changing the perspectives for the management of these patients. We present the case of a 43-year-old woman with right sinus thrombosis who was treated with local thrombolysis plus alteplase (tissue plasminogen activator). The authors describe the technique employed and review the literature. (Author) 16 refs.

  9. Balloon dilatation and thrombus extraction for the treatment of cerebral venous sinus thrombosis

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    Shao-Feng Shui

    2014-01-01

    Full Text Available Background and Purpose: This study aimed to investigate the efficacy and safety of balloon dilatation and thrombus extraction for the treatment of cerebral venous sinus thrombosis (CVST. Materials and Methods: Twenty-six cases of digital subtraction angiography-confirmed CVST were treated with balloon dilatation and thrombus extraction. Active treatment of primary disease was carried out after cerebral venous sinus recanalization, and the subsequent anticoagulant therapy lasted for 6 months. Results: Recanalization of the cerebral venous sinus was achieved in all 26 patients, and no endovascular treatment-related complications occurred during or after the procedure. At discharge, the Glasgow Coma Scale (GCS of the patients had improved from an average of 12.3 points to 15 points, and clinical symptoms were improved in 100% of the patients. Follow-up times ranged from 12-62 months (mean follow-up time of 42.3 months and no thrombus re-formation or new neurological deficits occurred during that time. Conclusion: Based on our small study population, balloon dilatation and thrombus extraction appears to be a safe and effective treatment for cerebral venous sinus thrombosis. However, further research is needed to confirm this.

  10. Underlying prothrombotic states in pregnancy associated cerebral venous thrombosis

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    Aaron S

    2010-01-01

    Full Text Available Background : The exact pathogenesis of pregnancy associated cerebral venous thrombois is still unsettled. Aims : To identify possible inherited and acquired prothrombotic risk factors and also identify the factors associated with mortality in pregnancy associated CVT. Settings and Design : Prospective cohort study to identify prothrombotic risk factors and case control study of influence of local traditional practice of puerperal water restriction on postpartum CVT. Materials and Methods : Consecutive patients with pregnancy associated CVT seen over a period of three years. Thrombotic workup included genetic markers, protein assays, and other factors. Statistical Analysis : Univariate and chi-square analysis. Results: Of the 41 patients studied during the study period, 71% of patient had a single and 34% had multiple prothrombotic risk factors. Methylene tetrahydro-folate reductase (MTHFR heterozygosity (19.5% and factor V Leiden heterozygous (7.3% were the commonest genetic markers. Hyperhomocysteinemia (34% and elevated factor VIII levels (14.6% were the other important risk factors. In this cohort the mortality was 17%. Mortality increased by odds of 1.3 for every additional prothrombotic marker. The factors associated with increased mortality included: status epileptics (P = 0.05, OR 13.2, 95% CI 1.002 - 173, deep venous system involvement (P = 0.016, OR 9.64, 95% CI 1.53 - 60.6, presence of midline shift (P = 0.012, OR 24.7, 95% CI 2.05 - 29.8 and diffuse cerebral edema (P = 0.006, OR 14.5, 95% CI 2.18- 96.4. The traditional practice of decrease intake of water during puerperium was significant in woman with pregnancy associated CVT when compared to control subjects (P < 0.02. Conclusion : In patients with pregnancy associated CVT, prothrombotic markers can be multiple and are associated with increased odds of mortality. Deep venous system involvement, presence of midline shift and diffuse cerebral edema increased mortality. Peuperial water

  11. Subarachnoid hemorrhage with transient ischemic attack: Another masquerader in cerebral venous thrombosis

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    Bhawna Sharma

    2010-01-01

    Full Text Available Cerebral venous thrombosis has a wide spectrum of clinical manifestations that may mimic many other neurological disorders and lead to frequent misdiagnoses or delay in diagnosis. The most frequent symptoms and signs are headache, seizures, focal deficits, and papilledema. A number of rare atypical manifestations have been described. Cerebral venous thrombosis may present with an isolated intracranial hypertension type picture, thunderclap headache, attacks of migraine with aura, isolated psychiatric disturbances, pulsatile tinnitus, isolated or multiple cranial nerve involvement, and occasionally as subarachnoid hemorrhage (SAH or transient ischemic attack. Our patient presented with thunderclap headache and transient ischemic attack like episode with obvious SAH on CT scan. Acute SAH suggests the presence of a vascular lesion, such as ruptured aneurysm, and CVT is not generally considered in the diagnostic workup of SAH. The case emphasizes the importance of cerebral venous study in nonaneurysmal cases of SAH. It is important to have a high index of suspicion in such atypical cases to avoid delay in diagnosis.

  12. Predisposing factors, diagnosis, treatment and prognosis of cerebral venous thrombosis during pregnancy and postpartum: a case-control study

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    GAO Hui; YANG Bao-jun; JIN Li-ping; JIA Xiao-fang

    2011-01-01

    Background Previous investigations have demonstrated a relatively low incidence of stroke among young women,though both pregnancy and delivery can substantially increase the risk.Cerebral venous thrombosis may manifest different characteristics during pregnancy and postpartum as a result of their specific physiological statuses.This study aimed to identify the clinical manifestations,diagnosis,treatment,and prognosis of cerebral venous thrombosis during pregnancy and postpartum.Methods We conducted a retrospective analysis of 22 patients with cerebral venous thrombosis who were assigned to either group A (during pregnancy) or group B (during postpartum).The relevant risk factors,initiation and development of the disease,clinical presentations,diagnosis,treatment,and prognosis were compared between the two stages.Results Cerebral venous thrombosis occurred during both pregnancy and postpartum,but was more common postpartum.Patients in group A had a longer hospitalization period than those in group B.Confirmed predisposing factors in 85.7% of patients of group A were dehydration,infection,and underlying cerebrovascular disorders.No obvious predisposing factors were identified in group B.The most frequent symptom was headache,with epileptic seizures,hemiparalysis and aphasia being less frequent symptoms.Focal neurological symptoms (P=0.022) and cerebral infarction (P=0.014) occurred more frequently in group A than in group B.Anticoagulation therapy proved to be safe for cerebral venous thrombosis patients during puerperium,regardless of parenchymal hemorrhage.However,more attention should be paid to spontaneous in-site placental hemorrhage in pregnant patients.Both groups had similar prognoses (P=1.000),with 36.3% patients suffering from consequential dysfunction or recurrent intracranial hypertension.Delayed diagnosis was associated with a poorer prognosis.Conclusions Cerebral venous thrombosis manifests different clinical characteristics during pregnancy and

  13. A Case of Cerebral Sinus Venous Thrombosis Resulting in Mortality in Severe Preeclamptic Pregnant Woman

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    Hatice Ender Soydinc

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVST is a rarely encountered condition during pregnancy. A 21-year-old pregnant woman with labour pains was hospitalized in our clinic. Diagnosis of severe preeclampsia was made based on her clinical and laboratory findings. She suffered from convulsive episodes during postpartum period which lead to initiation of treatment for eclampsia. However neurological and radiological examinations were performed after emergence of additional neurological symptoms disclosed the diagnosis of CVST. In this paper, we aimed to present a case with CVST which diagnosis was confused with eclampsia and resulting in maternal mortality.

  14. Cerebral venous thrombosis in patient of relapse of ulcerative colitis:report of a case

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    Rajat Agarwal; Anuradha Batra; Ish Anand; Davinder Singh Rana; Samir Patel

    2016-01-01

    Amongst the various systemic complications of ulcerative colitis, cerebral venous thrombosis (CVT) is an uncommon and serious neurological complication mainly associated during episodes of relapse of ulcerative colitis. CVT is suspected to be a consequence of hypercoagulable state occurring during the disease in genetic predisposed persons. Most patients present with rapid neurological deterioration. This devastating intracranial complication requires immediate medical intervention to avoid potentially life threatening consequences. The outcome is good, provided the disease is diagnosed on time and the treatment is started early. The authors present a patient of CVT, a rare complication seen during relapse of ulcerative colitis.

  15. Cerebral Venous Thrombosis in a Patient with Clinically Isolated Spinal Cord Syndrome

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    Jasem Yousef Al-Hashel

    2013-01-01

    Full Text Available Background. The association between cerebral venous thrombosis (CVT and multiple sclerosis (MS has already been reported in patients with clinically definite MS in relation to intravenous methylprednisolone (IVMP or previously performed lumbar puncture (LP. Case Summery. We report a 29-year-old Indian female who presented with a clinically isolated spinal cord syndrome according to the revised 2010 McDonald Criteria. She developed CVT after a lumbar puncture and two days of finishing the course of IVMP. Conclusion. We conclude that the sequence of doing lumbar puncture followed by high-dose IVMP may increase the risk of CVT. A prophylactic anticoagulation may be indicated in this setting.

  16. Cerebral Venous Thrombosis Revealing Primary Sjögren Syndrome: Report of 2 Cases

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    A. Mercurio

    2013-01-01

    Full Text Available Sjögren syndrome (SS is an autoimmune disease of the exocrine glands, characterized by focal lymphocytic infiltration and destruction of these glands. Neurologic complications are quite common, mainly involving the peripheral nervous system (PNS. The most common central nervous system (CNS manifestations are myelopathy and microcirculation vasculitis. However, specific diagnostic criteria for CNS SS are still lacking. We report two cases of primary SS in which the revealing symptom was cerebral venous thrombosis (CVT in the absence of genetic or acquired thrombophilias.

  17. Trombose venosa cerebral e homocistinúria: relato de caso Cerebral venous thrombosis and homocystinuria: case report

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    Gisele Sampaio Silva

    2001-09-01

    Full Text Available Homocistinúria apresentando-se como trombose venosa cerebral é incomum. Relatamos o caso de um adolescente com características fenotípicas de homocistinúria que foi admitido por cefaléia intensa, vômitos e sonolência. Investigação diagnóstica com tomografia computadorizada de crânio, ressonância magnética e angiorressonância foi compatível com trombose dos seios transversos e sigmóides. Altos níveis de homocisteína foram detectados no sangue e na urina. Apresentamos os aspectos clínicos e radiológicos deste caso discutindo a controversa fisiopatologia da tendência trombofílica associada a homocistinúria.Homocystinuria presenting as cerebral venous thrombosis is not usual. We report on a 13-year-old boy who was admitted to the hospital due to severe headache, nausea, vomiting and fever (38ºC. The patient was Marfan like and presented left hemiparesis and meningeal irritation sings. He was mentally retarded, had severe myopia, and had right lens dislocation one month before. Cranial CT scan was suggestive of cerebral venous infarct. MRI and magnetic resonance angiography showed venous infarcts more prominent in the right thalamic projection with hemorrhagic transformation and multiple foci of cortical (occipital and parietal bilaterally deep parietal and left capsular bleeding, secondary of thrombosis of the transverse and sigmoid venous sinuses. High levels of homocysteine were detected in the blood and urine. Homocystinuria is an autossomal recessive inborn error of methionine metabolism caused by cystathione-ß-synthase defect in most cases. We discuss the clinical and radiological findings in this patient, analyzing the pathophysiology of the thrombotic events related to homocystinuria.

  18. [Lower limb vein thrombosis in dynamics of acute impairments of cerebral circulation].

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    Kuntsevich, G I; Maksimova, M Iu; Popova, L A; Riabinkina, Iu V; Gnedovskaia, E V; Piradov, M A

    2012-01-01

    The present work was aimed at studying the state of the inferior vena cava system according to the findings of duplex scanning in dynamics of acute cerebral circulation impairments (ACCI). Amongst 100 patients with ACCI, lower limb vein deep thrombosis (LLVDT) was revealed in 57% of cases. The incidence of LLVDT in patients with intracerebral haemorrhage was higher than in those with ischaemic stroke, however there were no statistically significant differences between the type of ACCI (p=0.06) and subtypes of ischaemic stroke (atherothrombotic, ceardioembolic) (p = 0.68). The main risk factors for LLVDT are the presence of pronounced motion deficit in the extremities, induced by the underlying disease (p=0.02) and immobilization. In the overwhelming majority of patients (81%) thrombosis localized isolatedly in the crural veins. Ascending thrombosis and the development of a floating thrombus were represented mainly on the side of motility deficit in the extremities. We have confirmed a strong association between positive dynamics in the neurological status of patients and frequency of recanalization of thrombi (p=0.043). Ultrasonographic examination of lower limb veins in dynamics of ACCI is an important component of preventive and therapeutic process.

  19. Evaluation of risk factors for thrombophilia in patients with cerebral venous thrombosis

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    Osman Yokuş

    2010-09-01

    Full Text Available Objective: The increased risk for thrombosis is known as hypercoagulability or thrombophilia. In our study, we aimed to determine the frequency of the identified defects for thrombophilia in patients with central venous thrombosis aged under 50 years and to compare results with the findings in the current literature. Materials and Methods: Forty-three patients (16-50 years old were retrospectively evaluated. Thrombophilia investigation included determinations of protein C, protein S, antithrombin, and activated protein C resistance, factor V Leiden (FVL, prothrombin 20210A (PT 20210 and methylene tetrahydrofolate reductase (MTHFR C677T mutations, antiphospholipid antibodies (APA, factor VIII levels, and homocysteine levels. Results: We detected a single thrombophilic defect in 67.4%, two defects in 27.9% and three defects in 4.7% of our patients. The most common thrombophilic defect was mutation in the MTHFR gene (41.8%, and this was followed by the FVL mutation (34.9%.Conclusion: Since the prevalence of individual thrombophilic defects varies in each population, ethnic group and geographical location, screening for thrombophilic defects in patients presenting with cerebral venous thrombosis should primarily investigate the most frequent thrombophilia risk factors.

  20. Cerebral Venous Sinus Thrombosis following Diagnostic Curettage in a Patient with Uterine Fibroid

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    Xiao-Qun Zhu

    2014-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVST is a relatively rare cerebrovascular disease, of which the risk has been documented in patients with numerous conditions. However, CVST has never been previously described in association with the use of a diagnostic curettage in patient with uterine fibroid. Herein, we described a 43-year-old woman who presented with recurrent convulsive seizures and severe and progressive headache 1 day after a diagnostic curettage of the uterus, which was confirmed to be uterine fibroid pathologically later, and her condition subsequently progressed to confusion. Brain magnetic resonance imaging (MRI revealed an acute extensive thrombosis of the left transverse and sigmoid sinus and the ipsilateral cerebellum infarction. Evaluation for primary thrombophilia revealed that an iron deficiency anemia (IDA due to the fibroid bleeding induced menorrhagia together with a diagnostic curettage might be the sole hypercoagulable risk factor identified. Treatment with anticoagulation led to full recovery of her symptoms and recanalization of the thrombosis was proven on magnetic resonance venography (MRV 2 months later. We suggest that CVST should be recognized as a potential complication related to this diagnostic technique, especially in patient with IDA. The early diagnosis and timely treatment would be of significance in improving the prognosis of this potentially lethal condition.

  1. Progressive Ischemic Stroke due to Thyroid Storm-Associated Cerebral Venous Thrombosis

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    Tanabe, Natsumi; Hiraoka, Eiji; Hoshino, Masataka; Deshpande, Gautam A.; Sawada, Kana; Norisue, Yasuhiro; Tsukuda, Jumpei; Suzuki, Toshihiko

    2017-01-01

    Patient: Female, 49 Final Diagnosis: Cerebral venous thrombosis Symptoms: Altered mental state • weakness in limbs Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Rare co-existance of disease or pathology Background: Cerebral venous thrombosis (CVT) is a rare but fatal complication of hyperthyroidism that is induced by the hypercoagulable state of thyrotoxicosis. Although it is frequently difficult to diagnose CVT promptly, it is important to consider it in the differential diagnosis when a hyperthyroid patient presents with atypical neurologic symptoms. Care Report: A 49-year-old Japanese female with unremarkable medical history came in with thyroid storm and multiple progressive ischemic stroke identified at another hospital. Treatment for thyroid storm with beta-blocker, glucocorticoid, and potassium iodide-iodine was started and MR venography was performed on hospital day 3 for further evaluation of her progressive ischemic stroke. The MRI showed CVT, and anticoagulation therapy, in addition to the anti-thyroid agents, was initiated. The patient’s thyroid function was successfully stabilized by hospital day 10 and further progression of CVT was prevented. Conclusions: Physicians should consider CVT when a patient presents with atypical course of stroke or with atypical MRI findings such as high intensity area in apparent diffusion coefficient (ADC) mapping. Not only is an early diagnosis and initiation of anticoagulation important, but identifying and treating the underlying disease is essential to avoid the progression of CVT. PMID:28228636

  2. CEREBRAL SINUS THROMBOSIS IN A CASE OF ANTI-PHOSPHOLIPID ANTIBODY SYNDROME WITHOUT ASSOCIATED CONNECTIVE TISSUE INVOLVEMENT

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    Biswarup

    2014-12-01

    Full Text Available : The association of antiphospholipid antibodies with vascular thrombotic episodes is well established. In absence of other connective tissue disease such an association is very rare & known as the primary antiphospholipid antibody syndrome. Cerebral venous sinus thrombosis is associated with hypercoaguable states and a number of immune-mediated conditions. However the report of cerebral venous sinus thrombosis with antiphospholipid antibodies alone is limited. Here a case presenting with painful bilateral ophthalmoplegia with bilateral optic disc edema (due to raised intra cranial tension showing positive lupus anticoagulant in serum and right central venous sinus (transverse and sigmoid thrombosis on MRI and MR venogram is reported which showed clinical improvement with anticoagulant therapy

  3. Prognostic indices for cerebral venous thrombosis on CT perfusion: A prospective study

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    Gupta, Rakesh Kumar, E-mail: rakrakgupta@gmail.com [Department of Radiodiagnosis and Imaging, MMIMSR, Mullana, Ambala (India); Bapuraj, J.R., E-mail: jrajiv@med.umich.edu [Department of Radiology, Division of Neuroradiology, University Hospital, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109 (United States); Khandelwal, N. [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (India); Khurana, Dheeraj [Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (India)

    2014-01-15

    Purpose: We determined the prognostic significance of CT perfusion characteristics of patients with cerebral venous sinus thrombosis (CVST) and assessed the change in perfusion parameters following anticoagulation therapy. Materials and methods: 20 patients with CVST diagnosed on non-contrast computed tomography (NCCT), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) were included in this study. The initial CT perfusion study was performed at the time of admission. The following perfusion parameters: relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) were calculated in the core and periphery of the affected area of the brain. Follow-up CT perfusion studies were performed at 1 month following anticoagulation therapy and the perfusion parameters thus obtained were compared with pre-treatment results. Receiver operating characteristic (ROC) curve analysis was performed to determine the prognostic significance of perfusion parameters. Results: All patients in this study showed areas of hypoperfusion on CT perfusion. To determine the favorable clinical outcome on basis of perfusion parameters, ROC curve analysis was performed which showed that the optimal threshold for rCBF > 60.5%, rCBV > 75.5%, and rMTT < 148.5% correlated with better clinical outcomes. Post treatment perfusion parameters showed significant correlation in core of the lesion (p < 0.05) than in the periphery. Conclusion: CT perfusion studies in CVST are a good prognostic tool and yield valuable information regarding clinical outcome.

  4. Acute posttraumatic pediatric cerebral venous thrombosis: Case report and review of literature

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    Al-Wala Awad

    2014-01-01

    Full Text Available Background : Pediatric cerebral venous thrombosis (CVT is a common sequelae of infection, coagulopathies, and dehydration in the pediatric population. Acute posttraumatic CVT is an uncommon etiology of pediatric CVT that presents a unique management challenge. There are no established guidelines outlining the treatment of this small subset of patients. Case Description: We present a case of a 12-year-old boy with posttraumatic CVT who was safely treated with anticoagulation therapy, and had resolution of his symptoms and radiographic improvement within 3 days of therapy. The relevant literature is reviewed. Conclusion : Anticoagulation therapy may be safely used in the treatment of acute posttraumatic CVT in pediatric patients, and may reduce the incidence of clot propagation, hospitalization time, and cost of treatment.

  5. Early pregnancy cerebral venous thrombosis and status epilepticus treated with levetiracetam and lacosamide throughout pregnancy.

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    Ylikotila, Pauli; Ketola, Raimo A; Timonen, Susanna; Malm, Heli; Ruuskanen, Jori O

    2015-11-01

    Cerebral venous thrombosis (CVT) is an uncommon cause of stroke, accounting to less than 1% of all strokes. We describe a pregnant woman with a massive CVT in early pregnancy, complicated by status epilepticus. The mother was treated with levetiracetam, lacosamide, and enoxaparin throughout pregnancy. A male infant was born on pregnancy week 36, weighing 2.2kg. Both levetiracetam and and lacosamide were present in cord blood in levels similar to those in maternal blood. The infant was partially breast-fed and experienced poor feeding and sleepiness, starting to resolve after two first weeks. Milk samples were drawn 5 days after the delivery and a blood sample from the infant 3 days later. Lacosamide level in milk was low, resulting in an estimated relative infant dose of 1.8% of the maternal weight-adjusted daily dose in a fully breast-fed infant. This is the first case describing lacosamide use during pregnancy and lactation.

  6. Communicating hydrocephalus due to cerebral venous sinus thrombosis treated with ventriculoperitoneal shunt

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    Rahul T Chakor

    2012-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVT is a rare cerebrovascular disease with variable presentation. CVT rarely causes hydrocephalus. Communicating hydrocephalus due to CVT is extremely rare. We describe a patient of CVT presenting with chronic headache and communicating hydrocephalus. The patient was successfully treated with ventriculoperitoneal (VP shunt. A 40 year old man presented with moderate to severe headache since six months and progressive visual loss since two months. Head Computed tomogram showed mild hydrocephalus without obstruction. Lumbar puncture (LP demonstrated elevated pressure but was otherwise normal. Magnetic resonance venogram showed extensive CVT. Repeated CSF drainage and thecoperitoneal shunt did not relieve the severe headache hence a VP shunt was placed. Post shunt headache subsided with resolution of hydrocephalus. CVT can present as communicating hydrocephalus. Gradual reduction of intra-ventricular pressure by repeated LPs followed by VP shunt can safely treat hydrocephalus due to CVT.

  7. Paradoxical presentation of orthostatic headache associated with increased intracranial pressure in patients with cerebral venous thrombosis

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    Jung B Kim

    2013-01-01

    Full Text Available Headache is the most common symptom of cerebral venous thrombosis (CVT; however, the detailed underlying mechanisms and characteristics of headache in CVT have not been well described. Here, we report two cases of CVT whose primary and lasting presentation was orthostatic headache, suggestive of decreased intracranial pressure. Contrary to our expectations, the headaches were associated with elevated cerebrospinal fluid (CSF pressure. Magnetic resonance imaging and magnetic resonance venography showed characteristic voiding defects consistent with CVT. We suggest that orthostatic headache can be developed in a condition of decreased intracranial CSF volume in both intracranial hypotensive and intracranial hypertensive states. In these cases, orthostatic headache in CVT might be caused by decreased intracranial CSF volume that leads to the inferior displacement of the brain and traction on pain-sensitive intracranial vessels, despite increased CSF pressure on measurement. CVT should be considered in the differential diagnosis when a patient complains of orthostatic headache.

  8. Coagulation factor VII R353Q polymorphism and the risk of puerperal cerebral venous thrombosis.

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    Kruthika-Vinod, T P; Nagaraja, Dindagur; Christopher, Rita

    2012-01-01

    Puerperal cerebral venous thrombosis (CVT) is a relatively common form of stroke in young women in India. The blood coagulation factor VII (FVII) R353Q polymorphism increases the risk for venous thrombosis. Our aim was to investigate the association of FVII R353Q polymorphism with the risk of puerperal CVT. A total of 100 women with puerperal CVT and 102 age-matched women without postpartum complications were investigated. FVII R353Q genotypes were identified using restriction fragment length polymorphism analysis. Our results showed that the homozygous FVII 353QQ genotype was present in 9% and 8% of patients and controls, respectively; and 42% of patients and 31.4% of controls had the heterozygous 353RQ genotype (odds ratio = 1.55, 95% confidence interval = 0.89-2.70; p = 0.243). Our findings suggest that the FVII R353Q polymorphism is not associated with increased risk for CVT occurring during the puerperal period in Indian women.

  9. Correlation analysis of internal jugular vein abnormalities and cerebral venous sinus thrombosis

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    JIA Ling-yun; HUA Yang; JI Xun-ming; LIU Jiang-tao

    2012-01-01

    Background Cerebral venous sinus thrombosis (CVST) is a special form of stroke with multiple causes and risk factors.However,there are still a portion of cases with unknown reasons.The aim of this study was to investigate the relationship between internal jugular vein (IJV) abnormalities and the development of CVST.Methods A total of 51 CVST patients and 30 healthy controls were enrolled.The diameter,the maximum velocity (Vmax) and the reflux time in bilateral IJVs were measured by color Doppler flow imaging (CDFI).The paired t test was used to compare the numeric values between the bilateral IJVs.The Pearson chi-square test was used to evaluate the relationship between IJV abnormality and CVST,IJV abnormality and IJV reflux,respectively.Results Among the 51 CVST patients,20 (39%) patients were with normal IJV and 31 (61%) patients were with abnormal IJV.The types of IJV abnormality included annulus stenosis 19 cases (61%),hypoplasia 9 cases (29%),thrombosis 2 cases (7%) and anomalous valve 1 case (3%).In patients with unilateral IJV abnormality,the minimum diameter of the IJV on the lesion side was significantly smaller than that of the contralateral side (P <0.0001).When compared with contralateral side,the Vmax of the lesion side with unilateral annulus stenosis was significant higher,however,it was obvious lower in patients with unilateral hypoplasia (P <0.05).Furthermore,among 27 cases with unilateral IJV abnormality,all the CVST occurred on the same side as the IJV lesions.Conclusion IJV abnormality closely correlated with the development of CVST,which is a newly identified risk factor for CVST.

  10. Diagnostic Value of D-Dimer’s Serum Level in Iranian Patients with Cerebral Venous Thrombosis

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    Hashami, Leila; Rakhshan, Vahid; Karimian, Hoda; Moghaddasi, Mehdi

    2016-01-01

    Cerebral venous thrombosis (CVT) is a long-term debilitating vascular brain disease with high morbidity and mortality. It may be associated with rise in D-dimer level. The aim of this study was to examine this potential association and identify the critical D-dimer cut-off level corresponding to increase the risk of CVT. This case-control study was conducted on two groups of patients with and without CVT attending the Rasool Akram Hospital (Iran) during 2014 and 2015. D-dimer levels were measured by the rapid sensitive D-dimer assay. Data were analyzed by Spearman’s correlation coefficient test, independent-samples t-test, backward-selection multiple linear regression and multiple binary logistic regression analyses. Sensitivity-specificity tests were used to detect D-dimer cut-off for CVT. Differences between the D-dimer levels of the case and control groups were significant (P<0.001). It showed that each level of increase in the number of symptoms could increase the risk of thrombosis occurrence for about 3.5 times. All symptom types except for headache were associated with D-dimer level, while headache has negative association with D-dimer level. D-dimer cut-off point for CVT diagnosis was estimated at 350 ng/mg. We concluded that D-dimer serum level significantly rises in CVT patients. A rounded cut-off point of 350 ng/mg can be used as a diagnostic criterion for CVT prediction. PMID:27441064

  11. Diagnostic value of D-dimer’s serum level in Iranian patients with cerebral venous thrombosis

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    Leila Hashami

    2016-06-01

    Full Text Available Cerebral venous thrombosis (CVT is a longterm debilitating vascular brain disease with high morbidity and mortality. It may be associated with rise in D-dimer level. The aim of this study was to examine this potential association and identify the critical D-dimer cut-off level corresponding to increase the risk of CVT. This case-control study was conducted on two groups of patients with and without CVT attending the Rasool Akram Hospital (Iran during 2014 and 2015. D-dimer levels were measured by the rapid sensitive D-dimer assay. Data were analyzed by Spearman’s correlation coefficient test, independent-samples t-test, backward-selection multiple linear regression and multiple binary logistic regression analyses. Sensitivity-specificity tests were used to detect D-dimer cut-off for CVT. Differences between the D-dimer levels of the case and control groups were significant (P<0.001. It showed that each level of increase in the number of symptoms could increase the risk of thrombosis occurrence for about 3.5 times. All symptom types except for headache were associated with D-dimer level, while headache has negative association with D-dimer level. D-dimer cut-off point for CVT diagnosis was estimated at 350 ng/mg. We concluded that D-dimer serum level significantly rises in CVT patients. A rounded cut-off point of 350 ng/mg can be used as a diagnostic criterion for CVT prediction.

  12. Cerebral venous thrombosis and heparin-induced thrombocytopenia in an 18-year old male with severe ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Gudrun Scheving Thorsteinsson; Maria Magnussson; Lena M Hallberg; Nils Gunnar Wahlgren; Fredrik Lindgren; Petter Malmborg; Thomas H Casswall

    2008-01-01

    The risk of thromboembolism is increased in inflammatory bowel disease and its symptoms may be overlooked. Furthermore, its treatment can be complex and is not without complications. We describe a case of an adolescent boy who developed a cerebral sinus venous thrombosis during a relapse of his ulcerative colitis and who, while on treatment with heparin,developed heparin-induced thrombocytopenia (HIT).The treatment was then switched to fondaparinux, a synthetic and selective inhibitor of activated factor x.

  13. Cerebral venous and sinus thrombosis with cerebrospinal fluid circulation block after the first methotrexate administration by lumbar puncture

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    Bienfait, H.P. [Gelre Hospital, location Lukas, Apeldoorn, Department of Neurology, Albert Schweitzerlaan 31, PO Box 9014, 7300 DS Apeldoorn (Netherlands); Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Gijtenbeek, J.M.M. [Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Department of Neurology, University Medical Center Nijmegen, St Radboud, Postlaan 4, 6525 GC Nijmegen (Netherlands); Bent, M.J. van [Department of Neuro-Oncology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Bruin, H.G. de [Department of Radiology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Voogt, P.J. [Department of Hematology, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands); Pillay, M. [Department of Nuclear Medicine, Daniel den Hoed Kliniek, Academisch Ziekenhuis Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands)

    2002-11-01

    We report a patient treated for small lymphocytic lymphoma/leukemia with cerebral venous and sinus thrombosis (CVST) after lumbar puncture with intrathecal administration of methotrexate (MTX). He also developed a cerebrospinal fluid flow block. This is the first report of an association between lumbar puncture and intrathecally administered MTX and the development of CVST. Intrathecal treatment in this patient was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously. (orig.)

  14. Hormonal contraceptives and cerebral venous thrombosis risk: A systematic review and meta-analysis

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    Farnaz eAmoozegar

    2015-02-01

    Full Text Available Objectives: Use of oral contraceptive pills (OCP has previously been shown to increase the risk of cerebral venous sinus thrombosis (CVST. Whether this risk varies by type of OCP use, duration of use and other forms of hormonal contraceptives is largely unknown. This systematic review and meta-analysis updates the current state of knowledge on these issues.Methods: We performed a search to identify all published studies on the association between hormonal contraceptive use and risk of CVST in women aged 15-50, using MEDLINE, EMBASE, Cochrane systematic review, the Cochrane Center for Clinical Trials and CINAHL. Risk of CVST was estimated using random effects models. Stratification and meta-regression were used to assess heterogeneity. Results: Of 861 studies reviewed for eligibility, quality, and data extraction, 11 were included in the final systematic review. The pooled odds of developing CVST in women of reproductive age taking oral contraceptives was over 7 times higher compared to women not taking oral contraceptives (OR=7.59, 95% CI 3.82 – 15.09. There is some indication that third generation OCPs may confer a higher risk of CVST than second generation OCPs, but this remains controversial. Data is insufficient to make any conclusions about duration of use and other forms of hormonal contraceptives and risk of CVST. Conclusions: OCP use increases the risk of developing CVST in women of reproductive age. Better studies are needed to determine if duration and type of hormonal contraceptive use modifies this risk.

  15. Clinical characteristics and prognosis of cerebral venous thrombosis in Chinese women during pregnancy and puerperium

    Science.gov (United States)

    Liang, Zhu-Wei; Gao, Wan-Li; Feng, Li-Min

    2017-01-01

    Due to the specific physiology associated with pregnancy and puerperium, cerebral venous sinus thrombosis (CVT) may manifest different characteristics. This study aimed to identify the clinical manifestations and prognosis of pregnancy-associated CVT. A total of 43 pregnancy-associated CVT patients were enrolled. We analysed the clinical presentations of the disease and performed a multivariate logistic regression analysis to determine which variables were associated with prognosis. Our descriptive results showed the following: 1) the incidence was 202 per 100,000 deliveries, and the mortality rate was 11.63%; 2) the most frequent symptom was headache; 3) the most frequent abnormal laboratory findings were increased levels of fibrinogen and several serum lipoproteins (including triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein, apolipoprotein A1, and apolipoprotein B); and 4) the superior sagittal sinus and transverse sinus were the most frequently affected locations. Moreover, an increased modified Rankin Scale score was positively associated with infection, seizure, intracerebral haemorrhage (ICH) and hypertensive disorders of pregnancy (HDP). Comparably, the occurrence of death was positively and significantly associated with infection, seizure and ICH. Consequently, timely diagnosis and treatment of pregnancy-associated CVT patients with infection, seizure, ICH or HDP are needed. Patients with infection, seizure or ICH have a greater risk of death. PMID:28262755

  16. Unusual Case of Cerebral Venous Thrombosis in Patient with Crohn's Disease

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    Inha Kim

    2015-05-01

    Full Text Available The development of cerebral venous thrombosis (CVT as a secondary complication of Crohn's disease (CD seems to be rare, but it is generally accepted that the disease activity of CD contributes to the establishment of a hypercoagulable state. Here, we describe a case of CVT that developed outside the active phase of CD. A 17-year-old male visited the emergency room because of a sudden onset of right-sided weakness and right-sided hypesthesia. He had been diagnosed with CD 1 year before and was on a maintenance regimen of mesalazine and azathioprine. He did not exhibit any symptoms indicating a CD flare-up (bloody stools, abdominal pain, complications, or weight loss. A brain MRI scan revealed an acute infarction of the left frontal cortex and a cortical subarachnoid hemorrhage. Additionally, a magnetic resonance venography revealed a segmental filling defect in the superior sagittal sinus and also the non-visualizability of some bilateral cortical veins. The characteristics of the present case suggest that the risk of CVT is most likely related to CD per se rather than disease activity associated with CD.

  17. Thrombolytic Therapy for Cerebral Vein Thrombosis in Antiphospholipid Syndrome Secondary to Systemic Lupus Erythematosus

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    Mehrzad Hajialilo

    2012-03-01

    Full Text Available A 20-year-old woman was admitted to a Gynecology Hospital in her 6th month of pregnancy for high blood pressure and tonic-clonic seizure. Primary diagnosis was eclampsia, and for that reason she underwent cesarean section. She also had headache on frontal and parietal areas without nausea or vomiting. There was not a focal neurological sign. Rheumatology consultation was requested. Sys-temic lupus erythematosus and secondary antiphospholipid (APS was confirmed. The patient had headache that continued several days after cesarean section, therefore, brain magnetic resonance im-aging (MRI and magnetic resonance venography (MRV were performed, and cerebral vein thrombosis was documented. Distal segment of right lateral sinus and sigmoid sinus were not ap-peared in brain MRV. Abnormal hypersignal intensity of right lateral sinus/coronal T2 was detected. Thrombolytic therapy with 20 mg tissue plasminogen activator on right sigmoid and transverse sinus was performed by an interventional neurologist. After this procedure, the patient's headache healed and she was discharged in a good condition.

  18. Cerebral venous thrombosis and thrombophilia: a systematic review and meta-analysis.

    Science.gov (United States)

    Lauw, Mandy N; Barco, Stefano; Coutinho, Jonathan M; Middeldorp, Saskia

    2013-11-01

    Cerebral venous thrombosis (CVT) is a rare manifestation of venous thromboembolism (VTE) and stroke. The aim of our systematic review was to provide an updated summary of the strength of association between CVT and thrombophilia and to explore the relevance of thrombophilia for recurrence of CVT or other VTE, or other outcome variables. MEDLINE (via PubMed), EMBASE (via Ovid), and CENTRAL were systematically searched, including references of retrieved articles. Cohort studies of ≥ 40 patients and case-control studies comparing the prevalence of thrombophilia in patients with CVT and unrelated controls were eligible. Two reviewers independently selected studies, assessed quality, and extracted data. A meta-analysis was performed for high quality case-control studies with unselected cases and healthy controls. Odds ratios with 95% confidence intervals were calculated and pooled. We included 23 cohort studies and 33 case-control studies. A significant association was demonstrated between CVT and all inherited thrombophilic factors, as well as increased levels of homocysteine. Inconclusive results were found on the relevance of thrombophilia for recurrent CVT or other VTE. Although there is a strong association between CVT and thrombophilia, the clinical relevance of thrombophilia testing in patients with CVT seems limited, similarly to other forms of VTE.

  19. Cerebral Vein Thrombosis:Screening of Acquired and Hereditary Thrombophilic Risk Factors

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    Sarraf Payam

    2009-10-01

    Full Text Available Cerebral vein thrombosis (CVT is an infrequent condition with a large variety of causes that can lead to serious disabilities. However, in 20% to 35% of cases, no cause is found. In this study we evaluated the hereditary (P & C Proteins, antithrombin, mutation of prothrombin G20210A and factor V Leiden, other risk factors (hyperhomocycteinemia, factor VIII, ACL-ab, APL-ab, and OCP and clinical manifestations among a population of Iranian patients with CVT. 18 women and 10 men aged 16 to 50 years with CVT were screened for inherited and acquired coagulation risk factors. No one had an abnormal ACL-ab, APL-ab or antithrombin III deficiency. One had prothrombin G20210A mutation (heterozygot (3.6%. Hyperhomocycteinemia was observed in 5 patients (17.9%. APC-R was decreased in 3 (10.7%. 2 had positive factor V Leiden mutation (heterozygot (7.1%. 17 had an increased of factor VIII (60.7. PS and PC deficiencies were each detected in two cases (7.1%. Conclusion: Our study suggests that screening for inherited thrombophilia may be an integral part in the diagnostic workup and duration of treatment in patients with CVT.

  20. Clinical and neuroimaging correlation in patients with cerebral sinus venous thrombosis

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    Basavaraj Mangshetty

    2015-01-01

    Full Text Available Objectives: To study the clinical and neuroimaging correlation in patients with cerebral sinus venous thrombosis. Methods: Clinically suspected 50 patients of CSVT, were subjected to neuro imaging techniques, fulfilling the study criteria were recruited by simple random sampling and data collected was analyzed by correlational studies. Results: Of the 50 patients, 29 (58% were females and 21 (42% were males, and the mean age was 29.7 years, with maximum incidence of 87.5% in age group 20-40 years. Most common symptoms were headache 88%, seizures 66%, focal deficits 54%, altered sensorium 52% and mode of presentation was sub acute in 46% cases. Radiologically most common sinus involved was superior sagittal sinus 70%. 5 patients died during hospitalization. Out of the survived patients 35 patients (70% had complete recovery. Poor prognostic factors at the time of admission were stupor and coma and evidence of haemorrhagic infarction in primary CT scan. Conclusion: Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Overall prognosis was good, but small percentage of patients died. Management with heparin and oral anticoagulants is safe and effective.

  1. Parenchymal abnormalities in cerebral venous thrombosis: findings of magnetic resonance imaging and magnetic resonance angiography; Alteracoes parenquimatosas na trombose venosa cerebral: aspectos da ressonancia magnetica e da angiorressonancia

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    Ferreira, Clecia Santos; Pellini, Marcos [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: csferreira@superig.com.br; Boasquevisque, Edson [Universidade do Estado do Rio de Janeiro, (UERJ), RJ (Brazil). Faculdade de Medicina. Dept. de Patologia; Souza, Luis Alberto M. de [Hospital da Beneficencia Portuguesa do Rio de Janeiro, RJ (Brazil). Servico de Imagem. Setor de Ressonancia Magnetica

    2006-09-15

    Objective: to determine the frequency and localization of parenchymal abnormalities in cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography as well as their correlation with the territory and affected venous drainage. Materials and methods: retrospective analysis (1996 to 2004) of 21 patients (3 male and 18 female) age range between 3 and 82 years (mean 40 years, median 36 years) with clinical and radiological diagnosis of cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography in 2D PC, 3D PC and contrast-enhanced 3D TOF sequences. The statistical analysis was performed with the qui-square test. Four patients had follow-up exams and three patients underwent digital subtraction angiography. Results: main predisposing factors were: infection, use of oral contraceptives, hormone replacement therapy and collagenosis. Predominant symptoms included: focal deficit, headache, alteration of consciousness level and seizures. Most frequent parenchymal manifestations were: cortical/subcortical edema or infarct, venous congestion and collateral circulation, meningeal enhancement and thalamic and basal ganglia edema or infarct. Occlusion occurred mainly in superior sagittal, left transverse, left sigmoid and straight sinuses. Cavernous sinus and cortical veins thrombosis are uncommon events. Conclusion: cerebral venous thrombosis is an uncommon cause of stroke, with favorable prognosis because of its reversibility. Diagnosis is highly dependent on the radiologist capacity to recognize the presentations of this disease, principally in cases where the diagnosis is suggested by parenchymal abnormalities rather than necessarily by visualization of the thrombus itself. An accurate and rapid diagnosis allows an immediate treatment, reducing the morbidity and mortality rates. (author)

  2. A case-series study of cerebral venous thrombosis in women using short course oral ‎contraceptive

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    Payam Khomand

    2016-04-01

    Full Text Available Background: We report a case series of cerebral vein thrombosis (CVT in women who used oral contraceptive pill (OCP in the Muslims Ramadan and fasting month.Methods: This study was a retrospective case series of 9 patients with diagnosis of CVT, who admitted in the neurology ward of Tohid Hospital of Sanandaj, Iran, in July-August 2014-2015.Results: Patients had no history of thrombosis before. They were treated with oral contraceptive more than 1 month to be able to fast during Ramadan. They did not have other possible risk factors for CVT. A headache was the most common in 9/9 patients (100% followed by vomiting and vertigo.Conclusion: We found that high rate of CVT in female population during Ramadan indicates that it needs be considered as a specific risk factor and should be considered by healthcare system.

  3. Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

    Science.gov (United States)

    Yadegari, Samira; Ghorbani, Askar; Miri, S. Roohollah; Abdollahi, Mohammad; Rostami, Mohsen

    2016-01-01

    Introduction: Despite increasing the use of magnetic resonance imaging (MRI), cerebral venous sinus thrombosis (CVST) has remained an under-diagnosed condition. In this study, characteristics and frequency of various risk factors of CVST patients in a tertiary referral hospital were closely assessed. Methods: Patients with an unequivocal diagnosis of CVST confirmed by MRI and magnetic resonance venography during 6 years of the study were included. All data from the onset of symptoms regarding clinical signs and symptoms, hospital admission, seasonal distribution, medical and drug history, thrombophilic profile, D-dimer, neuroimaging, cerebrospinal fluid findings, mortality, and outcome were collected and closely analyzed. Result: A total of 53 patients with female to male ratio of 3.07 and mean age of 33.7 years were included in the study. Headache and papilledema were the most frequent clinical features (44 and 36 patients, respectively). An underlying disease (diagnosed previously or after admission) was the most common identified risk factor for CVST in both females and males (21 patients). A total of 15 women used the oral contraceptive pill (OCP) where 12 of them had simultaneously other predisposing factors. Overall, 19 patients (36%) had more than one contributing factor. D-dimer had a sensitivity of 71.4% in CVST patients. The mortality of patients in this study was 3.7% (n = 2). Focal neurologic deficit and multicranial nerve palsy were associated with poor outcome which defined as death, recurrence, and massive intracranial hemorrhage due to anticoagulation (P = 0.050 and 0.004, respectively). Conclusion: Unlike most of the CVST studies in which OCP was the main factor; in this study, an underlying disease was the most identified cause. Considering the high probability of multiple risk factors in CVST that was shown by this study, appropriate work up should be noted to uncover them. PMID:27695236

  4. Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

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    Samira Yadegari

    2016-01-01

    Full Text Available Introduction: Despite increasing the use of magnetic resonance imaging (MRI, cerebral venous sinus thrombosis (CVST has remained an under-diagnosed condition. In this study, characteristics and frequency of various risk factors of CVST patients in a tertiary referral hospital were closely assessed. Methods: Patients with an unequivocal diagnosis of CVST confirmed by MRI and magnetic resonance venography during 6 years of the study were included. All data from the onset of symptoms regarding clinical signs and symptoms, hospital admission, seasonal distribution, medical and drug history, thrombophilic profile, D-dimer, neuroimaging, cerebrospinal fluid findings, mortality, and outcome were collected and closely analyzed. Result: A total of 53 patients with female to male ratio of 3.07 and mean age of 33.7 years were included in the study. Headache and papilledema were the most frequent clinical features (44 and 36 patients, respectively. An underlying disease (diagnosed previously or after admission was the most common identified risk factor for CVST in both females and males (21 patients. A total of 15 women used the oral contraceptive pill (OCP where 12 of them had simultaneously other predisposing factors. Overall, 19 patients (36% had more than one contributing factor. D-dimer had a sensitivity of 71.4% in CVST patients. The mortality of patients in this study was 3.7% (n = 2. Focal neurologic deficit and multicranial nerve palsy were associated with poor outcome which defined as death, recurrence, and massive intracranial hemorrhage due to anticoagulation (P = 0.050 and 0.004, respectively. Conclusion: Unlike most of the CVST studies in which OCP was the main factor; in this study, an underlying disease was the most identified cause. Considering the high probability of multiple risk factors in CVST that was shown by this study, appropriate work up should be noted to uncover them.

  5. Surgery-related thrombosis critically affects the brain infarct volume in mice following transient middle cerebral artery occlusion.

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    Xiaojie Lin

    Full Text Available Transient middle cerebral artery occlusion (tMCAO model is widely used to mimic human focal ischemic stroke in order to study ischemia/reperfusion brain injury in rodents. In tMCAO model, intraluminal suture technique is widely used to achieve ischemia and reperfusion. However, variation of infarct volume in this model often requires large sample size, which hinders the progress of preclinical research. Our previous study demonstrated that infarct volume was related to the success of reperfusion although the reason remained unclear. The aim of present study is to explore the relationship between focal thrombus formation and model reproducibility with respect to infarct volume. We hypothesize that suture-induced thrombosis causes infarct volume variability due to insufficient reperfusion after suture withdrawal. Seventy-two adult male CD-1 mice underwent 90 minutes of tMCAO with or without intraperitoneal administration of heparin. Dynamic synchrotron radiation microangiography (SRA and laser speckle contrast imaging (LSCI were performed before and after tMCAO to observe the cerebral vascular morphology and to measure the cerebral blood flow in vivo. Infarct volume and neurological score were examined to evaluate severity of ischemic brain injury. We found that the rate of successful reperfusion was much higher in heparin-treated mice compared to that in heparin-free mice according to the result of SRA and LSCI at 1 and 3 hours after suture withdrawal (p<0.05. Pathological features and SRA revealed that thrombus formed in the internal carotid artery, middle cerebral artery or anterior cerebral artery, which blocked reperfusion following tMCAO. LSCI showed that cortical collateral circulation could be disturbed by thrombi. Our results demonstrated that suture-induced thrombosis was a critical element, which affects the success of reperfusion. Appropriate heparin management provides a useful approach for improving reproducibility of reperfusion

  6. Effects of the Lifting Manipulation of Scalp Acupuncture for Raising Myodynamia of the Affected Limbs in Hemiplegic Patients Due to Cerebral Thrombosis

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To provide a new therapy with definite quality controllable therapeutic effects for functional restoration of the affected limbs in hemiplegic patients due to cerebral thrombosis. Method: 180 patients with hemiplegia due to cerebral thrombosis were randomly divided into 2 groups: the treatment group (treated with scalp acupuncture by using the lifting manipulation) and the control group (treated with scalp acupuncture by using the twirling manipulation). Evaluations were given for the two groups based on the improvement of myodynamia and comprehensive functions after the treatment. Results: Both groups showed increased myodynamia, but with different cured and much relieved rates (86.67% in the treatment group and 5% in the control group, P<0.01). Conclusion: Scalp acupuncture with the lifting manipulation can dramatically increase myodynamia of the affected limbs in hemiplegic patients due to cerebral thrombosis.

  7. Combined heterozygosity of factor V leiden and the G20210A prothrombin gene mutation in a patient with cerebral cortical vein thrombosis.

    Science.gov (United States)

    Liu, X Y; Gabig, T G; Bang, N U

    2000-07-01

    Cerebral venous thrombosis (CVT) is a rare type of stroke with a variety of causes. Several reports have suggested that either factor V Leiden or G20210A prothrombin gene mutation is associated with an increased risk of CVT. The genetic thrombophilias are typically associated with other predisposing factors. We report a unique case of CVT in a patient with both the factor V Leiden and the G20210A prothrombin gene mutations without other identifiable precipitating factors in a 28-year-old white male in good health. MRI and cerebral arterial angiography showed cerebral cortical venous thrombosis. This case suggests that combined heterozygous individuals may be particularly prone to spontaneous thrombosis, like CVT.

  8. Infarto cerebral secundario a trombosis de la carótida interna por traumatismo cervical Cerebral infarction secondary to internal carotid thrombosis following cervical trauma

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    Rico, A.; Santos, M; R. Marín; Blanco, M; Sánchez, A.; R. González-Cámpora; J. Lucena

    2011-01-01

    Se presenta el caso de una trombosis postraumática de la arteria carótida interna en un varón de 33 años, tras recibir un golpe con un balón en el cuello. La muerte se produjo 10 días después del golpe como consecuencia de un cuadro de hipertensión intracraneal y herniación cerebral secundaria a infarto isquémico extenso que afectaba a todo el territorio de la arteria cerebral media derecha, tanto superficial como profundo.In this paper, a case of post-traumatic thrombosis in the internal car...

  9. Safety Assessment of Anticoagulation therapy in Patients with Hemorrhagic Cerebral Venous Thrombosis

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    Kavian Ghandehari

    2013-07-01

    Full Text Available Background: Anticoagulation therapy is a routine treatment in patients with hemorrhagic cerebral venous thrombosis (CVT. However, fear of hemorrhagic complications and deterioration course following anticoagulation often disturbs the responsible physician.Methods: This was a Prospective observational study on consecutive CVT patients with hemorrhagic venous infarction or subarachnoid hemorrhage (SAH admitted in Ghaem Hospital, Mashhad, Iran, during 2006-2012. The diagnosis of CVT in suspected cases was confirmed by magnetic resonance imaging/magnetic resonance venography (MRI/MRV, and computerized tomography (CT angiography following established diagnostic criteria. Demographic data, clinical manifestations from onset to end of the observation period, location of thrombus, location and size of infarction and hemorrhage, and clinical course during treatment were recorded. Choice of the treatment was left to the opinion of the treating physician. Clinical course during 1 week of treatment was assessed based on the baseline modified National Institute of Health Stroke Scale (NIHSS score. Three or more points decrease or increase of modified NIHSS after 1 week of treatment was considered as improvement or deterioration courses, respectively. Other clinical courses were categorized as stabilization course.Results: 102 hemorrhagic CVT patients (80 females,22 males with mean age of 38.6 ± 8 years were prospectively investigated. Of the 102 hemorrhagic CVT patients in the acute phase, 52 patients (50.9% were anticoagulated with adjusted dose intravenous heparin infusion and 50 cases (49.1% received subcutaneous enoxaparin 1mg/Kg twice daily. Decreased consciousness had a significant effect on the clinical course of the patients (X2 = 9.493, df = 2, P = 0.009. Presence of SAH had no significant effect on the clinical course of our anticoagulated hemorrhagic CVT cases (X2 = 0.304, df = 2,P = 0.914. Extension of Infarction in more than two thirds of a

  10. Spontaneous thrombosis of giant intracranial aneurysm and posterior cerebral artery followed by also spontaneous recanalization

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    Guilherme Brasileiro de Aguiar

    2016-01-01

    Conclusions: Thrombosis is not the final event in the natural history of giant aneurysms, and partial thrombosis does not preclude the risk of rupture. Thrombosed aneurysms may display additional growth brought about by wall dissections or intramural hemorrhages. Their treatment may be either surgical or involve endovascular procedures such as embolization. Thrombosed giant aneurysms are dynamic and unstable lesions. A noninterventional treatment is feasible, but aneurysmal growth or recanalization may suggest the need for a more active intervention.

  11. Improving effect of Ginkgolide B on mitochondrial respiration of ischemic neuron after cerebral thrombosis in tree shrews

    Institute of Scientific and Technical Information of China (English)

    LI Shu-qing; ZHANG Ying; YANG Li-jun

    2007-01-01

    Background It has been known that platelet activating factor receptors (PAFR) may mediate many acute pathological responses and that PAFR antagonist Ginkgolide B (GB) possesses multiple effects, but the actions of GB on PAFR affinity and mitochondrial respiration in the ischemic neuron were unclear until now. This study explored the possible effects of GB on PAFR and the mitochondrial respiration of the neuron in the ischemic microenvironment.Methods Thrombotic cerebral ischemia in tree shrews was induced by a photochemical reaction; changes in the regional cerebral blood flow (rCBF, using 99mTc tracer technique ), the brain water content (specific gravimetric method), PAFR (3H-labelled PAF assay), the respiratory control rate (RCR), the phosphorus-oxygen (P/O) ratio of mitochondrial respiration (Clark oxygen electrode), mitochondrial permeability transition (MPT) pore, and the mitochondrial ultrastructure in the ischemic neurons were also observed. Data were compared between the two groups (the ischemia group vs the sham group, and the ischemia group vs the GB group).Results There were high affinity and low affinity sites for PAFR on the tree threws' brain cell membranes. The varying-affinity PAFR binding sites, the respiration state Ⅲ, the state Ⅳ, RCR, the P/O ratio of the mitochondria, and the rCBF all decreased markedly (respectively, P<0.01 and P<0.05), but the water content increased (P<0.01) in the ischemia group after the application of cerebral thrombosis. In tree shrews treated with GB (5 mg/kg I.v.) 6 hours after photochemical reaction, their PAFR binding sites and respiratory state increased markedly. The rCBF gradually increased and the brain edema ameliorated (P<0.01) at 24h after cerebral ischemia. There were significant differences between the ischemia group and sham group (P<0.01). In GB treated isolated neurons' mitochondria, with or without cerebral ischemia, the energy metabolism of the mitochondria had not been changed

  12. Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

    Institute of Scientific and Technical Information of China (English)

    梁晖; 陈甦; 陈少芳

    2002-01-01

    Objective: to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen (FIB) and D-dimer (DD) in plasma of patients with cerebral thrombosis. Method: 73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases. The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment. Result: FIB content in plasma after treatment was lower than that before treatment in the control group (P<0.01) and more remarkable in the treatment group (P<0.001). There was an obvious difference in DD content before and after treatment in both groups. DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group (P<0.01 and P<0.05 respectively). Conclusion: Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis, raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

  13. Development of cerebral venous sinus thrombosis in an aplastic anemia patient with antiphospholipid syndrome

    Institute of Scientific and Technical Information of China (English)

    CHEN Jian-hua; YOU Xin; QIAN Min

    2010-01-01

    @@ Aplastic anemia (AA) is an acquired disorder in which bone marrow fails to produce or release sufficient amounts of blood cell. Antiphospholipid syndrome (APS)is an autoimmune disease characterised by recurrent arterial or venous thrombosis, pregnancy morbidity and the persistence of positive antiphospholipid antibodies (aPL), including anticardiolipin antibody (ACL) and lupus anticoagulant (LA).

  14. Two rare manifestations of Q fever: splenic and hepatic abscesses and cerebral venous thrombosis, with literature review ma non troppo.

    Science.gov (United States)

    Gomes, Manuel Mendes; Chaves, Andreia; Gouveia, Ana; Santos, Lèlita

    2014-02-05

    Q fever is a zoonosis caused by Coxiella burnetii. It often manifests as a flu-like syndrome; other common manifestations are pneumonia, hepatitis and endocarditis. Its course may be acute or chronic. The authors present two clinical cases of Q fever with rare manifestations. Case 1: A 55-year-old man admitted due to abdominal pain, diarrhoea and fever. Blood tests showed elevated transaminases, low platelets and elevated C reactive protein, with normal white cell counts; abdominal ultrasound showed splenic and hepatic abscesses. Serologies to C burnetii were positive (1:640), leading to the diagnosis of Q fever with splenic and hepatic abscesses. Case 2: A 47-year-old man admitted due to headache after sneezing, with unstable gait and vertigo. A brain tomography showed cerebral venous thrombosis. After an exhaustive investigation, antibodies to C burnetii were found and were undoubtedly positive (1:5120), leading to the diagnosis of Q fever. Both patients were treated with oral doxycycline.

  15. Ten years of cerebral venous thrombosis: male gender and myeloproliferative neoplasm is associated with thrombotic recurrence in unprovoked events.

    Science.gov (United States)

    Lim, H Y; Ng, C; Donnan, G; Nandurkar, H; Ho, Prahlad

    2016-10-01

    Cerebral venous thrombosis (CVT) is a rare venous thrombotic event. We review our local experience in the management of CVT in comparison to other venous thromboembolism (VTE) with specific focus on risk factors for thrombotic recurrence. Retrospective evaluation of consecutive CVT presentations from January 2005 to June 2015, at two major tertiary hospitals in Northeast Melbourne, Australia. This population was compared to a separate audit of 1003 consecutive patients with DVT and PE. Fifty-two patients (30 female, 22 male) with a median age of 40 (18-83) years, presented with 53 episodes of CVT. Twenty-nine episodes (55 %) were associated with an underlying risk factor, with hormonal risk factors in females being most common. The median duration of anticoagulation was 6 months with 11 receiving life-long anticoagulation. Eighty-one percent had residual thrombosis on repeat imaging, which was not associated with recurrence at the same or distant site. Nine (17 %) had CVT-related haemorrhagic transformation with two resultant CVT-related deaths (RR 22.5; p = 0.04). All three VTE recurrences occured in males with unprovoked events (RR 18.2; p = 0.05) who were subsequently diagnosed with myeloproliferative neoplasm (MPN). Compared to the non-cancer VTE population, non-cancer CVT patients were younger, had similar rate of provoked events and VTE recurrence, although with significantly higher rate of MPN diagnosis (RR 9.30 (2.29-37.76); p = 0.002) CVT is a rare thrombotic disorder. All recurrences in this audit occurred in male patients with unprovoked events and subsequent diagnosis of MPN, suggesting further evaluation for MPN may be warranted in patients with unprovoked CVT.

  16. Endovascular rescue from arterial rupture and thrombosis during middle cerebral artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, J.Y.; Chung, Y.S. [Department of Neurosurgery, College of Medicine, Pundang CHA Hospital, 351 Yatap-ding, Pundang-gu, 463-712, Sungnam (Korea); Lee, B.H. [Department of Interventional Neuroradiology, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea); Kim, O.J. [Department of Emergency Medicine, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea)

    2003-08-01

    Intravascular stents are being used with increasing frequency in interventional neuroradiology. Iatrogenic arterial rupture is an uncommon but serious complication. We present a case of arterial rupture and subarachnoid haemorrhage during middle cerebral artery stenting, treated by emergency additional, overlapping stenting and balloon tamponade of the dissected vessel. Thrombotic occlusion of the artery was managed by intra-arterial abciximab. Normal vessel patency was re-established within 20 min and the patient recovered with no neurological deficit. (orig.)

  17. Efficacy of T2*-Weighted Gradient-Echo MRI in Early Diagnosis of Cerebral Venous Thrombosis with Unilateral Thalamic Lesion

    Directory of Open Access Journals (Sweden)

    Shingo Mitaki

    2013-01-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke with diverse etiologies and varied clinical presentations. Because of variability in clinical presentation and neuroimaging, CVT remains a diagnostic challenge. Recently, some studies have highlighted the value of T2*-weighted gradient-echo MRI (T2*WI in the diagnosis of CVT. We report the case of a 79-year-old woman with CVT due to a hypercoagulable state associated with cancer. On the initial T2-weighted image (T2WI, there was a diffuse high-intensity lesion in the right thalamus, extending into the posterior limb of the internal capsule and midbrain. T2*WI showed diminished signal and enlargement of the right basilar vein and the vein of Galen. Even though there is a wide range of differential diagnoses in unilateral thalamic lesions, and a single thalamus lesion is a rare entity of CVT, based on T2*WI findings we could make an early diagnosis and perform treatment. Our case report suggests that T2*WI could detect thrombosed veins and be a useful method of early diagnosis in CVT.

  18. 脑静脉系统血栓形成典型病例临床分析%Clinical analysis of cerebral venous system thrombosis

    Institute of Scientific and Technical Information of China (English)

    夏海平; 任乃勇; 钱进军; 赵康仁; 张渭芳; 汤继平

    2014-01-01

    Objective To analyze the cerebral venous system thrombosis (CVT ). Methods The data of patients with CVT were analyzed. Results Patients with CVT had the following symptoms :the progressive headache ,nausea and vomiting , and increased intracranial pressure with epilepsy ,with or without focal neurological deficits. The imaging examination showed that there were superior sagittal sinus thrombosis ,transverse sinus ,sigmoid sinus and transverse sinus thrombosis ,which were obviously improved by the dehydration ,anticoagulation and thrombolysis therapy. Conclusion Early cerebral venous si-nus thrombosis has non-specific symptoms and is definitely diagnosed by head CT combined with CTV examination.%目的:对脑静脉系统血栓形成进行临床分析。方法对 CVT患者临床资料进行分析。结果早期表现均有头痛、恶心、呕吐、颅内压增高表现,且呈进行性加重、常有癫痫、伴或不伴局灶性神经功能缺失。影像学检查显示:有上矢状窦、横窦血栓形成和乙状窦、横窦血栓形成,经脱水、抗凝、溶栓等治疗患者症状明显改善。结论脑静脉窦血栓形成早期临床无特异性,头颅CT结合CTV检查对本病诊断值较高。

  19. 抗凝血酶Ⅲ与孕产妇脑静脉窦血栓形成的关系%Study on the relationship between antithrombin Ⅲ and maternal cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    冯笑丰; 周才芳; 黎肖梅; 陈琼

    2011-01-01

    目的:研究孕产妇血浆中抗凝血酶Ⅲ与孕产妇脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的关系.方法:以孕产妇脑静脉窦血栓形成患者为研究组,正常孕产妇病例为对照组,通过检测两组孕产妇血浆中抗凝血酶Ⅲ的含量并进行统计学分析.结果:孕产妇脑静脉窦血栓形成患者血浆中的抗凝血酶Ⅲ较正常孕产妇血浆中的抗凝血酶Ⅲ显著降低,差异有统计学意义(P<0.01).结论:抗凝血酶Ⅲ下降是孕产妇脑静脉窦血栓形成的危险因素之一.%Objective: To study the relationship between maternal plasma antithrombin Ⅲ and maternal cerebral venous sinus thrombosis (cerebral venous sinus thrombosis, CVST).Methods: The cases of maternal cerebral venous sinus thrombosis were collected as study group, and the cases of normal maternal were collected as control group, the plasma antithrombin Ⅲ content of the two groups was tested and analyzed statistically.Results: The plasma antithrombin Ⅲ in maternal cerebral venous sinus thrombosis was significantly reduced than normal maternal, there was statistical significance (P <0.01 ).Conclusion: Antithrombin Ⅲ decline is a risk factor of maternal cerebral venous sinus thrombosis.

  20. Coexistence of High Fibrinogen and Low High-density Lipoprotein Cholesterol Levels Predicts Recurrent Cerebral Venous Thrombosis

    Institute of Scientific and Technical Information of China (English)

    Xin Ma; Xun-Ming Ji; Paul Fu; Yu-Chuan Ding; Qiang Xue; Yue Huang

    2015-01-01

    Background:Cerebral venous thrombosis (CVT) may lead to serious neurological disorders;however,little is known about the risk factors for recurrent CVT.Our aim was to determine the association between elevated fibrinogen and decreased high-density lipoprotein cholesterol (HDL-C) levels with recurrent CVT.Methods:This retrospective cohort study included participants if they had a first episode of objectively defined CVT and were admitted to Xuan Wu Hospital,Capital Medical University from August 2005 to September 2009.Demographic and clinical variables were collected,as well as laboratory parameters,including plasma fibrinogen and HDL-C.Patients with CVT were followed for recurrent symptomatic CVT.Follow-up was through the end of September 2010.Potential predictors of recurrence were analyzed using Cox survival analysis.Results:At the end of the follow-up,95 patients were eligible for the study.Twelve of 95 patients (12.6%) had recurred CVT.The median time of recurrence was 7 months (range:1-39 months).Eight of these 12 (66.7%) experienced recurrence within the first 12 months after their initial CVT.The recurrence rate of CVT was 2.76 per 100 patient-years.Multivariate Cox regression analysis demonstrated that the coexistence of high fibrinogen (>4.00 g/L) and low HDL-C (<1.08 mmol/L) levels at baseline was the only independent predictor for recurrent CVT (hazard ratio:4.69;95% confidence interval:1.10-20.11;P < 0.05).Of the twelve patients with recurrent CVT in our study,7 (58.3%) had high fibrinogen plus low HDL-C levels.All 7 of these patients took warfarin for 3-12 months,and 6 of 7 had recurrent CVT after the discontinuation of anticoagulant treatment.Conclusions:Concomitant high fibrinogen and low HDL-C levels may be associated with recurrence of CVT.The effect of potential risk factors related to atherothrombosis on recurrent CVT should be closely monitored.

  1. The Clinical Analysis of 32 Patients with Cerebral Venous Thrombosis%颅内静脉窦血栓32例临床分析

    Institute of Scientific and Technical Information of China (English)

    张亚丽; 周慧杰

    2009-01-01

    Objective: Analyze theiopathogenisis, symptomm, sign, Screen-age and therapeutic efficacy of 32 patients with cerebral venous thrombosis. Method: Analyze the etiopathogenisis, feature and therapeutic efficacy of 32 patients with cerebral venous thrombosis. Result: 59.4% patients and definite reason, the patients with infection about 21.9 %, with unknown origin about 40.6 %. There is intracranial hypertension and sing in almost all patients, about 12 patients incorporate epilepsia, 20 patients have been therapied by losing intracranial hypertension and anticoagulation conspicuous outcome about 75 % ; 7 patients have been therapied by interventional therapy, conspicuous outcome about 57.1% ; 7 patients have been therapies by neutral therapy, conspicuous outcome about 50 %. Conclusion:There is no specificity of thrombosis of intracranial venous sinus, easily misdiagnosis, missed diagnosis, to diagnose in earlier, can boose therapeutic effect.%目的:对32例颅内静脉窦血栓形成患者的发病原因症状、体征、影像和治疗效果进行分析.方法:对32例颅内静脉窦血栓形成患者的病因,临床特点及治疗效果分析.结果:有原因占59.4%,其中感染占21.9%.原因不明占40.6%,几乎全部有颅内高压症状和体征,合并糖尿病者12例,用降颅内压方法及抗凝治疗20例,显效75%,介入治疗7例,显效57.1%,中性治疗5%,显效50%.结论:颅内静脉窦血栓形成缺乏特异性,易误诊、漏诊,早期诊治可以提高疗效.

  2. Buflomedil Treat Diabetes Combined with Acute Cerebral Thrombosis Effect Observation%丁咯地尔治疗糖尿病合并急性脑血栓形成效果探讨

    Institute of Scientific and Technical Information of China (English)

    李玉博

    2016-01-01

    目的:探究丁咯地尔治疗糖尿病合并急性脑血栓形成的临床价值。方法选取糖尿病合并急性脑血栓形成患者40例(2013年6月-2015年6月)作为该次研究对象,按照患者治疗方法的不同将患者分为2组,对照组患者接受复方丹参治疗,实验组则接受丁咯地尔治疗,对比2组糖尿病合并急性脑血栓形成患者治疗效果的差异性。结果实验组糖尿病合并急性脑血栓形成患者治疗效果(95.00%)优于对照组(70.00%),(P<0.05)。结论丁咯地尔治疗糖尿病合并急性脑血栓形成,可以有效改善患者功能缺损评分,减少患者脑血栓的致残率,对糖尿病合并急性脑血栓形成患者预后的改善十分有益。%Objective To explore the buflomedil clinical value for the treatment of diabetes combined with acute cerebral thrombosis. Methods Select 40 patients with diabetes mellitus complicating acute cerebral thrombosis (June 2013 - June 2015) as the research object, according to the treatment of patients with different divided the patients into two groups, con-trol group patients treated with compound salvia miltiorrhiza, the experimental group received butyl luo to treatment, com-pared two groups of diabetic patients with acute cerebral thrombosis treatment effect. Results In experimental diabetic pa-tients with acute cerebral thrombosis treatment effect (95.00%) than the control group (70.00%),(P< 0.05). Conclusion Bu-flomedil treatment diabetes complicating acute cerebral thrombosis, can effectively improve the function defect scale, reduce the disability, in patients with cerebral thrombosis, to improve the prognosis of diabetic patients with acute cerebral throm-bosis is very good.

  3. 奥扎格雷钠治疗脑血栓形成的临床研究%Clinical Study on Sodium Ozagrel Treatment of Cerebral Thrombosis

    Institute of Scientific and Technical Information of China (English)

    张守东

    2015-01-01

    Objective Clinical effect on sodium ozagrel in treatment of cerebral thrombosis is to be studied. Methods Selected 46 patients of cerebral thrombosis that were treated in hospital from April 2014 to December 2014 and separated them into control group and study group at random which were given danshen injection treatment and sodium ozagrel treatment respectively,and then compared clinical treatment effects between two groups. Results Patients’treatment efficacy in study group was much higher than treatment efficacy in control group,besides,score of patients’neurology function damage in study group was less than that in control group,there was a treatment differential between two groups and such a differential had statistic value(P<0.05). Conclusion Sodium ozagrel is of efficacy in treatment of cerebral thrombosis,it is conducive to improving patients’neurology function damage.%目的:对奥扎格雷钠治疗脑血栓形成的临床效果进行分析研究。方法选取于2014年4月~2014年12月期间在我院接受治疗的46例脑血栓形成患者,并随机分为对照组和治疗组对采取丹参粉针和奥扎格雷钠治疗的临床疗效进行对比分析。结果观察组患者的治疗总有效率高于对照组,神经功能缺损评分低于对照组,差异有统计学意义(P<0.05)。结论奥扎格雷钠治疗脑血栓形成的临床效果显著,能够大大改善患者的神经功能缺损情况。

  4. The assessment of proinflammatory ‎cytokines in the patients with the ‎history of cerebral venous sinus ‎thrombosis

    Directory of Open Access Journals (Sweden)

    Farnaz Akbari

    2016-04-01

    Full Text Available Background: Evidence is accumulating that venous thromboembolism is not limited to coagulation system and immune system seems to be involved in formation and resolution of thrombus. Some studies have demonstrated the role of inflammatory factors in deep venous thrombosis (DVT of limbs; however, there has not been such study in the patients with cerebral venous sinus thrombosis (CVST. The purpose of this study was to evaluate inflammatory cytokines including interleukin-6 (IL-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α in the patients with the history of CVST.Methods: In a cross-sectional study, 20 patients with the first episode of CVST and 20 age- and sex-matched healthy controls were included. The patients were seen only after anticoagulant treatment had been discontinued for at least 3 months. IL-6, IL-8, IL-10, TNF-α levels, and erythrocyte sedimentation rate (ESR were measured in two groups.Results: The median age of patients was 37.0 [interquartile range (IQR = 31.75-42.75] and in control group was 42.0 (IQR = 38.0-40.6 (P = 0.18. In patients group, 14 (70% were females and in control group, also, 14 (70% subjects were female (P = 0.01. It is significant that the level of IL-6 was significantly higher in the control group [patients: median: 9.75, IQR: 8.98-10.65; controls: median: 11.45, IQR: 10.28-13.10; P = 0.01]; however, the ESR level was higher in the patients. On the subject of IL-8, IL-10, and TNF-α, no significant difference was detected.Conclusion: We did not find higher concentrations of inflammatory ILs in the patients with the history of CVST that is contradictory with some findings in venous thrombosis of the extremities; however, the studies with larger sample size may be required.

  5. Trombose de seios venosos cerebrais: Estudo de 15 casos e revisão de literatura Cerebral venous thrombosis: Study of fifteen cases and review of literature

    Directory of Open Access Journals (Sweden)

    Paulo Pereira Christo

    2010-01-01

    Full Text Available OBJETIVO: Analisar uma série de 15 pacientes com trombose venosa cerebral (TVC e comparar os resultados com dados da literatura. MÉTODOS: Foram avaliados, por meio de estudo retrospectivo, transversal e descritivo, as características epidemiológicas, o quadro clínico, os fatores de risco e o prognóstico de 15 pacientes com TVC admitidos no serviço de Neurologia da Santa Casa de Belo Horizonte no período de abril de 2007 a Dezembro de 2008. RESULTADOS: O diagnóstico de TVC foi confirmado por exame de ressonância nuclear magnética de encéfalo em 14 casos e por angiografia cerebral em um caso. Os principais fatores de risco identificados foram o uso do anticoncepcional oral (40% e uma história prévia ou familiar de trombose venosa profunda. Trombofilia foi encontrada em dois pacientes (13%. O seio mais acometido foi o transverso (73%, seguido pelo sagital superior, em 53%. Quatro pacientes apresentaram acidente vascular cerebral e outros 5 apresentaram-se apenas com cefaleia isolada. Doze pacientes foram tratados com heparina e anticoagulação oral sequencial. CONCLUSÃO: A terapêutica com heparina na fase aguda seguida do anticoagulante oral demonstrou-se segura e eficaz na prevenção da progressão da doença, de sua recidiva e na rápida recuperação do quadro neurológico de todos os pacientes tratados. A TVC deve ser considerada no diagnóstico de cefaleia secundária mesmo em pacientes com ausência de outros sinais ou sintomas.OBJECTIVE: To analyze a series of 15 patients with cerebral venous thrombosis (CVT who had follow-ups at the neurology service of Santa Casa de Belo Horizonte Hospital from April, 2007 to December, 2008. These results were compared with data in literature. METHODS: Cases were evaluated by retrospective study of the epidemiologic characteristics, signs and symptoms, risk factors and prognosis of 15 patients with cerebral venous thrombosis. RESULTS: Diagnoses were reached through magnetic resonance

  6. Imaging diagnosis and clinical findings of cerebral venous thrombosis in full-term neonates without brain damage: a ten-year review;Diagnostico por imagem e aspectos clinicos da trombose venosa cerebral em recem-natos a termo sem dano cerebral: revisao em 10 anos

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, Alexandra Maria Vieira, E-mail: cmaol@br.inter.ne, E-mail: cmaolima@gmail.co [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Faculdade de Ciencias Medicas; Lima, Claudio Marcio Amaral de Oliveira [Fatima Digital, Nova Iguacu, RJ (Brazil). Centro de Diagnostico por Imagem; Ribeiro, Erica Barreiros [Hospital Sao Jose, Criciuma, SC (Brazil). Servico de Ressonancia Magnetica; Lins, Maria Cristina; Miranda, Silvia; Miranda, Luis Eduardo [Casa de Saude Sao Jose (CSSJ), Rio de Janeiro, RJ (Brazil). Unidade de Terapia Intensiva Neonatal

    2010-05-15

    Objective: to describe and compare imaging methods and clinical findings of cerebral venous thrombosis in four full-term neonates without brain damage, admitted to a neonatal intensive care unit. Materials and methods: ten-year review of four cases diagnosed with cerebral venous thrombosis by transfontanellar ultrasonography associated with Doppler fluxometry and confirmed by magnetic resonance imaging/magnetic resonance angiography in correlation with clinical findings and neurological progression. Results: ultrasonography presented normal results in 75% of cases and magnetic resonance imaging in 100%. Doppler fluxometry and magnetic resonance angiography were abnormal in 100% of cases. Hypoxia (100%) and early seizures (100%) were predominant among clinical findings with evoked potential changes in 50% of cases. In the assessment of the neuro development all the areas remained within normality parameters up to the conclusion of the present study. Conclusion: ultrasonography in association with Doppler can identify changes related to cerebral venous thrombosis and should be complemented with magnetic resonance imaging that is the gold standard for diagnosis in these cases. (author)

  7. Reversible diencephalic dysfunction as presentation of deep cerebral venous thrombosis due to hyperhomocysteinemia and protein S deficiency: Documentation of a case

    Directory of Open Access Journals (Sweden)

    Kaukab Maqbool Hassan

    2013-01-01

    Full Text Available A 45-year-old man presented with global headache, vomiting and abnormal behavior after cross-country run at high altitude. There was no seizure, loss of consciousness, fever or head injury. He was conscious, abulic and uncooperative with normal vitals. There was no focal neurological deficit. Non contrast computed tomography scan of head was normal. Magnetic resonance imaging of brain showed venous infarct in bilateral thalami, left basal ganglia and periventricular white matter. Magnetic resonance venography revealed thrombosis involving internal cerebral veins, septal veins, thalamostriate veins, vein of Galen and proximal portion of straight sinus. His condition steadily improved on low molecular weight heparin bridged with oral anticoagulation for one year. At two months, serum homocysteine was 31.51 μmol/l (5.46-16.2 μmol/l and protein S was 49.00% (77-143.00%. He received methylcobalamin, pyridoxine and folic acid. After 16 months, he was asymptomatic with partially recanalized deep cerebral veins and serum homocysteine falling to 16.50 μmol/l (5.46-16.2 μmol/l.

  8. Pseudotumor cerebral secundário a trombose venosa dural: relato de caso pediátrico Pseudotumor cerebri secondary to dural sinus thrombosis: pediatric case report

    Directory of Open Access Journals (Sweden)

    Adriana Rocha Brito

    2005-09-01

    Full Text Available O pseudotumor cerebral é uma síndrome neurológica relativamente comum na adolescência. Na maioria dos casos, a etiologia é idiopática, mas pode haver complicações graves, como cegueira, relacionadas com a hipertensão intracraniana. O objetivo deste artigo é enfatizar o diagnóstico diferencial do pseudotumor cerebral, com atenção especial às etiologias tratáveis. Relatamos o caso de um adolescente de 12 anos que se apresentou com diplopia e cefaléia 9 dias após otite média e mastoidite à direita. A tomografia computadorizada do crânio foi normal, mas a ressonância magnética do encéfalo detectou trombose dos seios transverso e sigmóideo ipsilaterais, a qual respondeu à anticoagulação precoce. A conclusão é que a ressonância magnética do encéfalo é essencial nos pacientes com diagnóstico clínico de pseudotumor cerebral para exclusão de causas tratáveis, como a trombose venosa dural.Pseudotumor cerebri is a relatively common neurologic syndrome in adolescence. In most cases, etiology is idiopathic, but it may have serious complications, such as blindness, that are related to increased intracranial pressure. The aim of this article is to emphasize the differential diagnosis of pseudotumor cerebri, with special attention to treatable etiologies. We report a case of an 12 year-old adolescent who presented with diplopia and headache 9 days after right-sided otitis media and mastoiditis. Head computerized tomography was normal, but brain magnetic resonance imaging demonstrated thrombosis of ipsilateral transverse and sigmoid sinuses, which responded promptly to early anticoagulation. The conclusion is that magnetic resonance imaging is essential for patients with a clinical diagnosis of pseudotumor cerebri in order to exclude treatable causes, such as dural sinus thrombosis.

  9. 脑内静脉窦血栓10例临床分析%Clinical analysis of 10 cases of cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    杨月仙

    2016-01-01

    目的::探讨脑静脉及静脉窦血栓形成( cerebral venous sinus thrombosis,CVT)的临床表现、影像学特征及诊治方法。方法:分析了10例CVT病例的临床特点及脑脊液、影像学特征,结合文献复习其诊治方法。结果:此病可见于各年龄段,以中青年女性为多,临床表现以头痛多见,其次为癫痫发作或其他局灶性神经功能缺损。腰椎穿刺多数病例压力偏高,磁共振静脉血管成像( magnetic resonance venography,MRV)可见病变静脉窦显影不良或不显影。经抗凝、降颅压等对症治疗,多数病例病情好转,少数病情恶化。结论:中青年患者表现为头痛、呕吐伴或不伴神经功能缺损、腰椎穿刺检查颅内压升高时应高度怀疑CVT可能。围产期女性为高危人群、疑似病例应尽早行颅脑CT和MRI检查以明确诊断。治疗方面早期抗血栓治疗,同时根据病因进行针对性治疗。%Objective:To explore the clinical manifestation, radiological feature, diagnosis and treatment of cerebral venous thrombosis ( CVT) and cerebral venous sinus thrombosis ( CVST) . Methods:Clinical feature, cerebral spinal fluid and radiological manifestation of 10 patients with CVST were analyzed, and the diagnosis and treatment of CVST were discussed by reviewing the literature. Results: All age groups would suffer from CVST, particularly the young and middle-aged women. Headache was the most common symptom, and then was epilepsy and other focal neurological impairment. Increased intracranial pressure was found by lumbar puncture in most patients. Poor visualization or nonvisualization of ve-nous sinus were found on magnetic resonance venography( MRV) . Most patients improved and few of them deteriorated after the treatment with anti-coagulant and decreasing the intracranial pressure. Conclusion:Young and middle-aged patients with headache and vomiting, with or without fo-cal neurological impairment, and with increased intracranial

  10. Research Progress in Inherited Thrombophilia Associated with Cerebral Venous Sinus Thrombosis%颅内静脉窦血栓形成的遗传性易栓危险因素研究现状

    Institute of Scientific and Technical Information of China (English)

    郑丽琴; 陈静炯; 赵玉武

    2016-01-01

    More than 20% of cerebral venous sinus thrombosis patients are companied with thrombophilia. The common genetic thrombophilia includes the lack of coagulation factors, antithrombin deficiency, abnormalities in fibrinolysis, hyperhomocysteinemia and the elevated level of coagulation factors. The article introduces the research status of inherited thrombophilia associated with cerebral venous sinus thrombosis.%超过20%的颅内静脉窦血栓形成患者可以检测到易栓症。常见的遗传性易栓症有凝血因子缺陷、抗凝蛋白缺乏、纤溶异常、高同型半胱氨酸血症、凝血因子水平增高等。本文介绍颅内静脉窦血栓形成相关的遗传性易栓危险因素。

  11. 自发性低颅压并发颅内静脉窦血栓形成临床分析%Clinical Analysis of Cerebral Venous Thrombosis in Spontaneous Intracranial Hypotension

    Institute of Scientific and Technical Information of China (English)

    宋田; 杨中华

    2011-01-01

    Objective The occurrence of cerebral venous thrombosis (CVT) has been reported rarely among patients with spontaneous intracranial hypotension (SIH). We reviewed our experience and attempted to establish a causal relationship between these 2 entities.Methods We reported 2 cases in our experience with spontaneous intracranial hypotension and cerebral venous thrombosis and reviewed the relevant literature.Results Clinical or radiographic evidences for SIH preceding CVT were found in 2 patients. There were no other CVT risk factors in 2 cases, except SIH. Therefore we proposed that SIH should be considered as one of risk factors of CVT. CVT relieved after the intracranial pressure was corrected.Conclusion Spontaneous intracranial hypotension may result in cerebral venous thrombosis.which is also confirmed by relevant literatures.%目的 自发性低颅压(spontaneous intracranial hypotension,SIH)及颅内静脉窦血栓形成(cerebral venous thrombosis,CVT)均为神经科少见疾病,而SIH合并CVT更为少见,本研究旨在探寻二者之间有无内在联系.方法 报道2例SIH并发CVT的临床资料,并复习相关文献.结果 2例患者SIH在前,CVT发生在后,同时排除了其他导致静脉窦血栓的危险因素,因此推测SIH也是CVT的危险因素之一.经补液纠正低颅压后,静脉窦血栓也随之好转.结论 SIH可能导致CVT,这一观点也被相关文献所证实.

  12. Towards the genetic basis of cerebral venous thrombosis—the BEAST Consortium: a study protocol

    Science.gov (United States)

    Cotlarciuc, Ioana; Marjot, Thomas; Khan, Muhammad S; Hiltunen, Sini; Haapaniemi, Elena; Metso, Tiina M; Putaala, Jukka; Zuurbier, Susanna M; Brouwer, Matthijs C; Passamonti, Serena M; Bucciarelli, Paolo; Pappalardo, Emanuela; Patel, Tasmin; Costa, Paolo; Colombi, Marina; Canhão, Patrícia; Tkach, Aleksander; Santacroce, Rosa; Margaglione, Maurizio; Favuzzi, Giovanni; Grandone, Elvira; Colaizzo, Donatella; Spengos, Kostas; Arauz, Antonio; Hodge, Amanda; Ditta, Reina; Debette, Stephanie; Zedde, Marialuisa; Pare, Guillaume; Ferro, José M; Thijs, Vincent; Pezzini, Alessandro; Majersik, Jennifer J; Martinelli, Ida; Coutinho, Jonathan M; Tatlisumak, Turgut; Sharma, Pankaj

    2016-01-01

    Introduction Cerebral venous thrombosis (CVT) is a rare cerebrovascular condition accounting for <1% of all stroke cases and mainly affects young adults. Its genetic aetiology is not clearly elucidated. Methods and analysis To better understand the genetic basis of CVT, we have established an international biobank of CVT cases, Biorepository to Establish the Aetiology of Sinovenous Thrombosis (BEAST) which aims to recruit highly phenotyped cases initially of European descent and later from other populations. To date we have recruited 745 CVT cases from 12 research centres. As an initial step, the consortium plans to undertake a genome-wide association analysis of CVT using the Illumina Infinium HumanCoreExome BeadChip to assess the association and impact of common and low-frequency genetic variants on CVT risk by using a case–control study design. Replication will be performed to confirm putative findings. Furthermore, we aim to identify interactions of genetic variants with several environmental and comorbidity factors which will likely contribute to improve the understanding of the biological mechanisms underlying this complex disease. Ethics and dissemination BEAST meets all ethical standards set by local institutional review boards for each of the participating sites. The research outcomes will be published in international peer-reviewed open-access journals with high impact and visibility. The results will be presented at national and international meetings to highlight the contributions into improving the understanding of the mechanisms underlying this uncommon but important disease. This international DNA repository will become an important resource for investigators in the field of haematological and vascular disorders. PMID:27881526

  13. Alterações parenquimatosas na trombose venosa cerebral: aspectos da ressonância magnética e da angiorressonância Parenchymal abnormalities in cerebral venous thrombosis: findings of magnetic resonance imaging and magnetic resonance angiography

    Directory of Open Access Journals (Sweden)

    Clécia Santos Ferreira

    2006-10-01

    -mortalidade da doença.OBJECTIVE: To determine the frequency and localization of parenchymal abnormalities in cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography as well as their correlation with the territory and affected venous drainage. MATERIALS AND METHODS: Retrospective analysis (1996 to 2004 of 21 patients (3 male and 18 female age range between 3 and 82 years (mean 40 years, median 36 years with clinical and radiological diagnosis of cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography in 2D PC, 3D PC and contrast-enhanced 3D TOF sequences. The statistical analysis was performed with the qui-square test. Four patients had follow-up exams and three patients underwent digital subtraction angiography. RESULTS: Main predisposing factors were: infection, use of oral contraceptives, hormone replacement therapy and collagenosis. Predominant symptoms included: focal deficit, headache, alteration of consciousness level and seizures. Most frequent parenchymal manifestations were: cortical/subcortical edema or infarct, venous congestion and collateral circulation, meningeal enhancement and thalamic and basal ganglia edema or infarct. Occlusion occurred mainly in superior sagittal, left transverse, left sigmoid and straight sinuses. Cavernous sinus and cortical veins thrombosis are uncommon events. CONCLUSION: Cerebral venous thrombosis is an uncommon cause of stroke, with favorable prognosis because of its reversibility. Diagnosis is highly dependent on the radiologist capacity to recognize the presentations of this disease, principally in cases where the diagnosis is suggested by parenchymal abnormalities rather than necessarily by visualization of the thrombus itself. An accurate and rapid diagnosis allows an immediate treatment, reducing the morbidity and mortality rates.

  14. 颅内静脉窦血栓形成的发病规律研究%Study the occurrence regularity of cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    陈宏涛; 刘恒方; 董子明; 朱红灿; 段小玲

    2014-01-01

    目的:探讨颅内静脉窦血栓形成(cerebral venous sinus thrombosis ,CVST )的发病规律。方法回顾性分析2003-12-2013-07住院的40例CVST患者的临床资料,研究其临床特征、辅助检查,着重从年龄、性别、职业、发病时间、影像等方面用统计图表分析发病规律。结果男11例,女29例,男女比例1:2.64;年龄17~58岁;平均(33.1±10.5)岁,血栓部位:上矢状窦(62.5%);左横窦(37.5%);右横窦(42.5%);左乙状窦(30%);右乙状窦(32.5%)。居民类型:农村34例(85%),城镇6例(15%)。发病年龄:男:20~29岁4例(36.4%),40~49岁5例(45.5%),其他年龄段2例(18.2%);女:20~29岁13例(44.8%),30~39岁11例(37.9%),其他年龄段5例(17.2%)。发病月份:男全年散发;女2月8例(27.6%),7月5例(17.2%),其他月份散发。结论(1)CVST多发生于青中年人(20~50岁),女性发病率远高于男性;(2)血栓好发部位主要为上矢状窦、横窦、乙状窦;(3)农村发病率远高于城镇,女性更明显;(4)女性发病集中于20~39岁;男性集中于20~29、40-49岁;(5)女性2月、7月为高发月份,男性无季节规律。%Objective To investigate the occurrence regularity of cerebral venous sinus thrombosis (CVST ).Methods Clinical data of 40 cases with cerebral venous sinus thrombosis from December 2003 to July 2013 were retrospectively analyzed , the clinical characteristics ,laboratory examinations were studied ,the occurrence regularity was performed by statistical charts mainly from age ,sex ,occupation ,history and time of onset ,image etc.Results There were 11 males and 29 females of all pa-tients ;the ratio was 1∶2.64.The mean age was 33.1 ± 10.5.The age range was 17-58 years old.The most common thrombo-sis were as follows :Superior sagittal sinus(62.5% ) ,left transverse

  15. Clinical features of cerebral venous thrombosis%脑静脉系统血栓形成的临床特点

    Institute of Scientific and Technical Information of China (English)

    蔺春玲; 叶尔克巴义·阿沙白依; 杨纶先

    2012-01-01

    Objective To explore the clinical features of cerebral venous thrombosis (CVT). Methods The clinical data of 27 CVT patients were retrospectively analyzed. Results There were 25 cases having inducement including pregnancy and puerperum in 18 cases, fever and diarrhea in 5 cases, etc. The average age was (29. 7 ± 9. 3) years old. Most of them onset was acute (7 cases, 25. 9% ) and subacute ( 19 cases, 70. 4% ). The onset symptom was headache in 23 cases (91.7% ) , and combined with vomiting in 21 cases. There was disturbance of consciousness in 12 cases. There was neurologic impairment in the different part in all the cases. There were 21 cases with high CSF pressure. Blood routine in 22 cases (81. 5%) and blood clotting in 13 cases (48. 2%) were abnormal. The imaging examination [(CT, MRI, MR venography(MRV) ] showed that intracranial venous or venous sinus were involved in different degree, and the mostly of them was superior longitudinal sinus (77. 8% ). Twenty-four cases received heparin anticoagulant therapy, and 2 cases received thrombolytic therapy. Seventeen cases were cured, 4 cases were improved, and 6 cases were died (including 4 cases complicated with hemorrhagic brain infarction and 2 cases complicated with cerebral great vein thrombosis). Conclusions CVT is often secondary to insufficient circulating blood volume and high blood coagulation state. The onset is acute or subacute mostly. The main manifestations is increased intracranial pressure syndrome. The mortality is higher. MRI and MRV are sensitive and efficient methods for the early diagnosis. Early application of heparin may acquire better curative effect.%目的 探讨脑静脉血栓形成(CVT)的临床特点.方法 回顾性分析27例CVT患者的临床资料.结果 本组患者中25例有发病诱因(包括妊娠或产褥期18例,高热、腹泻5例等),平均年龄(29.7±9.3)岁;多以急性(7例,25.9%)、亚急性(19例,70.4%)起病.以头痛为首发症状23例(91.7%),伴呕吐21

  16. A Retrospective Analysis of 18 Misdiagnosed Cases of Cerebral Venous Sinus Thrombosis%18例颅内静脉窦血栓形成误诊分析

    Institute of Scientific and Technical Information of China (English)

    胡华; 刘锋昌; 宋文峰; 罗国刚

    2015-01-01

    目的:对18例颅内静脉窦血栓(CVST)形成患者临床资料、误诊原因进行分析,减少误诊率。方法回顾分析18例被误诊的CVST患者的临床特点、误诊原因。结果18例CVST患者以年轻人为主,发病初期分别误诊为:中枢神经系统感染5例、病毒性脑膜炎3例、病毒性脑炎1例、病毒性脑膜脑炎1例、脑出血2例、偏头痛2例、脑梗死和出血性脑梗死2例、蛛网膜下腔出血1例、脑梗死合并蛛网膜下腔出血1例。平均误诊时间7 d (1~30 d)。CVST以上矢状窦、横窦、乙状窦最为常见,绝大多数病因不明。结论 CVST临床表现复杂多样,误诊率极高。针对年轻、产褥期妇女、突发进行性加重或不典型头痛,或既往头痛性质如头痛频率、部位、程度发生变化时都要排查CVST。应重视腰穿和脑脊液测压检查,发现头痛伴颅内压增高时需行头颅MRV或DSA检查尽早明确诊断,减少CVST误诊和漏诊。%Aim To analyze the clinical data of ever misdiagnosed CVST cases and reduce the misdiagnosis rate of cerebral venous sinus thrombosis (CVST).Methods The clinical characteristics and misdiagnosis causes of 18 ever misdiagnosed CVST patients were retrospectively analyzed.Results Most CVST patients were young. The initial misdiagnosed diseases were as follow. Five cases of central nervous system infection, 3 cases of viral meningitis, one case of viral encephalitis, one case of viral meningeal and encephalon infections, 2 cases of cerebral hemorrhage, 2 cases of migraine attack, 2 cases of cerebral infarction and hemorrhagic infarction, one case of subarachnoid hemorrhage, one case of cerebral infarction complicated with subarachnoid hemorrhage. The correct diagnosis of CVST had been made at the median 7 (1~ 30) days after initial symptoms occurrence. CVST mainly occured in superior sagittal sinus, sigmoid sinus and transverse sinus, most of patients couldn’t determine the etiology

  17. 脑静脉窦血栓形成的临床和影像学表现%Clinical and radiological findings of cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    林雪; 陈军; 赵益林

    2012-01-01

    目的 结合临床资料分析脑静脉窦血栓形成(CYST)的临床特点及磁共振成像(MRI)与多层螺旋CT的影像学特征,以提高其早期诊断率.方法 回顾性分析经临床确诊的13例CVST患者的临床特点和影像学特征.结果 13例CVST患者中,病变位于横窦3例,上矢状窦2例,乙状窦1例,直窦2例,同时累及横窦及乙状窦4例,同时累及横窦及矢状窦1例;急性期发病者7例,亚急性期4例,慢性期2例,CT平扫显示静脉窦密度增高或条状低密度影,MRI平扫显示静脉窦内信号异常,CT与MRI增强扫描可见受累静脉窦空三角征或充盈缺损;MRV可直接显示受累静脉窦变细、不连续、充盈缺损或不显示以及侧支循环形成.11例CVST患者发生继发性脑损害,包括脑肿胀、出血及梗死等.结论 对于以头痛为首发症状并有颅内压增高表现的患者,无论伴或不伴神经系统症状,都应警惕CVST,同时结合CT和MRI检查有助于其早期诊断.%Objective To analyze the clinical and radiological characteristics of the cerebral venous sinus thrombosis(CVST).Methods Thirteen cases of clinically proved CVST were retrospectively analyzed,focused on the clinics,MRI,and CT findings.Results Among the 13 CVST cases,3 cases was involved in the transverse sinus,while 2 cases in the superior sagittal sinus,1 case in the sigmoid sinus,2 cases in the straight sinus,Both the transverse sinus and sigmoid sinus were involved in 4 cases and both the transverse sinus and sagittal sinus were involved in 1 case.According to the onset styles,acute onset 7 cases,subacute onset 4 cases,and chronic onset 2 cases.Plain CT scan showed venous sinus as density enhanced or as low density strip.Conventional MRI showed venous sinus signal was abnormal.The enhanced CT and MRI scan manifestated the sign of"△ " or" filling defect"in the sinus involved.Magnetic resonance venography (MRV)could directly display the involved cerebral venous sinuses becoming

  18. Risk factors, clinical profile, and long-term outcome of 428 patients of cerebral sinus venous thrombosis: Insights from Nizam′s Institute Venous Stroke Registry, Hyderabad (India

    Directory of Open Access Journals (Sweden)

    Deekshanti Narayan

    2012-01-01

    Full Text Available Background: With the widespread use of neuroimaging and hematological workup, many of the previously held concepts about cerebral sinus venous thrombosis (CSVT are changing. Objective: The objective of this study was to investigate the risk factors, clinical profile, and outcome of the fully investigated cases of CSVT from a major university referral hospital in South India. Materials and Methods: Consecutive patients of CSVT confirmed by definite neuroimaging criteria and fully investigated for prothrombotic states, between June 2002 and September 2010, were prospectively studied in the Venous Stroke Registry of Nizam′s Institute of Medical Sciences, Hyderabad, South India. Results: Of the 428 patients, 230 (53.7% were men and the mean age was 31.3 years (range 8-65 years. Seizures were noted in 126 (29.4% patients, stroke like presentation was found in 122 (28.5% patients, and benign intracranial hypertension like presentation was found in 78 (18.2% patients. Common risk factors were anemia in 79 (18.4%, hyperhomocysteinemia in 78 (18.2%, alcoholism in 67 (15.6%, oral contraceptive pill intake in 49 (11.4%, postpartum state in 42 (9.8%, anticardiolipin antibodies in 31 (7.2%, and protein S deficiency in 53 (12.3% patients. Good outcome at 90 days (modified Rankin Scale £ 2 was observed in 273 (71.2% of 383 patients available for follow-up. In-house mortality was noted in 33 (7.7% and recurrence in 22 (5.1% patients. Conclusions: Compared to the previous studies, prevalence of CSVT was higher in men. Anemia, hyperhomocysteinemia, alcoholism, oral contraceptive use, and postpartum state were the most common risk factors. Overall prognosis was good, but a small percentage of patients died or showed recurrence.

  19. Effects of Alcohol Extract Substances from the Aerial Roots of Ficus microcarpa on Cerebral Thrombosis and Coagulation%榕树须醇提取物对脑血栓形成和凝血功能的影响

    Institute of Scientific and Technical Information of China (English)

    陈敬民; 袁志林; 吴超伟; 李开双

    2015-01-01

    Objective]This study observed the effects of different extract substances from the aerial roots of Ficus microcarpa on coagulation,as well as the effect on cerebral thrombosis.[Methods]The mice model of cerebral thrombosis was induced by collagen protein and the rat thrombotic model was induced by electric stimulation,which were used to examine the effects of extract substances on the protective rate of mice cerebral thrombosis and rat thrombotic for-mation,respectively.The mice model of blood stasis was established by combined application of epinephrine with ice bath,which was used to observe the influences of the compounds on thrombin time and fibrinogen time.[Results]Different extract substances from 95% ASARFM (alcohol-soluble substance from the aerial roots of Ficus microcarpa )or 80% ASARFM could increase the recovery rate of cerebral thrombosis in mice (20%~60%).Both acetidine-soluble extract substance and n-butanol-soluble substance had better protective effect on the model of cerebral thrombosis by electric stimulation (P<0·01 and P <0·001),and could delay thrombin time of the mice with cold and stasis (P <0.05 and P <0.001 );N-butanol-soluble substance could delay fibrinogen time of the mice with cold and stasis (P <0.05).[Conclusion]N-butanol-soluble substance extracted from 80% ASARFM had better protective effect on the model of cerebral thrombosis and could improve the coagulation of mice.%【目的】探讨榕树须不同提取物的抗脑血栓作用,并评价其对凝血功能的影响。【方法】采用小鼠脑偏瘫、电刺激致大鼠血栓模型观察提取物对小鼠脑血栓的保护率、大鼠血栓形成时间的影响;采用肾上腺素加冰浴致小鼠血瘀模型观察其对凝血酶时间及纤维蛋白原时间的影响。【结果】榕树须95%、80%醇提物的不同提取部位能提高小鼠脑偏瘫恢复率(20%~60%);乙酸乙酯及正丁醇部位对电刺激引起的脑血栓有较好保护作用(P <0.01,P<0.001);

  20. 心理及康复护理干预在脑血栓患者中的应用效果分析%Analysis the Application Effect of Psychological and Rehabilitation Nursing Intervention in Patients With Cerebral Thrombosis

    Institute of Scientific and Technical Information of China (English)

    许晓崴; 赵冬梅; 刘一婷; 黄国峰

    2016-01-01

    Objective To study the effect and clinical value of psychological and rehabilitation nursing intervention in patients with cerebral thrombosis. MethodsSelected 60 patients with cerebral thrombosis in our hospital were selected as the research subjects. The control group was treated with general nursing, the experimental group used the psychological and rehabilitation nursing intervention methods. Results The experimental group recovery of neurological deficits, motor function and daily living ability were signiifcantly better than that of the control group, and the difference was statistically signiifcant.ConclusionUse of psychological and rehabilitation nursing intervention for patients with cerebral thrombosis has a good clinical effect.%目的:研究心理及康复护理干预在脑血栓患者中的应用效果及其临床价值。方法选取在我院进行诊治的60位脑血栓患者作为研究对象,对照组使用一般护理方式,实验组使用心理及康复护理干预方法。结果实验组神经功能缺损恢复的情况、运动能力、日常生活能力优于对照组,差异具有统计统意义。结论使用心理及康复护理干预进行脑血栓患者护理有很好的临床效果。

  1. Cerebral venous thrombosis in adult patients with acute lymphoblastic leukemia or lymphoblastic lymphoma during induction chemotherapy with l-asparaginase: The GRAALL experience.

    Science.gov (United States)

    Couturier, Marie-Anne; Huguet, Françoise; Chevallier, Patrice; Suarez, Felipe; Thomas, Xavier; Escoffre-Barbe, Martine; Cacheux, Victoria; Pignon, Jean-Michel; Bonmati, Caroline; Sanhes, Laurence; Bories, Pierre; Daguindau, Etienne; Dorvaux, Véronique; Reman, Oumedaly; Frayfer, Jamile; Orvain, Corentin; Lhéritier, Véronique; Ifrah, Norbert; Dombret, Hervé; Hunault-Berger, Mathilde; Tanguy-Schmidt, Aline

    2015-11-01

    Central nervous system (CNS) thrombotic events are a well-known complication of acute lymphoblastic leukemia (ALL) induction therapy, especially with treatments including l-asparaginase (l-ASP). Data on risk factors and clinical evolution is still lacking in adult patients. We report on the clinical evolution of 22 CNS venous thrombosis cases occurring in 708 adults treated for ALL or lymphoblastic lymphoma (LL) with the Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)-induction protocol, which included eight L-ASP (6,000 IU/m(2) ) infusions. The prevalence of CNS thrombosis was 3.1%. CNS thrombosis occurred after a median of 18 days (range: 11-31) when patients had received a median of three l-ASP injections (range: 2-7). Patients with CNS thrombosis exhibited a median antithrombin (AT) nadir of 47.5% (range: 36-67%) at Day 17 (range: D3-D28), and 95% of them exhibited AT levels lower than 60%. There were no evident increase in hereditary thrombotic risk factors prevalence, and thrombosis occurred despite heparin prophylaxis which was performed in 90% of patients. Acquired AT deficiency was frequently detected in patients with l-ASP-based therapy, and patients with CNS thrombosis received AT prophylaxis (45%) less frequently than patients without CNS thrombosis (83%), P = 0.0002). CNS thrombosis was lethal in 5% of patients, while 20% had persistent sequelae. One patient received all planned l-ASP infusions without recurrence of CNS thrombotic whereas l-ASP injections were discontinued in 20 patients during the management of thrombosis without a significant impact on overall survival (P = 0.4).

  2. Antithrombin Cambridge II(A384S) mutation frequency and antithrombin activity levels in 120 of deep venous thrombosis and 150 of cerebral infarction patients in a single center in Southern China.

    Science.gov (United States)

    Zhang, Guang-sen; Tang, Yang-ming; Tang, Mei-qing; Qing, Zi-Ju; Shu, Chang; Tang, Xiang-qi; Deng, Ming-yang; Tan, Li-ming

    2010-09-01

    Antithrombin Cambridge II(A384S) mutation shows a relatively high frequency in western population. Some studies suggest that the mutation is an independent genetic risk factor both for deep vein thrombosis (DVT) and for arterial thrombosis, but whether the mutation has racial difference or has a general significance for thrombophilia remains unclear. In this study we performed an analysis of the prevalence of the mutation in Chinese southern population; Also, the antithrombin activity levels were evaluated in each investigated individual. The studies included 120 patients with DVT, 150 patients with cerebral infarction, and 110 controls. The mutation was detected using polymerase chain reaction/PvuII restrictive fragment length polymorphism procedures. Antithrombin activity assay was done using chromogenic substrate method. The results showed that no antithrombin Cambridge II mutation was detected in all three groups (DVT, cerebral infarction and controls), the incidence was 0/380. Plasma antithrombin activity was 91.37% +/- 16.15% in the DVT patients and 102.68% +/- 13.10% in the controls; the antithrombin activity was significantly reduced in the DVT group (P Cambridge II mutation has a racial difference, and may not be a valuable risk factor of thrombophilia in Asian population, and antithrombin deficiency remains a major genetic risk factor for DVT patients in China.

  3. Cerebral and Sinus Vein Thrombosis

    Science.gov (United States)

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  4. The correlation between clinical neurologic impairment in acute cerebral thrombosis patients and the status of platelet and fibrinogen%急性脑梗死患者临床神经功能缺损程度与血小板及纤维蛋白原状态的相关性

    Institute of Scientific and Technical Information of China (English)

    李秀珍; 殷宇刚; 杨静; 万太玉; 韩恩吉

    2002-01-01

    @@ Large numbers of researches indicate that platelets (PLT) and fibrinogen (FIB)play important roles in the pathogenesis and progress of cerebral thrombosis. In the present study,PLT,platelet mean volume (MPV),platelet aggregation ratio (PtAgt) and FIB concentration were observed,and the pathogenesis and the progress were discussed.

  5. 辛伐他汀在脑血栓治疗中的效果分析%Analysis of the effect of simvastatin in the treatment of cerebral thrombosis

    Institute of Scientific and Technical Information of China (English)

    向玲

    2015-01-01

    目的::研究分析辛伐他汀用于脑血栓的治疗效果.方法:择取2013.09-2014.09期间在我院接受药物治疗的74例脑血栓患者,利用随机双盲法将其以1∶1比例分成对照组(应用阿司匹林进行治疗)与研究组(应用辛伐他汀进行治疗),每组各有患者37例.结果:研究组患者的临床总有效率约为94.59%(35/37)显著高于对照组的83.78%(31/37),差异P<0.05有统计学意义.结论:辛伐他汀用于脑血栓的治疗能够明显延缓动脉粥样的发展,疗效甚佳,具有较高的临床治疗价值.%Objective:To study the analysis of simvastatin treatment ef ect for cerebral thrombosis.Methods:74 cases of cerebral thrombosis patients choose 2013.09-2014.09 during receiving drug treatG ment in our hospital,the use of random double blind method,its proportion to 1:1 were divided into control group(aspirin treatment)and study group(simvastatin treatment),37 patients each group.ReG sult:The clinical study group patients with total ef iciency is about 94.59%(35/37)was significantly higher than that in control group 83.78%(31/37),the dif erence was statistical y significant P<0.05. Conclusion:Simvastatin for the development,treatment of cerebral thrombosis can significantly retard atherosclerosis ef ect is very good,has a high value of clinical treatment.

  6. 脑静脉窦血栓形成患者血管内介入治疗的临床分析%Clinical analysis of intravascular interventional therapy for patients with cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    王金成; 蔡竹茵

    2015-01-01

    Objective:To evaluate treatment effects of intravascular intervention for patients with cerebral venous sinus throm-bosis. Methods:116 patients with cerebral venous sinus thrombosis were divided into two groups according to random number table method. Among them, intravascular interventional therapy was used for the treatment group, while anticoagulant therapy was used for control group. One course of treatment was 7 days, and the clinical effects after 2 courses of treatment of the two groups were com-pared. Results:The clinical total effective rates of treatment group and control group were 93. 1% and 70. 7% (P<0. 05). In the process of the treatment, no adverse reactions in the two groups occurred. Conclusions:Intravascular interventional in the treatment of cerebral venous sinus thrombosis has more significant clinical efficacies than conventional anticoagulant therapy.%目的::评价脑静脉窦血栓形成患者的血管内介入治疗效果。方法:对116例脑静脉窦血栓患者随机数字表的方法分为两组。其中治疗组患者实施血管内介入治疗,对照组患者使用常规抗凝治疗方法。7 d为1个疗程,2个疗程后比较两组临床效果。结果:治疗组患者的临床总有效率为93.1%,与对照组的70.7%相比,P<0.05。两组在治疗过程中均未出现不良反应。结论:血管内介入方法治疗脑静脉窦血栓的临床疗效优于常规抗凝治疗。

  7. Clinical and imaging features of cerebral venous sinus thrombosis%脑静脉窦血栓形成的临床与影像学特点

    Institute of Scientific and Technical Information of China (English)

    朱德生; 张悦; 管阳太

    2013-01-01

    目的 探讨脑静脉窦血栓形成的临床与影像学特点.方法 回顾性分析28例脑静脉窦血栓形成患者的临床资料.结果 男8例(28.6%),女20例(71.4%);急性起病18例(64.3%),亚急性起病8例(28.6%),慢性起病2例(7.1%).首发症状表现为头痛伴恶心、呕吐22例,发热伴视物模糊3例,发热伴精神异常2例,癫痫发作1例.主要临床表现为意识与认知功能障碍16例(57.1%),大脑皮质刺激症状5例(17.9%),运动功能障碍3例(10.7%),眼部症状6例(21.4%).白细胞增高6例,淋巴细胞增高2例;C反应蛋白升高3例,血沉升高2例;凝血酶原时间缩短2例,D-二聚体升高4例.颅内压升高11例;CSF生化和细胞学检查异常4例.头颅CT平扫示条带征13例,头颅MRI平扫示实三角征14例,增强示空三角征7例,头颅磁共振静脉成像与数字减影血管造影均见血栓部位血流消失.经抗凝治疗,痊愈23例,好转4例,死亡1例.结论 脑静脉窦血栓女性多见,主要首发症状为头痛伴恶心、呕吐,主要临床表现为意识与认知功能障碍.神经影像学特点为直接征像及间接征像.%Objective To explore the clinical and imaging features of cerebral venous sinus thrombosis (CVST).Methods Clinical data of 28 CVST patients were analyzed retrospectively.Results Eight patients (28.6%) were male,and 20 patients (71.4%) were female.Acute onset was in 18 cases (64.3%),subacute onset in 8 cases (28.6%),chronic onset in 2 cases (7.1%).The first symptoms was headache accompanied with nausea and vomited in 22 cases,fever accompanied with blurred vision in 3 cases,fever accompanied with mental anomaly in 2 cases,seizure disorder in 1 case.The main manifestations were consciousness disorders and cognitive dysfunction in 16 cases (57.1%),cerebral cortex stimulation symptom in 5 cases (17.9%),motor dysfunction in 3 cases (10.7%),and eye symptom in 6 cases (21.4%).Leukocyte increased was in 6 cases

  8. Dissecting aneurysm of the middle cerebral artery treated with heparin infusion in a 6-year-old child; neurological recovery with delayed spontaneous thrombosis: case illustration and literature review.

    Science.gov (United States)

    Anichini, G; Passacantilli, E; Lenzi, J; Guidetti, G; Santoro, A

    2012-04-01

    Aneurysms in the pediatric population are a rare pathology with specific features which requires a deep knowledge of their pathogenesis for the best therapeutic choice; the authors report their experience with a patient presenting aneurysm of the middle cerebral artery (MCA) associated with proximal stenosis of the vessel. A six-year-old girl came to our observation after sudden onset of headache and left hemiparesis. Angio-MRI and angio-CT scan showed a right MCA dissecting aneurysms associated with proximal stenosis of the vessel. Patient started a therapy with low molecular weight heparin (LMWH), replaced, 15 days later, with acetyl-salicylic acid (ASA). Patient showed a rapid and almost complete neurological recovery, despite several radiological exams confirmed a complete occlusion of the right MCA. As many other authors noted, dissecting aneurysms in the pediatric population are probably due to a defect of the entire arterial wall. Combination of stenosis, turbulence and partial thrombosis of the aneurysm led to a complete occlusion of artery involved, leading to the formation of collateral circles. In our case, complete thrombosis was probably delayed with anticoagulant therapy and the progressive reinforcement of collateral circles lead to the patient's neurological recovery.

  9. Portal Vein Thrombosis

    OpenAIRE

    Hakan Demirci

    2016-01-01

    Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low...

  10. Clinical Effects Analysis of Combination of Rehabilitation Exercises with Herbal Medicine on Acute Cerebral Thrombosis%康复锻炼联合中药治疗急性脑血栓的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    揭凤英; 何平

    2014-01-01

    Objective:To explore the clinical curative effects of combination of rehabilitation exercise with herbal medicine on acute cerebral thrombosis. Methods 56 patients with acute cerebral thrombosis were randomly divided into observation group and control group (n = 28). The observation group was adopted rehabilitation exercise combined with herbal medicine treatment while the control group was given herbal medicine therapy, to evaluate the curative effects of patients in the two groups. Results:total effective rate of the observation group was 92.9%while that of the control group was 75.0%, that the combined therapy obviously effective than simple herbal medicine therapy. Compared to that of the control group, the daily life Barthel index of the observation group was significantly higher. Conclusion: Combination of rehabilitation exercise with herbal medicine treatment can significantly improve the brain function state, increase cerebral blood flow and reduce morbidity, which is worth popularly application.%目的:探讨康复锻炼联合中药在治疗急性脑血栓中的临床疗效。方法将56例急性脑血栓患者随机分为观察组和对照组各28例。观察组采用康复锻炼联合中药治疗,对照组给予中药治疗,对两组患者的疗效进行评估。结果观察组总有效率为92.9%,对照组的总有效率为75.0%,联合组治疗的总有效率明显高于中药组,两组患者日常生活Barthel指数相比较,观察组明显高于对照组。结论康复锻炼联合中药治疗可以明显改善脑功能状态,增加脑血流量,降低致残率,值得在临床推广应用。

  11. Study on Effect of Excellent Nursing Management in the Nursing of Patients with Cerebral Thrombosis%优质护理管理在脑血栓患者护理中的作用探讨

    Institute of Scientific and Technical Information of China (English)

    李辉

    2016-01-01

    Objective To study the effect of excellent nursing management in the nursing of patients with cerebral throm-bosis. Methods 60 cases of patients with cerebral thrombosis treated in our hospital from January 2015 to January 2016 were selected as the research objects, and randomly divided into two groups with 30 cases in each according the nursing method, the excellent group were given excellent nursing management, the conventional group were given conventional nursing management, and the nursing effect of the two groups was compared. Results The satisfactory degree in the excel-lent group was obviously higher than that in the conventional group by comparison (P<0.05), the NIHSS score and Barthel index after nursing in the excellent group were obviously better than those in the conventional group (P<0.05), and the length of stay in the excellent group was obviously fewer than that in the conventional group by comparison(P<0.05). Con-clusion The excellent nursing management can effectively improve the prognosis of patients, promote the early discharge of patients and improve the satisfactory degree of patients, which can be promoted and applied in patients with cerebral throm-bosis.%目的:探讨优质护理管理在脑血栓患者护理中的作用。方法于2015年1月-2016年1月间,在该院选择60例脑血栓患者作为研究对象,将患者按护理方法随机分为优质组(n=30)和常规组(n=30),给予优质组患者优质护理管理,给予常规组患者常规护理管理,对比两组患者的护理效果。结果优质组患者满意度与常规组相比明显较高(P<0.05)。优质组患者护理后NIHSS评分、Barthel指数与常规组相比明显较优(P<0.05)。优质组患者住院时间与常规组相比明显较少(P<0.05)。结论优质护理管理能有效改善患者预后,促进患者早日出院,提高患者满意度,可在脑血栓患者中推广运用。

  12. 脑出血患者术后早期活动对预防下肢深静脉血栓形成的影响%The effect of the postoperative patients' early activities with cerebral hemorrhage to prevent deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    李爱文; 谢春雷; 李春霞; 黄维明; 钟丽丽

    2010-01-01

    Objective To explore the clinical results that the postoperative patients' early activities with cerebral hemorrhage to prevent deep venous thrombosis. Methods A total of 84 cases of the postoperative patients with cerebral hemorrhage were randomly divided into experimental group and control group, the experimental group was implemented the early activities' program; the control group was implemented the current clinical to prevent the conventional care of deep venous thrombosis; the two groups' patients were recorded the change of the blood pressure and heart rate after they were operated in 6 hours; the two groups' patients during hospitalization were observed if the complication with deep venous thrombosis or not Results The comparison of the change in blood prssure and heart rate after they were operated in 6 hours had no significance different (P > 0. 05) , the comparison in the prevention of occuring the deep venous thrombosis (P 0.05);术后发生下肢深静脉血栓的防治上比较,差异有统计学意义(P<0.05).结论 脑出血术后早期活动可促进患者术后早期康复,预防下肢深静脉血栓的发生.

  13. Doping and thrombosis in sports.

    Science.gov (United States)

    Lippi, Giuseppe; Banfi, Giuseppe

    2011-11-01

    Historically, humans have long sought to enhance their "athletic" performance to increase body weight, aggressiveness, mental concentration and physical strength, contextually reducing fatigue, pain, and improving recovery. Although regular training is the mainstay for achieving these targets, the ancillary use of ergogenic aids has become commonplace in all sports. The demarcation between ergogenic aids and doping substances or practices is continuously challenging and mostly based on perceptions regarding the corruption of the fairness of competition and the potential side effects or adverse events arising from the use of otherwise unnecessary ergogenic substances. A kaleidoscope of side effects has been associated with the use of doping agents, including behavioral, skeletal, endocrinologic, metabolic, hemodynamic, and cardiovascular imbalances. Among the various doping substances, the most striking association with thrombotic complications has been reported for androgenic anabolic steroids (i.e., cardiomyopathy, fatal and nonfatal arrhythmias, myocardial infarction [MI], intracardiac thrombosis, stroke, venous thromboembolism [VTE], limb arterial thrombosis, branch retinal vein occlusion, cerebral venous sinus thrombosis) and blood boosting (i.e., VTE and MI, especially for epoetin and analogs). The potential thrombotic complication arising from misuse of other doping agents such as the administration of cortisol, growth hormone, prolactin, cocaine, and platelet-derived preparations is instead speculative or anecdotal at best. The present article provides an overview on the epidemiological association as well as the underlying biochemical and biological mechanisms linking the practice of doping in sports with the development of thrombosis.

  14. Cancer associated thrombosis: risk factors and outcomes.

    Science.gov (United States)

    Eichinger, Sabine

    2016-04-01

    Deep vein thrombosis of the leg and pulmonary embolism are frequent diseases and cancer is one of their most important risk factors. Patients with cancer also have a higher prevalence of venous thrombosis located in other parts than in the legs and/or in unusual sites including upper extremity, splanchnic or cerebral veins. Cancer also affects the risk of arterial thrombotic events particularly in patients with myeloproliferative neoplasms and in vascular endothelial growth factor receptor inhibitor recipients. Several risk factors need to interact to trigger thrombosis. In addition to common risk factors such as surgery, hospitalisation, infection and genetic coagulation disorders, the thrombotic risk is also driven and modified by cancer-specific factors including type, histology, and stage of the malignancy, cancer treatment and certain biomarkers. A venous thrombotic event in a cancer patient has serious consequences as the risk of recurrent thrombosis, the risk of bleeding during anticoagulation and hospitalisation rates are all increased. Survival of cancer patients with thrombosis is worse compared to that of cancer patients without thrombosis, and thrombosis is a leading direct cause of death in cancer patients.

  15. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hakan Demirci

    2016-01-01

    Full Text Available Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low molecular weight heparin achieves recanalization in more than half of acute cases.

  16. A RARE CASE OF EXTENSIVE THROMBOSIS OF INFERIOR VENA CAVA, PORTAL VEIN, SPLENIC VEIN AND SUPERIOR MESENTRIC VEIN

    Directory of Open Access Journals (Sweden)

    Giridhar

    2015-03-01

    Full Text Available While the most common presentation of venous thromboembolic disease is deep vein thrombosis (DVT or pulmonary thromboembolism, rarer manifestations are thrombosis of jugular vein, cerebral sinus and inferior vena cava. Here we are presenting a rare case of inferior vena caval thrombosis with multiple thrombus in portal vein, splenic vein and superior mesenteric vein

  17. Risk Factors for Thrombosis

    Institute of Scientific and Technical Information of China (English)

    包承鑫

    2002-01-01

    @@ Thrombotic disease is a multifactorial disease, multiple interactions between genetic and environmental factors contribute to the development of the disease.This review summarized some risk factors reported for arterial thrombosis and venous thrombosis in recent few years.

  18. Deep Vein Thrombosis

    Science.gov (United States)

    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  19. Effect of acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm%针刺肌筋膜触发点治疗缺血性脑卒中痉挛的效果

    Institute of Scientific and Technical Information of China (English)

    龙佳佳; 庄小强; 谭树生; 言丽燕

    2013-01-01

    Objective To study the clinical curative effect of acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm.Methods 75 patients with cerebral arterial thrombosis spasm in Department of Rehabilitation Medicine,the National Hospital of Guangxi Zhuang Autonomous Region from February 2010 to December 2012 were divided into acupuncture myofascial trigger points group (treatment group,38 cases) and traditional acupuncture group (control group,37 cases) according to random number table with single-blind method.The FuglMeyer motor function score,Barthel index of daily life ability,degree of hemiplegic limb spasm,overall evaluation of spasticity comprehensive efficacy evaluation and clinical nerve function defect score of two groups before treatment and after 1,2 courses of treatment were evaluated.The dates were statistically analyzed by SPSS 17.0 statistics software.Results The Fugl-Meyer motor function score,Barthel index of daily life ability,modified Ashworth scale,clinic spasticity index and nerve function defect score of two groups could be improved obviously.The Fugl-Meyer motor function score,Barthel index of daily life ability,modified Ashworth scale,clinic spasticity index and nerve function defect score after 2 courses of treatment in the treatment group were better than those before treatment,after 1 course of treatment in the treatment group and after 2 courses of treatment in the control group (all P < 0.05).The total effective rate of treatment group (92.11%) was better than that of control group (75.68%) (P < 0.05).Conclusion Acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm has good clinical curative effect,less side effects and it is worthy of clinical application.%目的 探讨针刺肌筋膜触发点治疗缺血性脑卒中痉挛的临床疗效.方法 选取2010年2月~2012年12月来广西壮族自治区民族医院康复医学科就诊

  20. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  1. Imaging characteristics of two patients with isolated cortical venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Shunchang Han; Hui Zhang; Guoguang Fan; Baohai Sun

    2008-01-01

    BACKGROUND:Over the past twenty years, improvements in neuroimaging have greatly improved the ability to diagnose cerebral venous sinus thrombosis, as well as isolated cortical venous thrombosis. Neuroimaging allows for variations to be detected in the cortical vein and venous sinus. Diagnosis of thromboses in the venous system should not depend entirely on angiography of undeveloped veins or venous sinus. Currently, the combination of magnetic resonance imaging and magnetic resonance venography is the gold standard for diagnosing cerebral venous sinus thrombosis, rather than digital subtraction angiography. This article summarizes clinical manifestations, results from computed tomography and magnetic resonance imaging in two cases of isolated cortical venous thrombosis, analyzed relevant literature, and discussed the clinical and imaging characteristics of isolated cortical venous thromboses.

  2. An autopsy case of traumatic sinus thrombosis.

    Science.gov (United States)

    Seto, Y; Takeichi, S

    1996-02-01

    A 38-year-old male slipped accidentally and fell from a height of 4.6 m, and was admitted to a hospital. A radiograph indicated a linear fracture of the parietal bone across the sagittal sutura, and a computed tomography scan of the head showed severe subdural hematoma on both parietal sides, so an operation was performed to remove the hematoma. Five hours after the operation, brain death due to a cerebral herniation occurred, and he died six days later. Autopsy revealed a linear fracture of the parietal bones, which crossed obliquely the sagittal sutura. A slightly lacerated wound of the dura mater was seen on the sagittal sutura, from where the latter half of that point to the left and right transverse sinuses were occluded completely with thrombosis. The brain was markedly swollen. From these findings, the victim was considered to have died from acute cerebral swelling due to traumatic thrombosis of the superior sagittal sinus.

  3. 肾病综合征合并颅内静脉窦血栓致失明1例报告%A case of blindness caused by nephritic syndrome with cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    孙涛; 夏正坤; 樊忠民; 史卓; 高远赋

    2014-01-01

    Objectives To explore the clinical manifestations, treatment and prognosis of a case of blindness caused by nephrotic syndrome with cerebral venous sinus thrombosis (CVST). Methods The clinical manifestations, diagnosis and treatment of a case of NS with CVST were analyzed. The latest domestic and foreign reseach progresses in treatment for CVST in children were reviewed. Results Epilepsy suddenly appeared with diplopia, binocular vision loss and blindness in anticoagulant therapy for the child with NS. Brain magnetic resonance venography (MRV) suggested CVST. MRV reexam-ined showed that the intracranial thrombosis was completely dissolved after urokinase thrombolysis for one month followed by ineffective heparin anticoagulation. At present, international standards of anticoagulant therapy have been adopted in the treatment for CVST patients. Coagulation function (e.g.APTT) and international standardization ratio were monitored in order to prevent bleeding. Conclusions It is better to perform neural imaging examination early in suspected CVST patients. Anti-coagulation and thrombolytic therapy should be given immediately once the risk of bleeding was excluded and used for 3-6 months.%目的:探讨肾病综合征(NS)合并颅内静脉窦血栓(CVST)致失明患儿的临床表现、治疗方案及其预后。方法分析1例NS合并CVST患儿的临床特点及诊治经过,并复习和总结国内外有关儿童CVST治疗相关研究的最新进展。结果患儿在NS标准化抗凝治疗过程中突然出现抽搐等癫发作症状,并有复视、双眼视力下降、失明,头颅磁共振及脑血管造影检查(MRV)示CVST形成,肝素化抗凝治疗效果不佳,后予尿激酶溶栓治疗1个月,复查MRV示颅内血栓已完全溶解。目前国际上针对CVST患儿已采取标准化抗凝治疗方案,并随时监测凝血功能如活化部分凝血活酶时间(APTT)、国际标准化比值(INR)等预防出血风险。结论

  4. Intracranial venous sinus thrombosis complicating AIDS-associated nephropathy.

    Science.gov (United States)

    Afsari, Khosrow; Frank, Jeffrey; Vaksman, Yulia; Nguyen, Thanhan V

    2003-03-01

    An alert and oriented 27-year-old African American woman with AIDS presented with a 10-day history of fever, cough productive of yellow sputum, nausea, and vomiting and a 1-day history of excruciating headache and photophobia. Her condition rapidly deteriorated into a coma with decorticate and then decerebrate posture, and she died 3 weeks later. There was evidence of extensive intracranial venous sinus thrombosis (ICVST), renal vein thrombosis (RVT), and multiple cerebral hemorrhagic infarcts due to a hypercoagulable state complicating AIDS-associated nephrotic syndrome. This is the first reported case of fatal ICVST and RVT with extensive cerebral hemorrhagic infarcts complicating nephrotic syndrome in a patient with AIDS.

  5. Sagittal vein thrombosis caused by central vein catheter.

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-03-01

    Full Text Available Cerebral venous thrombosis, including thrombosis of cerebral veins and major dural sinuses, is an uncommon disorder in the general population. However, it has a higher frequency among patients younger than 40 years of age, patients with thrombophilia, pregnant patients or those receiving hormonal contraceptive therapy or has foreign body such as catheter in their veins or arterial system. In this case report, we described clinical and radiological findings in a patient with protein C-S deficiency and malposition of central vein catheter.

  6. Evaluation of treatment effect of sodium valproate for convulsive status epilepticus of cerebral arterial thrombosis%丙戊酸钠对于缺血性脑卒中惊厥性癫痫持续状态的治疗效果评价

    Institute of Scientific and Technical Information of China (English)

    赵勇刚

    2015-01-01

    目的:探讨丙戊酸钠(SV)治疗缺血性脑卒中惊厥性癫痫持续状态(CSE)的效果。方法:收治CSE患者38例,采用 SV 治疗,观察治疗效果。结果:治疗成功24例(63.15%),4例患者发生不良反应。10例(29.4%)难治性 CSE 的mRS>3;实验室检查无明显恶化。结论:SV治疗缺血性脑卒中后CSE安全有效,特别是mRS低分值患者。%Objective:To explore the treatment effect of sodium valproate(SV) for convulsive status epilepticus(CSE) of cerebral arterial thrombosis.Methods:38 patients with CSE were selected.They were treated with SV.We observed the effect of treatment. Results:24 cases(63.15% ) were treated successfully,and 4 cases had adverse reactions.The mRS was greater than 3 of 10 patients(29.4% ) with intractable CSE,and laboratory tests showed no deterioration.Conclusion:SV was safe and effective for treating CSE after cerebral arterial thrombosis,especially for patients with low mRS scores.

  7. 疏血通注射液联合奥扎格雷钠治疗脑血栓的疗效观察%Observation of the Curative Effect of Shuxuetong Injection Combined With Ozagrel in the Treatment of Cerebral Thrombosis

    Institute of Scientific and Technical Information of China (English)

    张英凡

    2016-01-01

    目的:探讨疏血通注射液联合奥扎格雷钠治疗脑血栓的效果。方法随机将120例脑血栓患者平均分为两组,对照组行奥扎格雷钠治疗,观察组在对照组的基础上行疏血通注射液治疗。结果观察组总有效率(96.67%)优于对照组(75.0%)(P<0.05)。结论疏血通注射液联合奥扎格雷钠治疗脑血栓效果理想。%Objective To investigate the effect of Shuxuetong injection combined with ozagrel sodium in the treatment of cerebral thrombosis. Methods 120 cases of patients were divided into two groups, control group was treated with sodium ozagrel, and observation group, on the basis of control group, was treated with Shuxuetong injection.ResultsThe total effective rate (96.67%) of observation group were better than control group (75.0%) (P<0.05). Conclusion Shuxuetong injection combined with sodium ozagrel in the treatment of cerebral thrombosis has ideal effects.

  8. Risk Factors and Early Unfavourable Prognosis Factors of Cerebral Venous Sinus Thrombosis%颅内静脉窦血栓形成的危险因素及早期不良预后相关因素分析

    Institute of Scientific and Technical Information of China (English)

    赵惠卿; 王安心; 赵性泉

    2013-01-01

    Objective To analyze the risk factors and early prognosis factors of cerebral venous sinus thrombosis (CVST). Methods 68 patients with CVST were analyzed retrospectively. The patients were divided into early favorable prognosis group and early unfavorable prognosis group according to modified Rankin Scale (mRS). The clinical data and prognosis were analyzed by univariate analysis and multi-variate logistic regression analysis. Results and Conclusion On discharge, there were 37(54.4%) cases and 31(45.6%) cases in the early fa-vorable prognosis group and the early unfavorable prognosis group respectively. Univariate analysis showed that 8 factors, including preg-nancy-associated factors, central nervous system infection, hyperhomocysteinemia, ocular symptoms, disturbance of consciousness, limb pa-ralysis, secondary cerebral infarction and ventricular compression/midline shift/encephaledema were associated with the early prognosis. Multivariate logistic regression analysis showed that pregnancy-associated factors, central nervous system infection, hyperhomocysteinemia, disturbance of consciousness and ventricular compression/midline shift/encephaledema were the independent factors.%目的:分析颅内静脉窦血栓形成(CVST)的危险因素及影响早期预后的相关因素。方法对68例CVST患者的临床资料进行回顾性分析。按改良Rankin量表(mRS)评分分为早期预后良好组与早期预后不良组。临床资料及其早期预后采用单因素和多因素Logistic回归分析。结果与结论68例CVST患者出院时早期预后良好37例(54.4%),早期预后不良31例(45.6%)。单因素Logistic回归分析结果显示,妊娠相关、中枢神经系统感染、高同型半胱氨酸血症、眼部症状、意识障碍、肢体瘫痪、伴继发性脑梗死、伴脑室受压/中线移位/全脑水肿8项因素是早期预后不良的影响因素。多因素Logistic回归分析显示,妊娠相关、中枢神经系统感染、高同型

  9. 阵发性睡眠性血红蛋白尿合并脑静脉窦血栓形成1例并文献复习%Paroxysmal nocturnal hemoglobinuria with cerebral venous sinus thrombosis:a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    鲁文先; 董晓梦; 胡耀芝; 陈金波

    2015-01-01

    阵发性睡眠性血红蛋白尿(paroxysmalnocturnalhemoglobinuria,PNH)是一种后天获得性造血干细胞克隆缺陷性疾病,可表现为溶血性贫血、血红蛋白尿和静脉血栓形成。脑静脉窦血栓形成(cerebral venous sinus thrombosis, CVST )是PNH的一种少见但较严重的并发症。文章报道1例PNH合并CVST患者,并对相关文献进行了复习。对于伴有CVST 危险因素且表现为头痛、颅内压升高等神经系统症状的患者,应及早行颅脑影像学检查明确诊断,积极给予抗凝、脱水、祛除病因、控制并发症等方面的治疗。%Paroxysmalnocturnalhemoglobinuria(PNH)isadefectdiseaseofacquiredclonal hematopoietic stem cel s. It can be expressed as hemolytic anemia, hemoglobinuria, and venous thrombosis. Cerebral venous sinus thrombosis (CVST) is a rare but serious complication of PNH. Here we report a PNH patient with CVST and reviewthe relevant literature. For patients who have the risk factors for CVST and neurological symptoms, such as headache and increased intracranial pressure, should early conduct brain imaging examination and make the diagnosis clear, and give an active treatment in the aspects of anticoagulation, dehydration, eliminating the causes of disease, and controling complications.

  10. Clinical analysis of twelve cases with cerebral venous sinus thrombosis in children%小儿颅内静脉窦血栓形成12例临床分析

    Institute of Scientific and Technical Information of China (English)

    王新华; 黄海娟; 张林妹; 周水珍

    2013-01-01

    目的 总结小儿颅内静脉窦血栓形成(CVST)的病因、临床表现和影像学特征,以期早期诊断和及时治疗.方法 对复旦大学附属儿科医院于2008年8月至2012年5月收治住院的12例CVST患儿的临床表现、实验室资料、影像学特征、治疗经过及短期预后进行回顾性分析.结果 (1)病因:12例患儿中,7例病因不明,临床表现为亚急性或者慢性头痛进行性或急性加重;2例与感染相关;1例为颅内肿瘤术后;另外2例发生在肾病综合征激素治疗过程中.确诊前有7例发生误诊.(2)诊断:12例患儿均行头颅磁共振及磁共振静脉成像检查,明确诊断为颅内静脉窦血栓.(3)短期预后:所有患儿确诊后均予以抗凝治疗,11例临床症状好转;7例病因不明的患儿中确诊时4例存在不同程度的视力障碍,治疗后短期视力无改善;1例患儿确诊后至外院行数字减影血管造影及球囊扩张,后治疗无效死亡.结论 小儿CVST临床表现缺乏特异性,误诊率高,认识其临床特征并及时行磁共振静脉成像检查是诊断的关键.抗凝治疗是一种安全且有效的方法.%Objective To summarize the etiological,clinical and imaging characteristics of cerebral venous sinus thrombosis (CVST) in children so as to provide the basis for early diagnosis and prompt treatment.Methods All the medical records including clinical manifestations,laboratory data,neuroimaging changes,treatment and short-term prognosis were analyzed retrospectively in 12 cases of CVST hospitalized in Children' s Hospital of Fudan University from Aug 2008 to May 2012.Results (1) Regarding the etiology:of the 12 cases,the causes of CVST were infection (2/12),intracranial tumor (1/12),nephrotic syndrome (2/12),cryptogenic disease (7/12).Seven out of all 12 cases without definite cause were presented subacute or chronic headache associated with progressive or acute exacerbation.Seven cases had been misdiagnosed.(2)Diagnosis

  11. Lifestyle and venous thrombosis

    NARCIS (Netherlands)

    Pomp, Elisabeth Rebekka

    2008-01-01

    In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA study), a large population-based case-control study, we investigated lifestyle factors as risk factors for venous thrombosis. Overweight, smoking and alcohol consumption were addressed and pregnancy and

  12. 脑静脉窦血栓形成患者磁共振成像与磁共振静脉血管成像联合诊断的价值%The value of magnetic resonance imaging combined with magnetic resonance venography in diagnosis of cere-bral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    徐炳福

    2015-01-01

    Objective To investigate the value of the magnetic resonance imaging (MRI) combined with magnetic reso‐nance venography (MRV) in the diagnosis of cerebral venous sinus thrombosis. Methods Patients who were collected from A‐pril 2009 to May 2013 in our hospital were analyzed retrospectively. All of the patients were scanned by MR ,12 of which went on DSA (digital subtraction angiography) ,6 of which were scanned by MRV and 22 of which were received enhanced scan. Re‐sults 6 patients with the thrombosis of single transverse sinus ,and 8 patients with superior sagittal sinus ,transverse sinus and sigmoid sinus involvement was observed;while single sigmoid sinus involvement in 16 and both superior sagittal sinus and transverse sinus in 10 patients.Abnormal venous enhancement was found on contrast enhanced MRI in 22 patients ,but venous sinus thrombosis did not be enhanced. The results of MRV in 6 patients and DSA in 12 patients showed that the cerebral ve‐nous sinus was not obvious ,narrow and irregular. Conclusion The value of the magnetic resonance imaging (MRI) combined with magnetic resonance venography (MRV) in the diagnosis of cerebral venous sinus thrombosis is effective ,should be widely applied to clinical practice.%目的:探讨脑静脉窦血栓(cerebral venous sinus thrombosis ,CVST )形成患者磁共振成像与磁共振静脉血管成像联合诊断的价值。方法选取脑静脉窦血栓患者40例进行分析。诊断过程中,全体患者均接受磁共振(magnetic resonance venography ,MR)平扫,数字减影血管造影(digital subtraction angiography ,DSA)检查12例,MRV检测6例,增强扫描22例。结果单一横窦受累6例,上矢状窦、乙状窦及横窦受累8例,单一乙状窦受累16例,横窦和上矢状窦联合受累10例。所有患者磁共振成像(magnetic resonance venography ,MRI)及磁共振静脉成像(magnetic resonance venography ,MRV)均表现出信号改变。22例

  13. Study on Effect of Compound Salvia Pellet in Preventing Atrial Fibrillation with Left Atrial Thrombosis

    Institute of Scientific and Technical Information of China (English)

    连耀植; 李玉光; 张汉灵; 张元春; 闫纯英; 林建才; 许瑞敏; 张钰; 郑宝群; 麦芒

    2004-01-01

    Atrialarrhythmia,fibrillation (AF) is a kind of common arrhythmia which, besides affecting cardiac function, has another serious outcome, that is, it is easy to form atrial thrombosis and induce thrombus/embolus, especially cerebral embolus. The incidence of left atrial thrombosis (LAT) could reach 25%—30%, the incidence of embolic complication per year could reach 2. 98%-6.30%, even 20% or more. To prevent thrombosis so as to lower the incidence of cerebral stroke and other embolic complications has been so far the focal point of AF treatment.

  14. Study on Effect of Compound Salvia Pellet in Preventing Atrial Fibrillation with Left Atrial Thrombosis

    Institute of Scientific and Technical Information of China (English)

    连耀植; 李玉光; 张汉灵; 张元春; 闫纯英; 林建才; 许端敏; 张钰; 郑宝群; 麦芒

    2004-01-01

    @@ Atrial fibrillation (AF) is a kind of common arrhythmia, which, besides affecting cardiac function, has another serious outcome, that is, it is easy to form atrial thrombosis and induce thrombus/embolus, especially cerebral embolus.The incidence of left atrial thrombosis (LAT)could reach 25%-30%(1), the incidence of embolic complication per year could reach 2. 98%-6.30%, even 20% or more(2,3). To prevent thrombosis so as to lower the incidence of cerebral stroke and other embolic complications has been so far the focal point of AF treatment.

  15. Deep vein thrombosis.

    Science.gov (United States)

    Bandyopadhyay, Gargi; Roy, Subesha Basu; Haldar, Swaraj; Bhattacharya, Rabindra

    2010-12-01

    Occlusive clot formation in the veins causes venous thrombosis, the site most common in the deep veins of leg, called deep vein thrombosis. The clot can block blood flow and when it breaks off, called an embolism which in turn can damage the vital organs. Venous thrombosis occurs via three mechanisms ie, Virchow's triad. The mechanisms are decreased flow rate of blood, damage to the blood vessel wall and an increased tendency of the blood to clot. There are several factors which can increase a person's risk for deep vein thrombosis. The symptoms of deep vein thrombosis in the legs are pain, swelling and redness of the part. One variety of venous thrombosis is phlegmasia alba dolens where the leg becomes pale and cool. Investigations include Doppler ultrasound examination of the limb, D-dimer blood test, plethysmography of the legs, x-rays to show vein in the affected area (venography). Hospitalisation is necessary in some cases with some risk factors. The mainstream of treatment is with anticoagulants, mostly low molecular weight heparin for 6 months. Deep venous thrombosis is a rising problem. Early diagnosis and treatment is associated with a good prognosis.

  16. Cortical venous thrombosis following exogenous androgen use for bodybuilding.

    Science.gov (United States)

    Sveinsson, Olafur; Herrman, Lars

    2013-02-05

    There are only a few reports of patients developing cerebral venous sinus thrombosis (CVST) after androgen therapy. We present a young man who developed cortical venous thrombosis after using androgens to increase muscle mass. He was hospitalised for parasthesia and dyspraxia in the left hand followed by a generalised tonic-clonic seizure. At admission, he was drowsy, not fully orientated, had sensory inattention, pronation drift and a positive extensor response, all on the left side. The patient had been using anabolic steroids (dainabol 20 mg/day) for the last month for bodybuilding. CT angiography showed a right cortical venous thrombosis. Anticoagulation therapy was started with intravenous heparin for 11 days and oral anticoagulation (warfarin) thereafter. A control CT angiography 4 months later showed resolution of the thrombosis. He recovered fully.

  17. Pediatric transplantation: preventing thrombosis.

    Science.gov (United States)

    Robertson, J D

    2015-06-01

    Due to progressive advances in surgical techniques, immunosuppressive therapies, and supportive care, outcomes from both solid organ transplantation and hematopoietic stem cell transplantation continue to improve. Thrombosis remains a challenging management issue in this context, with implications for both graft survival and long-term quality of life. Unfortunately, there remains a general paucity of pediatric-specific data regarding thrombosis incidence, risk stratification, and the safety or efficacy of preventative strategies with which to guide treatment algorithms. This review summarizes the available evidence and rationale underlying the spectrum of current practices aimed at preventing thrombosis in the transplant recipient, with a particular focus on risk factors, pathophysiology, and described antithrombotic regimens.

  18. Postpartal right ventricular thrombosis.

    Science.gov (United States)

    Velicki, Lazar; Milosavljević, Aleksandar; Majin, Marijan; Vujin, Bojan; Kovacević, Pavle

    2008-11-01

    The discovery of an intracardial mass in patients presents a serious diagnostic dilemma. The differential diagnosis of this condition may seem abundant, but myxomas and intracardial thrombosis are the most frequent diagnoses. A connection between pregnancy and the presence of thrombosis has been documented frequently. Normal pregnancy leads to changes of the coagulative and fibrinolytic status toward a hypercoagulable condition which has its own physiological justification (the risk of blood loss decreases during labor). The case of a patient suffering from postpartal right ventricular thrombosis, which was successfully resolved by surgery as described in this contribution, demonstrates the value of a multidisciplinary approach.

  19. Clinical analysis of cerebral venous sinus thrombosis in ten cases with severe preeclampsia%子痫前期重度合并颅内静脉窦血栓10例临床分析

    Institute of Scientific and Technical Information of China (English)

    魏华; 李晓琴

    2016-01-01

    目的:探讨重度子痫前期合并颅内静脉窦血栓的诊疗方法。方法回顾性分析10例重度子痫前期合并颅内静脉窦血栓患者的诊疗过程。结果10例患者中9例为初产妇、1例为经产妇,发病年龄:22岁~33岁,发病孕周:28周+5~35周+6,发病时期:妊娠晚期3例,产褥期7例,其中术后24 h内6例。头痛、视觉障碍、抽搐、肢体活动受限等为主要临床症状。10例患者均行MRI+MRV检测,7例患者上矢状窦栓塞。10例患者均积极给予抗凝对症治疗,均病情好转出院。围生儿7例痊愈出院。结论妊娠晚期及产褥期妇女出现头痛、视觉障碍、抽搐、肢体活动受限等体征时,需警惕颅内静脉窦血栓形成可能;行MRI+MRV检测有助于诊断;病情危重时及时选择终止妊娠去除病因并积极抗凝,是治疗重度子痫前期合并颅内静脉窦血栓的有效方法。%Objective To discuss the diagnosis and our treatment strategies of cerebral venous sinus thrombosis (CVST)in Severe Preeclampsia.MethodsWe presented 10 cases of Severe Preeclampsia with emergent CVST in the Department of Obstetrics,Neurology and Intensive Care Unit,Yun Chen Central Hospital. All got the disease in late pregnancy or after bortion .Results Of the 10 pregnant or maternity patients with CVST,Seven patients had headache, 5 had visual loss,3 had epilepsy,2 had focal neurological signs mainly ataxia,All 10 patients had MRI and MRA during acute or subacute period,Superior sagittal sinus in 7 cases,5 had infarction. pregnancy was timely terminated in 10 pregnant patients and all of them got active anticoagulant therapy. All of them got better when they were discharged. Conclusion When pregnant women in severe preeeclampsia had acute/subacute headache,epilepsy,visual loss and other local signs,the possibility of CVST should be suspected. Both MRI and MRV are helpful to diagnosis. Timely termination of pregnancy and the active

  20. The correlation between homocysteine,anticardiolipin antibodies and cerebral thrombosis%同型半胱氨酸、抗心磷脂抗体与脑血栓形成的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张弛; 徐劲; 张鹏飞

    2011-01-01

    Objective To investigate the relationship between homocysteine (Hcy), anticardiolipin antibodies (ACA) and the occurrence of cerebral thrombosis( CT), and to study the relationship between Hcy and the deficiency of folic acid ( FA), VitBl2. Methods Hcy was measured by enzymatic cycling assay, FA, VitBl2 was measured by electrochemiluminescence immunoassay, and ACA ( IgG, IgM type) was measured by enzyme - linked immunosorbent assay (ELISA). Results ①Compared with the control group, the Hcy level of first and recurrent group was significantly higher( P <0. 01 ); and the level of FA, VitB12 in patients of first and recurrent group were significantly lower;the relationship between FA, VitB12 and Hcy in first and recurrent group were negatively correlated. ②Compared with the control group, the positive rate of ACA of first and recurrent group was significantly higher; the Hcy level of ACA - positive patients in first and recurrent group was significantly higher than the Hcy level of ACA - negative patients ( P < 0. 01 ). Conclusion Hyperhomocysteinemia (HHM) and the ACA -positive were risk factors in the occurrence of CT; ACA -positive may be an independent risk factor of CT; there is close relationship between Hcy,ACA and the occurrence of CT, they influence each other and educe synergistic effect.%目的 探讨同型半胱氨酸(Hcy)、抗心磷脂抗体(ACA)对脑血栓形成(CT)的发生及Hcy与叶酸(FA)、VitB12缺乏之间的关系.方法 采用循环酶法测定Hcy,电化学发光免疫法检测FA、VitB12,酶联免疫吸附法(ELISA)检测ACA(IgG、IgM型)水平.结果 ①初发组和复发组CT患者Hcy水平显著高于对照组(P<0.01);FA、VitB12水平显著低于对照组;两组CT患者Hcy水平与FA、VitB12浓度均呈负相关.②初发组和复发组CT患者ACA阳性率显著高于对照组,并且两组CT患者中ACA阳性组Hcy水平显著高于ACA阴性组(P<0.01).结论 高同型半胱氨酸血症(HHM)和ACA阳性均系CT发生的危险

  1. Cancer and Thrombosis

    Institute of Scientific and Technical Information of China (English)

    刘敏涓

    2011-01-01

    @@ Relationship between cancer and thromboembolic disease, the research has been going on for more than a century.Armand trousseau in 1865 first reported the formation of venous thrombosis prone patients with gastric cancer.

  2. Cancer and Thrombosis

    Institute of Scientific and Technical Information of China (English)

    李家增

    2006-01-01

    @@ Since 1865, Aremand Trousseau first reported on the association between cancer and thrombosis. For many years, it has been recognized that venous thromboembolism (VTE) is a common occurrence in patients with malignant disease. Compared to other groups of patients with VTE the cancer population is unique because the pathogenesis of thrombosis differs, the frequency of VTE is greater and the clinical management required is more complex.

  3. CT平扫能否准确诊断脑静脉窦血栓?%Is it possible to accurately diagnose cerebral venous sinus thrombosis on non-contrast CT?

    Institute of Scientific and Technical Information of China (English)

    关键; 林玲; 黄展坤; 初建平; 杨智云

    2015-01-01

    Objective To investigate the efficacy of non-contrast CT for diagnosing cerebral venous sinus thrombosis (CVST). Methods 35 patients with CVST and 40 volunteers without CVST underwent non-contrast CT. .The two groups were matched by age and gender..Two radiologists blindly reviewed all CT examinations in consensus..Another experienced radiologist measured the CT values of cerebral venous..Independent samples t test was performed to compare the two groups,.and receiver operating characteristics ( ROC ) curve analysis was performed to obtain the critical CT value of venous sinus for differential diagnosis . . We calculated sensitivity,.specificity and reliability of 4 variables for diagnosis of CVST including the threshold CT value of venous sinus,history of systemic lupus erythematosis, nephropathy, or pregnancy, symptoms of headache and/or spasm, venous infarct and/or scalp swelling on CT. The readers graded the variables from 1 to 3 points and the sum of each variable in both groups were compared using the Chi-square test and Fisher exact test. Results The CT attenuation of thrombosed venous sinus was significantly higher than that of normal (P<0.001). The best threshold value for diagnosing CVST was 68HU (Youden index=0.886). The best single indicator was the CT threshold value with specificity of 93% and reliability score of 3 ,.followed by venous infarct and/or scalp swelling with specificity of 77% and reliability score of 2. .There was no significant difference in the history of associated disorders (1 score) or symptoms (1 score) between the two groups. The total score of 5 or more is highly correlated with CVST in follow-up with 88.6%sensitivity,.100%specificity and 94.7%reliability..Conclusion Together with the relevant history and symptoms , it is possible to make an accurate diagnosis of CVST on non-contrast CT.%目的:脑静脉窦血栓(CVST)临床表现多样,急诊准确诊断仍有一定困难,而 CT 平扫是急诊首选的影像检查,

  4. 孕产妇合并颅内静脉窦血栓形成的诊疗策略%Treatment Strategies for Pregnancy with Cerebral Venous Sinus Thrombosis

    Institute of Scientific and Technical Information of China (English)

    牛婧雯; 倪俊; 姚明; 周立新; 戴毅; 范思远; 朱以诚; 彭斌; 崔丽英

    2014-01-01

    Objective To discuss the possible cause, clinical symptoms, radiologic characteristics, diagnosis and our treatment strategies of cerebral venous sinus thrombosis (SCVT) in pregnancy. Methods We presented 12 cases of pregnancy with emergent SCVT admitted between 1993 and 2013 in the Department of Neurology, Peking Union Medical College (PUMC) hospital. The average age was (26±5) (19~34). Computed tomography (CT)/magnetic resonance imaging (MRI) was performed in all 12 patients in acute/subacute period; magnetic resonance venography (MRV) in 9 and digital subtraction angiography (DSA) in 6. The possible pathogenesis, clinical symptoms, radiological ifndings, diagnosis and treatment strategies were discussed. Results Of the 12 pregnant or maternity patients with SCVT, 7 got the disease in early pregnancy, 1 in late pregnancy, 4 within 2 weeks after delivery, 1 after abortion. The accompanied diseases were:one with protein S deficiency, one with hyperhomocystinemia, one with idiopathic thrombocytopenia purpura, one with infection, one with anemia. Clinical onset was acute or subacute. Twelve patients had headache, 5 had epilepsy, 5 had focal neurological signs (including weakness, Babinski signs, numbness, ataxia, peripheral facial paralysis), 1 had visual loss, 4 had disturbance of consciousness. All 12 patients had MRI during acute or subacute period, 9 had abnormal parenchymal signals--7 had infarction or hemorrhagic infarction, 1 had cerebral hemorrhage, and 1 had cerebral edema. Transverse sinus and sigmoid sinus were involved in 9 cases, superior sagittal sinus in 8, straight sinus and inferior sagittal sinus in 2, jugular vein in 2. Treatment:pregnancy was timely terminated in 6 pregnant patients; 1 patient whose family disagreed to terminate pregnancy aggravated and went back home. Ten patients accepted heparinized anti-coagulation as soon as possible, and all of them got better when they were discharged. Conclusion When pregnant women had acute

  5. Clinical features in patients with simultaneous cerebral arterial and venous lesions (with literature survey

    Directory of Open Access Journals (Sweden)

    Lee Peng Chew

    2014-01-01

    Full Text Available Nowadays, only few cases of simultaneous cerebral arterial and venous thrombosis were reported. However, there might be high probability of coexisted cerebral arterial and venous changes. It is worthy to study the reasons and frequency of these coexisted vascular changes contributing to the development of clinical pictures. We analyzed 12 cases of simultaneous cerebral and/or neck vascular changes based on vascular images and ultrasonography which were divided into 4 groups: coexistence of simultaneous arterial and venous thrombosis; venous thrombosis with arterial hypoplasia; arterial thrombosis, arteritis or dissections with venous sinus hypoplasia; coexistence of arterial and venous hypoplasia.

  6. Cerebral embolic stroke after disappearing takotsubo cardiomyopathy.

    Science.gov (United States)

    Matsuzono, Kosuke; Ikeda, Yoshio; Deguchi, Shoko; Yamashita, Toru; Kurata, Tomoko; Deguchi, Kentaro; Abe, Koji

    2013-11-01

    Takotsubo cardiomyopathy can induce cerebral embolic stroke because of intracardiac thrombosis, but the timing of cardiogenic embolism relating to takotsubo cardiomyopathy has not been well described. We evaluated a 71-year-old woman with takotsubo cardiomyopathy, who developed cardiogenic cerebral embolism after recovery of cardiac wall motion. Nevertheless, we treated her with anticoagulation therapy. The present clinical observation suggests that attention should be paid to the timing when takotsubo cardiomyopathy resolves against risk of cardiogenic cerebral embolism.

  7. Traumatic dural venous sinus thrombosis: A Mini Review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  8. Transcatheter Aortic Heart Valve Thrombosis

    DEFF Research Database (Denmark)

    Hansson, Nicolaj C; Grove, Erik L; Andersen, Henning R;

    2016-01-01

    BACKGROUND: There is increasing focus on transcatheter heart valve (THV) thrombosis. However, there are limited data on incidence, clinical implications and predisposing factors of THV thrombosis following transcatheter aortic valve replacement (TAVR). OBJECTIVES: We assessed the incidence...

  9. Venous thrombosis: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, C.W.

    1986-07-01

    Venous thromboembolic disease contributes to morbidity and mortality in certain groups of hospitalized patients, particularly those who have undergone surgery. Although principles of treatment have changed relatively little during the past 20 years, significant advances have been made in the diagnosis of deep vein thrombosis (DVT). Venography, once the only reliable diagnostic technique, has been largely replaced by noninvasive tests: impedance plethysmography, venous Doppler, /sup 125/I-radiofibrinogen-uptake test, and phleborheography. Virchow's triad of stasis, vessel injury, and hypercoagulability remains a valid explanation of the pathogenesis of thrombus formation, but laboratory and clinical data have refined our knowledge of how these factors interact to result in clinically significant disease. Knowledge of the natural history of venous thrombosis, plus heightened awareness of the long-term morbidity and expense associated with the postphlebitic syndrome, have led to increased interest in preventing DVT. Clinically and economically, venous thrombosis is best managed by prevention. 61 references.

  10. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

    Full Text Available Portal vein thrombosis (PVT is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community.

  11. Clinical analysis of headache in patients with cerebral venous sinus thrombosis%颅内静脉窦血栓形成患者头痛表现的临床分析

    Institute of Scientific and Technical Information of China (English)

    窦香君; 罗国刚; 袁兴运; 张强; 张丽芸; 刘憬杰; 张秋丽

    2014-01-01

    Objective To analyze the characteristics of the common first attack of headache in patients with cerebral venous sinus thrombosis (CVST). Methods The clinical data of 51 patients who were diagnosed as CVST with MR venography (MRV)or DSA were collected retrospectively. The patients were divided into either a acute group (≤3 week,n= 32)or a chronic group (>3 weeks, n=19). Results (1)The age of onset of symptoms in these patients was 20 to 40 years,and most of them were females. Of all the first symptoms,headache ranked first,accounting for 84. 3%(43/51 );headache only accounted for 52. 9%(27/51 ),headache with other symptoms (ophthalmic symptoms, hemiplegia,and aphasia,etc. )accounted for 31. 4%(16/51 ),and other symptoms such as epilepsy, paralysis,and ophthalmic symptoms accounted for 15. 7%(8/51). (2)The proportion of headache only as the first symptom in the acute group was higher than that in the chronic group (65. 6% vs. 31. 6%,P0. 05 ). Conclusion Young patients without previous history of migraine,especially women of childbearing age with sudden onset and progressive worsening headache,and the patients with idiopathic intracranial hypertension,CVST should be considered as an important possibility.%目的:分析不同发病形式的颅内静脉窦血栓形成(CVST)患者常见首发症状头痛的特征。方法回顾性收集2008年8月-2013年3月在西安交通大学第一附属医院、西安交通大学第二附属医院和西安高新医院住院的51例经MR静脉成像(MRV)或DSA确诊CVST患者的临床资料,包括主要临床表现及影像学检查结果。按发病时间将患者分为急性组(≤3周)32例;慢性组(>3周)19例。结果(1)51例患者首次发病年龄集中在20~40岁,且以女性多见。在诸多首发症状中,头痛居首位,占84.3%(43/51);以单纯头痛为首发症状占52.9%(27/51),以头痛伴有其他症状为首发症状(如眼科症状、偏

  12. Analysis of prognostic risk factors in patients with severe cerebral venous sinus thrombosis%重症颅内静脉系统血栓形成患者预后的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    宿英英; 王坤; 王淼; 陈卫碧; 叶红; 高岱佺; 张艳; 张运周

    2012-01-01

    目的 分析颅内静脉系统血栓形成(CVT)患者预后的影响因素. 方法 对80例重症CVT患者的临床资料进行回顾性队列分析.按结局分为生存组与死亡组,按格拉斯哥预后评分(GOS)分为预后良好组与预后不良组.临床资料及其预后采用单因素和多因素Logistic回归分析.结果 80例重症CVT患者出院时生存65例(81.2%),死亡15例(18.8%);预后良好49例(61.2%),预后不良31例(38.8%).①单因素Logistic回归分析结果显示,昏迷、格拉斯哥昏迷量表(GCS)评分≤8分、颅内出血、伴脑室受压/中线移位、脑疝、呼吸衰竭、低蛋白血症、低钾血症、高钠血症、血浆渗透压增高(10项因素)是死亡的影响因素.进入多因素Logistic回归分析显示,脑疝(OR=54.05,95%CI:3.40~ 859.55;P<0.01)、高钠血症(OR=22.50,95% CI:2.72 ~ 185.92;P< 0.01)、低钾血症(OR=17.30,95% CI:1.54 ~ 193.55;P=0.02)是死亡的独立危险因素.②年龄、性别、昏迷、GCS≤8分、病变累及≥3个静脉窦/静脉、伴脑室受压/中线移位、脑疝、肺炎、呼吸衰竭、高钠血症、低钾血症、血浆渗透压增高(12项因素)是预后不良的影响因素.经多因素Logistic回归分析,年龄(≥45岁)(OR=9.47,95% CI:1.71 ~52.46,P=0.01)和呼吸衰竭(OR=19.64,95% CI:3.06 ~ 126.02,P=0.002)是预后不良的独立影响因素. 结论 脑疝、高钠血症、低钾血症是重症CVT患者死亡的独立危险因素,中老年和呼吸衰竭是重症CVT患者预后不良的独立危险因素.%Objective To analyze the prognostic risk factors in patients with severe cerebral venous sinus thrombosis ( CVST). Methods The retrospective cohort analysis of the clinical data in 80 patients with severe CVST was conducted retrospectively. The patients were divided into either a survival group or a fatal group according to their outcomes. They were also divided into a good prognosis group and a poor prognosis group

  13. [Epidemiology and maternal thrombosis].

    Science.gov (United States)

    Bosson, Jean-Luc

    2003-01-01

    The monthly incidence of deep vein thrombosis during pregnancy varies from 0.1 to 0.8 per 1000 pregnancies, depending on the study. These figures are undoubtedly an underestimation because they were determined from clinical events with no estimation of asymptomatic forms which, in general, increase the prevalence about 3-fold. Although the absolute figures are reliable, the consequences in terms of maternal mortality and post-phlebitis sequelae warrant the careful attention paid to this condition. Moreover, it should be recalled that the prevalence of superficial venous thrombosis is similar and may be associated with a risk of pulmonary embolism.

  14. Predictive factors of the outcome of cerebral venous sinus thrombosis a retrospective case series study of 26 patients%脑静脉窦血栓形成转归的预测因素——26例回顾性病例系列研究

    Institute of Scientific and Technical Information of China (English)

    王中原; 李敬伟; 庞伟; 徐运

    2011-01-01

    Objective To investigate the predictive factors of long-term outcome of cerebral venous sinus thrombosis (CVST).Methods The clinical data of 26 patients with CVST were analyzed retrospectively.The clinical outcome was assessed with the modified Rankin Scale (mRS) at 6 months after symptom onset.Univariate and multivariate analysis were used to determine the independent predictors of the long-term poor outcome.Results The mRS scores for 26 patients with CVST:0 to 1 in 19 cases,2 in 2 cases,3 to 5 in 3 cases,and 6 in 2 cases.19.2% of patients had poor outcome (mRS score,≥3),and the mortality rate was 7.7%.The survivors did not have any recurrence within 6 months.Univariate analysis showed that disturbance of consciousness,papilloedema,cerebral edema,and cerebral deep venous thrombosis were the possible risk factors for poor outcome,while headache was the main clinical manifestation,which was negatively correlated with the poor prognosis.Multivariate regression analysis showed that disturbance of consciousness was an independent predictor of poor outcome in patients with CVST (odds ratio,48.0,95% confidence interval 2.311 to 997.176,P =0.012).Conclusions The long-term outcome of the patients was better,disturbance of consciousness was an independent predictor of poor outcome at 6 months after the onset.%目的 探讨脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)远期转归的预测因素.方法 回顾性分析26例CVST患者的临床资料,在发病后6个月应用改良Rankin量表(modified Ramkin Scale,mRS)评分评价临床转归.单变量和多变量分析确定远期转归不良的独立预测因素.结果 26例CVST患者mRS评分:0~1分19例,2分2例,3~5分3例,6分2例.19.2%的患者转归不良(mRS评分≥3分),病死率为7.7%,存活患者在6个月内均无复发.单变量分析显示,意识障碍、视盘水肿、脑水肿和脑深静脉血栓形成为转归不良的可能危险因素,而以头痛为主要表现与预后

  15. Sudden infant death syndrome, childhood thrombosis, and presence of genetic risk factors for thrombosis

    DEFF Research Database (Denmark)

    Larsen, TB; Nørgaard-Pedersen, B; Lundemose, JB

    2000-01-01

    . The vulnerability of the infant brain stem to ischemia has been suggested to be a conceivable cause of sudden infant death syndrome. This is compatible with a hypothesis that genetic risk factors for cerebral thrombosis could cause microinfarction in the brain stem during the first month of life, affecting vital......Sudden infant death syndrome or "cot death" has until the late eighties been a significant cause of death in children between the ages of 1 month and 1 year. Approximately two per 1000 children born alive dies of sudden infant death syndrome each year in Western Europe, North America, and Australia...... in the child. This prompted us to investigate these genetic markers of thromboembolic disease in 121 cases of sudden infant death syndrome and in relevant controls, in the expectation of a more frequent occurrence of these markers if thrombosis is an etiological factor in sudden infant death syndrome...

  16. Sudden infant death syndrome, childhood thrombosis, and presence of genetic risk factors for thrombosis

    DEFF Research Database (Denmark)

    Larsen, T B; Nørgaard-Pedersen, B; Banner, Jytte

    2000-01-01

    in the child. This prompted us to investigate these genetic markers of thromboembolic disease in 121 cases of sudden infant death syndrome and in relevant controls, in the expectation of a more frequent occurrence of these markers if thrombosis is an etiological factor in sudden infant death syndrome......Sudden infant death syndrome or "cot death" has until the late eighties been a significant cause of death in children between the ages of 1 month and 1 year. Approximately two per 1000 children born alive dies of sudden infant death syndrome each year in Western Europe, North America, and Australia....... The vulnerability of the infant brain stem to ischemia has been suggested to be a conceivable cause of sudden infant death syndrome. This is compatible with a hypothesis that genetic risk factors for cerebral thrombosis could cause microinfarction in the brain stem during the first month of life, affecting vital...

  17. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  18. Primary renal graft thrombosis

    NARCIS (Netherlands)

    Bakir, N; Sluiter, WJ; Ploeg, RJ; van Son, WJ; Tegzess, Adam

    1996-01-01

    Background. Renal allograft thrombosis is a serious complication of kidney transplantation that ultimately leads to graft loss. Its association with acute and hyperacute rejection is well documented; however, in a large proportion of patients the precise cause remains obscure. The exact incidence an

  19. Testosterone, thrombophilia, and thrombosis.

    Science.gov (United States)

    Glueck, Charles J; Richardson-Royer, Caitlin; Schultz, Reiker; Burger, Tim; Labitue, Fanta; Riaz, Muhammad K; Padda, Jagjit; Bowe, Dedrick; Goldenberg, Naila; Wang, Ping

    2014-01-01

    We describe thrombosis, deep venous thrombosis (DVT) pulmonary embolism (PE; n = 9) and hip-knee osteonecrosis (n = 5) that developed after testosterone therapy (median 11 months) in 14 previously healthy patients (13 men and 1 woman; 13 Caucasian and 1 African American), with no antecedent thrombosis and previously undiagnosed thrombophilia-hypofibrinolysis. Of the 14 patients, 3 were found to be factor V Leiden heterozygotes, 3 had high factor VIII, 3 had plasminogen activator inhibitor 1 4G4G homozygosity, 2 had high factor XI, 2 had high homocysteine, 1 had low antithrombin III, 1 had the lupus anticoagulant, 1 had high anticardiolipin antibody Immunoglobulin G, and 1 had no clotting abnormalities. In 4 men with thrombophilia, DVT-PE recurred when testosterone was continued despite therapeutic international normalized ratio on warfarin. In 60 men on testosterone, 20 (33%) had high estradiol (E2 >42.6 pg/mL). When exogenous testosterone is aromatized to E2, and E2-induced thrombophilia is superimposed on thrombophilia-hypofibrinolysis, thrombosis occurs. The DVT-PE and osteonecrosis after starting testosterone are associated with previously undiagnosed thrombophilia-hypofibrinolysis. Thrombophilia should be ruled out before administration of exogenous testosterone.

  20. Mesenteric vein thrombosis: CT identification

    Energy Technology Data Exchange (ETDEWEB)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-07-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis.

  1. [Unusual venous thrombosis revealing a human immunodeficiency virus infection and a protein S deficiency. Two cases and literature review].

    Science.gov (United States)

    Konin, C; Adoh, M; Adoubi, A; Anzouan-Kacou, J B; Azagoh, R; N'guetta, R; Kramoh, E; Séka, R

    2008-06-01

    The authors report two cases of unusual venous thrombosis associated with protein S deficiency in patients with the acquired immunodeficiency syndrome. The first case was a superior mesenteric vein thrombosis caused by HIV-1 infection associated with protein S deficiency in a 53-year-old patient. The second case was a cerebral venous thrombosis in a 34-year-old patient with HIV-1 and HIV-2 infections associated with protein S deficiency. None of the two patients were receiving antiretroviral therapy at the time of diagnosis. The evolution of thrombosis was favorable in both patients with heparin therapy and antivitamin K (AVK).

  2. Sagittal venous sinus thrombosis after cesarean section: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2013-07-01

    Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

  3. Curative effect of aspirin combined with clopidogrel in the treatment of patients with progress cerebral arterial thrombosis and its influence on hs-CRP levels%阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中的疗效及对hs-CRP水平的影响

    Institute of Scientific and Technical Information of China (English)

    邱麟; 高正伟; 罗志娟; 李盼; 李少波

    2015-01-01

    目的 探讨阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中的疗效及对高敏C反应蛋白( hs-CRP)水平的影响.方法 将108例进展性缺血性脑卒中患者,按随机数字表法分成观察组和对照组,每组各54例. 观察组采用阿司匹林联合氯吡格雷治疗;对照组单用阿司匹林治疗,疗程均为15 d. 治疗前后检测临床神经缺损程度及血清hs-CRP水平,并观察治疗后临床疗效及不良反应. 结果 两组神经功能缺损程度评分及血清hs-CRP水平比较,差异有统计学意义(P0. 05);观察组疗效、总有效率均优于对照组(P0. 05). 结论 阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中患者的神经功能恢复及疗效均优于单用阿司匹林,且血清hs-CRP水平也显著降低.%Objective To investigate the curative effect of aspirin combined with clopidogrel in the treatment of patients with progress cerebral arterial thrombosis and its influence on hs-CRP levels. Methods 108 cases of patients with progress cerebral arterial throm-bosis were randomly divided into two groups of 54 cases in each. The observation group used therapy aspirin combined with clopi-dogrel,control group used aspirin therapy,all for 15 d. Evaluated the clinical neurological defect degree and tested the level of serum hs-CRP before and after treatment,and the clinical efficacy and adverse reactions were observed after treatment. Results The differ-ence of the degree of nerve function defect score and serum hs CRP level between two groups was statistically significant (P0. 05). The effect and the total effective rate of observation group were better than the control group(P0. 05). Conclusion The nerve function and the curative effects of patients with progress cerebral arterial thrombosis who were treated with aspirin combined with clopidogrel were superior to aspirin alone,and the serum hs-CRP level significantly decreased.

  4. Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome

    Directory of Open Access Journals (Sweden)

    Miriam Michel

    2015-01-01

    Full Text Available Background. The causes of cerebral venous thrombosis (CVT are manifold as is its clinical presentation. Case. We report the case of a CVT following lumbar puncture and intravenous glucocorticosteroid therapy in a female adolescent with a clinically isolated syndrome and risk factors for thrombosis. Conclusion. In adolescent patients with acute inflammatory disease undergoing lumbar puncture followed by intravenous high-dose glucocorticosteroid therapy, one should be aware of the elevated risk for thrombosis. A persistent headache with change in the headache pattern and loss of a postural component might be a sign for CVT, requiring emergency imaging of the brain.

  5. Neonatal renal vein thrombosis.

    Science.gov (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  6. A Rare Case of Transverse Sinus Venous Thrombosis Simulating Postdural Puncture Headache After Cervical Epidural Injection.

    Science.gov (United States)

    Guirguis, Maged; Jusino, Eduardo; Tolba, Reda; Samuel, Samuel

    2016-08-01

    Postdural puncture headache (PDPH) is a feared complication related to epidural steroid injections. We report a unique case in which all subjective and objective findings indicated the diagnosis of PDPH. However, the patient failed appropriate conservative and interventional management. Therapeutic failure prompted further investigation to establish the correct diagnosis of cerebral venous sinus thrombosis. Cerebral venous sinus thrombosis is a rare, difficult to diagnose, but potentially lethal disorder with nonspecific and variable clinical presentations, including headache and focal neurological deficits. Performing magnetic resonance imaging and magnetic resonance venogram should be considered early, especially in patients who fail to respond to standard interventions for PDPH.

  7. Antithrombin gene Arg197Stop mutation-associated venous sinus thrombosis in a Chinese family

    Institute of Scientific and Technical Information of China (English)

    Ang Li; Dexin Wang; Qiming Xue; Baoen Wang; Tianhui Liu; Zhandong Liu; Jimei Li; Chunling Zhang; Jun Chen; Jinmei Sun; YanfeiHan; Lili Wang

    2011-01-01

    This study sought to elucidate the genetic correlation of cerebral venous sinus thrombosis caused by a hereditary antithrombin deficiency in a Chinese family, at the genetic and protein levels. A nonsense mutation from C to T on locus 6431 in exon 3B of the antithrombin gene was observed,leading to an arginine (CGA) to stop codon (TGA) change in the protein. This is the first report of this mutation in China. Ineffective heparin therapy in the propositus patient is associated with a lack of heparin binding sites after antithrombin gene mutation. Characteristic low intracranial pressure in the acute phase might be specific to this patient with cerebral venous sinus thrombosis.

  8. Numerical simulations of thrombosis

    Directory of Open Access Journals (Sweden)

    Naveen Kumar G Ramunigari

    2013-01-01

    Full Text Available Background: Mathematical approaches for biological events have gained significant importance in development of biomedical research. Deep vein thrombosis (DVT is caused by blood clot in veins deeply rooted in the body, resulting in loss of blood, pain, and numbness of the body part associated with that vein. This situation can get complicated and can be fatal, when the blood clot travels to other parts of the body which may result in pulmonary embolism (PE. PE causes approximately 300,000 deaths annually in the United States alone. Materials and Methods: We are trying to propose a computational approach for understanding venous thrombosis using the theory of fluid mechanics. In our study, we are trying to establish a computational model that mimics the venous blood flow containing unidirectional venous valves and will be depicting the blood flow in the veins. We analyzed the flow patterns in veins, which are included with lump like substances. This lump like substances can be clots, tissue debris, collagen or even cholesterol. Our study will facilitate better understanding of the biophysical process in case of thrombosis. Results: The predicted model analyzes the consequences that occur due to the clot formations in veins. Knowledge of Navier-Stokes equations in fluid dynamics along with the computational model of a complex biological system would help in diagnosis of the problem at much faster rate of time. Valves of the deep veins are damaged as a result of DVT, with no valves to prevent deep system reflux, the hydrostatic venous pressure in the lower extremity increases dramatically. Conclusion: Our model is used to determine the effects of an interrupted blood flow as a result of thrombin formation, which might result in disturbed systemic circulation. Our results indicated a positive inverse correlation exists between clots and the flow velocity. This would support medical practitioners to recommend faster curing measures.

  9. Testosterone, thrombophilia, thrombosis.

    Science.gov (United States)

    Freedman, Joel; Glueck, Charles J; Prince, Marloe; Riaz, Rashid; Wang, Ping

    2015-05-01

    We screened previously undiagnosed thrombophilia (V Leiden-prothrombin mutations, Factors VIII and XI, homocysteine, and antiphospholipid antibody [APL] syndrome) in 15 men and 2 women with venous thromboembolism (VTE) or osteonecrosis 7 months (median) after starting testosterone therapy (TT), gel (30-50 mg/d), intramuscular (100-400 mg/wk), or human chorionic gonadotropin (HCG) (6000 IU/wk). Thrombophilia was studied in 2 healthy control groups without thrombosis (97 normal controls, 31 subjects on TT) and in a third control group (n = 22) with VTE, not on TT. Of the 17 cases, 76% had ≥1 thrombophilia vs 19% of 97 normal controls (P 150%) (24% vs 7%, P = 0.058), by high homocysteine (29% vs 5%, P = 0.007), and from both normal and TT controls for APL syndrome (18% vs 2%, P = 0.023, vs 0%, P = 0.04). Despite adequate anticoagulation with TT continued after the first deep venous thrombosis-pulmonary embolus (DVT-PE), 1 man sustained 3 DVT-PEs 5, 8, and 11 months later and a second man had 2 DVT-PEs 1 and 2 months later. Of the 10 cases with serum T measured on TT, 6 (60%) had supranormal T (>800 ng/dL) and of 9 with estradiol measured on TT, 7 (78%) had supranormal levels (>42.6 pg/mL). TT interacts with thrombophilia leading to thrombosis. TT continuation in thrombophilic men is contraindicated because of recurrent thrombi despite anticoagulation. Screening for thrombophilia before starting TT should identify subjects at high risk for VTE with an adverse the risk to benefit ratio for TT.

  10. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  11. Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Del-Rio Camacho, G.; Leal Orozco, A.; Camino Lopez, M.; Ruiz-Moreno, M. [Dept. of Paediatrics, Fundacion Jimenez Diaz, Madrid (Spain); Perez-Higueras, A.; Al-Assir, I. [Dept. of Neuroradiology, Fundacion Jimenez Diaz, Madrid (Spain)

    2001-02-01

    A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is described. She was diagnosed after acute neurological deterioration by MRI and angiography. Recombinant tissue plasminogen activator (r-TPA) was injected locally to recanalise the thrombus. The patient's condition significantly improved and she was discharged. After 2 years of follow-up the child remains asymptomatic. Moyamoya syndrome and cerebral venous thrombosis should not be overlooked as a cause of acute neurological deterioration in a child with Down's syndrome. MRA appears to be a safe and accurate alternative to traditional angiography for the diagnosis of moyamoya disease. Local fibrinolysis with r-TPA is the treatment of choice for cerebral venous thrombosis due to its safety and efficacy. (orig.)

  12. Cerebral infarction in patient with minimal change nephrotic syndrome.

    Science.gov (United States)

    Babu, A; Boddana, P; Robson, S; Ludeman, L

    2013-01-01

    We report a case of 68-year-old Caucasian man who presented with cerebral infarcts secondary to arterial thrombosis associated with nephrotic syndrome. His initial presentation included edema of legs, left hemiparesis, and right-sided cerebellar signs. Investigations with computed tomography and magnetic resonance imaging of brain showed multiple cerebral infarcts in middle cerebral and posterior cerebral artery territory. Blood and urine investigations also showed impaired renal function, hypercholesterolemia, hypoalbuminaemia, and nephrotic range proteinuria. Renal biopsy showed minimal change disease. Cerebral infarcts were treated with antiplatelet agents and nephrotic syndrome was treated with high dose steroids. Patient responded well to the treatment and is all well till date.

  13. Increased rheumatoid factor and deep venous thrombosis

    DEFF Research Database (Denmark)

    Meyer-Olesen, Christine L; Nielsen, Sune F; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: The risk of deep venous thrombosis is increased in patients with rheumatoid arthritis. We tested the hypothesis that increased concentrations of rheumatoid factor are associated with increased risk of deep venous thrombosis in individuals without autoimmune rheumatic disease...... venous thrombosis. CONCLUSIONS: Increased rheumatoid factor in the general population was associated with up to 3-fold increased long-term risk and up to 9-fold increased 1-year risk of deep venous thrombosis....... was incident deep venous thrombosis. There were no losses to follow-up. RESULTS: During 368381 person-years, 670 individuals developed deep venous thrombosis. A rheumatoid factor concentration ≥ vs venous thrombosis, with multivariable adjusted hazard...

  14. Epidemiology of recurrent venous thrombosis

    Directory of Open Access Journals (Sweden)

    D.D. Ribeiro

    2012-01-01

    Full Text Available Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

  15. 吸烟大鼠脑血管内皮细胞P-选择素、E-选择素表达在脑血栓形成中的作用%Effect of cigarette smoking on expression of P-selectin and E-selectin on cerebrovascular endothelial cells in rat's cerebral thrombosis

    Institute of Scientific and Technical Information of China (English)

    柳忠兰; 冯昱; 刘淑杰; 刘菲; 耿建红

    2005-01-01

    目的观察吸烟大鼠脑动脉内皮细胞P-选择素、E-选择素表达,探讨吸烟致脑血栓形成的机制.方法建立吸烟动物模型,将50只大鼠随机分为正常对照组,短期大量吸烟组,长期小量吸烟组,长期大量吸烟组,戒烟组.免疫组织化学法检测大鼠脑动脉内皮细胞p-选择素、E-选择素和TNF-α的表达.结果吸烟大鼠脑血管内皮细胞P-选择素、E-选择素和TNF-α表达较不吸烟鼠明显增加(P<0.05).长期大量吸烟组P-选择素、E-选择素和TNF-α表达比其他各组明显增多,戒烟组P-选择素、E-选择素和TNF-α表达下降,与其他各吸烟组相比有显著性差异(P<0.05).结论吸烟致大鼠脑血管内皮细胞P-选择素、E-选择素和TNF-α表达升高是脑血栓形成的重要机制之一.%[Objective] To observe the expression of P-selectin and E-selectin on cerebrovascular endothelial cells of smoking rats in order to investigate pathogenesis of cerebral thrombosis induced by cigarette smoking.[Methods] Animal model of smoking rats were made, 50 male wistar rats were randomly grouped into normal control, short-term massive, long-term trifle, long-term massive and anti-smoking. Immunohistochemical technique was used to detect the expression of P-selectin, E-selectin and TNF-α in rat' s cerebrovascular endothelial cells. [Results] Compared with normal control, expression of P-selectin, E-selectin and TNF-α was increased notably in smoking groups (P <0.05). Expression of P-selectin, E-selectin and TNF-αin long-term massive smoking rats was significantly stronger than other groups. Expression of P-selectin, E-selectin and TNF-αwas decreased after antismoking and there were sifnificant differences compared with other groups (P <0.05). [Conclusion] Cigarette smoking increases expression of P-selectin, E-selectin and TNF-αin rat' s cerebrovascular endothelial cells, which may be one of pathogenesises in cerebral thrombosis.

  16. Vitamin K and thrombosis.

    Science.gov (United States)

    Merli, Geno J; Fink, James

    2008-01-01

    Vitamin K was discovered in the 1930s during cholesterol metabolism experiments in chickens. It is a fat-soluble vitamin which occurs naturally in plants as phylloquinone (vitamin K1) and is produced by gram-negative bacteria in the human gastrointestinal tract as menaquinone (vitamin K2). This vitamin was found to be essential for normal functioning of hemostasis. In addition, a number of clinical conditions in which vitamin K deficiency was found to be the underlying pathophysiologic problem were discovered. These conditions include hemorrhagic disease of the newborn, obstructive jaundice, and malabsorption syndromes. The importance of this vitamin has become more apparent with the discovery of the anticoagulant warfarin which is a vitamin K antagonist. There are millions of patients on this therapy for a variety of thrombogenic conditions such as atrial fibrillation, deep vein thrombosis, pulmonary embolism, and prosthetic cardiac valves. The wide use of this narrow therapeutic index drug has resulted in significant risk for major bleeding. Vitamin K serves as one of the major reversing agent for patients over-anticoagulated with warfarin. In the past few years, research has focused on new areas of vitamin K metabolism, which include bone and endovascular metabolism; cell growth, regulation, migration, and proliferation; cell survival, apoptosis, phagocytosis, and adhesion. These new areas of research highlight the significance of vitamin K but raise new clinical questions for patients who must be maintained on long-term warfarin therapy.

  17. Thrombosis in nephrotic syndrome.

    Science.gov (United States)

    Barbano, Biagio; Gigante, Antonietta; Amoroso, Antonio; Cianci, Rosario

    2013-07-01

    Nephrotic syndrome (NS) is characterized by heavy proteinuria, edema, hypoalbuminemia, and hyperlipidemia and the most frequent causes are glomerular diseases. An uncommon presentation is iatrogenic NS, an adverse effect of some drugs administration. In the clinical course of NS, a typical feature is dysregulated coagulation state, promoted by the breakdown of permselectivity barrier of the glomerular capillary wall, resulting in the leakage of high-molecular-mass proteins, at least the size of albumin. This hypercoagulable condition is supported by several factors, such as abnormalities in platelet activation and an imbalance between anticoagulation/antithrombosis and procoagulant/prothrombotic mechanisms. Thus, NS and the risk of developing thromboses are strictly related. Thrombotic events affect the venous system rather than arterial vessels with different features and frequencies. Deep venous system of the lower extremities and renal veins are the most frequent source of pulmonary embolism, the most dangerous NS complication. Prophylactic anticoagulation and thrombosis treatment are not clearly established because large randomized trials and guidelines are lacking. The management of NS and the decision of when and how to anticoagulate the patient represent a teamwork challenge for physicians.

  18. Prevalence of Janus kinase 2 mutations in patients with unusual site venous thrombosis

    Directory of Open Access Journals (Sweden)

    Ana Lisa Basquiera

    2011-08-01

    Full Text Available We aimed to study patients with splanchnic vein thrombosis (SVT and cerebral vein thrombosis (CVT searching for JAK2 mutations. We evaluated 14 patients (median age: 41.5 years with portal vein thrombosis (PVT = 7; mesenteric vein thrombosis (MVT = 3; and CVT = 4. JAK2 V617F was assessed by allele specific PCR of peripheral blood DNA. In addition, DNA was sequenced for other JAK2 mutations. Other inherited and acquired thrombophilia risk factors were evaluated. JAK2 V617F was positive in four out of seven patients with PVT and in one CVT patient. These five patients had a diagnosis of myeloproliferative disorder (MPD at the moment of the occurrence of thrombosis (n = 2 or later (n = 2. Patients with MVT and CVT were negative for JAK2 V617F, except one patient with CVT and a diagnosis of essential thrombocythemia. No other JAK2 mutations were found in this cohort. Besides MPD, other thrombophilia risk factors were identified in five patients. One patient had MPD as well as thrombophilia risk factor. In this group, 4 out of 7 of the patients with PVT carried the JAK2 V617F mutation with or without overt MPD. However, the investigation of other JAK2 mutations may not be necessary in patients with thrombosis at unusual sites.

  19. 窦内尿激酶溶栓可改善脑静脉窦血栓形成患者的转归%Intra-sinus thrombolysis by using urokinase may improve the outcomes in patients with cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    孫成梅; 居克舉; 李明超; 徐運

    2014-01-01

    Objective To compare the effects of intra-sinus thrombolysis by using urokinase and heparin anticoagulation alone for cerebral venous sinus thrombosis (CVST).Methods Consecutive inpatients with CVST were enrolled retrospectively.Their demographic and clinical data were collected.The treatment mainly consists of intra-sinus thrombolysis by using urokinase and heparin anticoagulation alone.The outcomes were evaluated according to the modified Rankin scale (mRS) at 6 months.The mRS score < 2 was defined as good outcome,and ≥2 was defined as poor outcome.Results A total of 36 patients were enrolled,including intra-sinus thrombolysis by using urokinase (n =18) and heparin anticoagulation alone (n =18).Twenty-one had good outcomes and 15 had poor outcomes.After treatment,the recanalization rate (94.4% vs.66.7% ;x2 =3.850,P=0.041) of the urokinase thrombolysis group and the good outcome rate at 6 months (72.2% vs.44.4% ; x2 =3.827,P =0.046) were significantly higher than those of the heparin anticoagulation group.The proportion of the patients receiving intra-sinus thrombolysis by using urokinase of the good outcome group was significantly higher than that of the heparin anticoagulation group (60.0% vs.18.2 % ; x2 =5.360,P =0.021).Multivariate logistic regression analysis showed that the intrasinus thrombolysis by using urokinase was an independent protective factor for good outcomes in patients with CVST (odds ratio,1.085,95% confidence interval 1.024-1.361; P=0.023),and the high coagulation state was its independent risk factor (odds ratio,0.185,95% confidence interval 0.049-0.611;P=0.004).None of the patients occurred symptomatic cerebral hemorrhage.Conclusions Intra-sinus thrombolysis with urokinase may improve the outcomes for patients with CVST,and it is superior to the heparin anticoagulation alone.%目的 比较窦内尿激酶溶栓与单纯肝素抗凝治疗脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的效果.方法 回顾

  20. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  1. Hormonal contraception, thrombosis and age

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind

    2014-01-01

    INTRODUCTION: This paper reviews the risk of thrombosis with use of different types of hormonal contraception in women of different ages. AREAS COVERED: Combined hormonal contraceptives with desogestrel, gestodene, drospirenone or cyproterone acetate (high-risk products) confer a sixfold increased......: First choice in women below 35 years should be a combined low-risk pill, that is, with a second-generation progestin, with the lowest compliable dose of estrogen. Young women with risk factors of thrombosis such as age above 35 years, genetic predispositions, adiposity, polycystic ovary syndrome...

  2. Thrombosis following ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Kasum, Miro; Danolić, Damir; Orešković, Slavko; Ježek, Davor; Beketić-Orešković, Lidija; Pekez, Marijeta

    2014-11-01

    The aim of this review is to analyse the pathophysiology and complications of thrombosis in conjuction with ovarian hyperstimulation syndrome (OHSS) following ovulation induction and to suggest practical guidelines usefull for the prevention and treatment. Although the incidence of thrombosis varies from 0.2% among in vitro fertilization (IVF) cycles and up to 10% for severe cases of the syndrome, it represents the most dangerous complication of OHSS. Different changes in haemostatic markers have been found to create a state of hypercoagulability, but no single standard test is available to estimate the state of thrombosis. The role of markers for thrombophilia is controversial. Thromboses are mostly venous (67-75%) involving upper limbs and neck, then arterial (25-33%) which are mainly intracerebral. The predominant sites of venous thromboembolism in the upper part of the body may be explained by higher concentrations of estrogens drained through lymphatic ducts from ascites and by compression of rudimentary branchyal cysts. Once early diagnosis is established, it is crucial to use an anticoagulant treatment with heparin proceeded with thromboprophylaxis. However, identification of patients at risk and preventive measures of OHSS are the best means in reducing the risk of thrombosis after ovarian stimulation.

  3. Hormonal contraceptives and venous thrombosis

    NARCIS (Netherlands)

    Stegeman, Berendina Hendrika (Bernardine)

    2013-01-01

    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a thromb

  4. Cavernous Sinus Thrombosis in Children

    Directory of Open Access Journals (Sweden)

    Rochelle Sweis

    2016-03-01

    Full Text Available Investigators from the Children’s Hospital of Philadelphia analyzed the clinical and radiographic findings in 12 cases of cavernous sinus thrombosis (CST seen between 2000 and 2013, and conducted a literature search and review of the pooled data.

  5. Venous thrombosis : a patient's view

    NARCIS (Netherlands)

    Korlaar, Inez van

    2006-01-01

    The studies described in this thesis had two main aims: 1) To study the quality of life of patients with venous thrombosis and to examine the role of illness perceptions in explaining the quality of life of these patients. 2) To assess the psychological consequences of genetic testing for thrombop

  6. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  7. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia. La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC.

  8. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  9. Cerebral sinustrombose ved Behçets sygdom

    DEFF Research Database (Denmark)

    Schytz, Henrik Winther; Wegener, Marianne; Lassen, Lisbeth Landschoff

    2012-01-01

    ). We present a case of a 32 year-old Lebanese woman with severe headache and papilloedema due to a cerebral venous thrombosis and secondary intracranial hypertension. During follow-up she was diagnosed with bilateral uveitis and a history of recidivating oral and genital ulcerations was disclosed. BD...

  10. Acute Arterial Thrombosis of the Hand.

    Science.gov (United States)

    Iannuzzi, Nicholas P; Higgins, James P

    2015-10-01

    Arterial thrombosis of the hand occurs infrequently but may result in considerable morbidity and compromise of hand function. The hand surgeon may be called upon to direct management in cases of acute arterial thrombosis of the hand and should have an understanding of the available diagnostic tools and treatment modalities. This article discusses the vascular anatomy of the hand and clinical manifestations of arterial thrombosis. Differences between isolated thrombosis and diffuse intravascular injury are detailed, and treatment options for these conditions are described. Appropriate care often requires coordination with interventional radiologists or vascular surgeons. Outcomes after treatment of arterial thrombosis of the hand are variable, and prognosis may be related to whether isolated thrombosis or diffuse intravascular injury is present.

  11. Thrombosis in pregnancy and maternal outcomes.

    Science.gov (United States)

    James, Andra H

    2015-09-01

    Pregnancy increases the risk of thrombosis four- to five-fold. Seventy-five to eighty percent of pregnancy-related thrombotic events are venous and twenty to -twenty-five percent are arterial. The main reason for the increased risk is hypercoagulability. Women are hypercoagulable because they have evolved so that they are protected against the bleeding challenges of pregnancy, miscarriage, or childbirth. Both genetic and acquired risk factors can further increase the risk of thrombosis. The maternal consequences of thrombosis of pregnancy include permanent vascular damage, disability, and death. While the maternal outcomes of thrombosis can be modified by anticoagulation therapy, management of thrombosis during pregnancy is the subject of another paper in this issue (see paper by B. Konkle). This review will focus on the epidemiology, pathophysiology, risk factors, and maternal consequences of thrombosis in pregnancy.

  12. Thrombosis in end-stage renal disease.

    Science.gov (United States)

    Casserly, Liam F; Dember, Laura M

    2003-01-01

    Although renal failure has classically been associated with a bleeding tendency, thrombotic events are common among patients with end-stage renal disease (ESRD). A variety of thrombosis-favoring hematologic alterations have been demonstrated in these patients. In addition, "nontraditional" risk factors for thrombosis, such as hyperhomocysteinemia, endothelial dysfunction, inflammation, and malnutrition, are present in a significant proportion of chronic dialysis patients. Hemodialysis (HD) vascular access thrombosis, ischemic heart disease, and renal allograft thrombosis are well-recognized complications in these patients. Deep venous thrombosis and pulmonary embolism are viewed as rare in chronic dialysis patients, but recent studies suggest that this perception should be reconsidered. Several ESRD treatment factors such as recombinant erythropoietin (EPO) administration, dialyzer bioincompatibility, and calcineurin inhibitor administration may have prothrombotic effects. In this article we review the pathogenesis and clinical manifestations of thrombosis in ESRD and evaluate the evidence that chronic renal failure or its management predisposes to thrombotic events.

  13. Epidemiology and Risk Factors for Venous Thrombosis

    OpenAIRE

    Cushman, Mary

    2007-01-01

    Venous thrombosis, including deep vein thrombosis and pulmonary embolism, occurs at an annual incidence of about 1 per 1000 adults. Rates increase sharply after around age 45 years, and are slightly higher in men than women in older age. Major risk factors for thrombosis, other than age, include exogenous factors such as surgery, hospitalization, immobility, trauma, pregnancy and the puerperium and hormone use, and endogenous factors such as cancer, obesity, and inherited and acquired disorde...

  14. Denaturing high-performance liquid chromatography for screening antithrombin Ⅲ gene mutation and polymorphisms in patients with cerebral venous thrombosis%应用变性高效液相色谱筛查颅内静脉系统血栓形成AT-Ⅲ基因突变及多态性

    Institute of Scientific and Technical Information of China (English)

    汪丽萍; 裘毓雯; 尹爱兰; 马云燕; 刘柯玲; 熊丽; 余艳红; 钟梅; 王辰

    2009-01-01

    Objective To identify antithrombin Ⅲ(AT- Ⅲ) gene mutation and polymorphisms in pregnant women and parturients with cerebral venous thrombosis (CVT) using denaturing high-performance liquid chromatography (DHPLC). Methods The genomic DNA was extracted from the blood samples of 50 pregnant women and parturients with CVT and 52 matched healthy women for molecular analysis using a PCR/DHPLC assay followed by DNA sequence analysis. Ten primer pairs were designed for amplifying the AT-Ⅲ promoter region and exons 1-6 including the exon/intron boundaries. A rapid screening assay based on DHPLC was established to screen the mutation and polymorphisms of AT- Ⅲ gene. Results Six abnormal peaks were detected in 40 of the patients by DHPLC. Direct DNA sequencing was performed on representative samples detected by DHPLC profiling. One pathogenic heterozygous G13328A missense mutation in exon 6, and a novel silent mutation in exon 4+243 G>A were identified. Six single nucleotide polymorphism (SNP) sites were found, including 4 previously reported ones in the SNP library and two were novel SNP sites. An abnormal peak was detected in the control group by DHPLC. Conclusion DHPLC allows automated and rapid high-throughput detection of AT-Ⅲ gene mutation and polymorphisms in the clinical setting and prenatal diagnosis. Our findings suggested that AT-Ⅲ gene mutation, as well as its polymorphisms, contributes to the occurrence of CVT in pregnant women and parturients.%目的 应用变性高效液相色谱(DHPLC)方法筛查生育期女性颅内静脉系统血栓形成(CVT)AT-Ⅲ基因的突变及多态性.方法 标本来自于2006年6月~2007年12月南方医院生育期女性CVT患者,及52例严格配伍的健康女性外周静脉血.提取所有受试者全血DNA.PCR扩增后应用变性高效液相色谱(DHPLC)技术分析抗凝血酶-Ⅲ(AT-Ⅲ)基因的启动子区,第1~6外显子及其侧翼序列的基因变异情况.结果 DHPLC技

  15. Combined use of cellulose acetate polymer and retrievable platinum coils for the thrombosis of cervical carotid aneurysms.

    Directory of Open Access Journals (Sweden)

    Hirotsune N

    2000-08-01

    Full Text Available Cellulose acetate polymer (CAP solution is a new liquid embolic material, and it has been used clinically for the thrombosis of cerebral aneurysms. The purpose of the study was to test a method of aneurysm treatment. In an experimental model, retrievable interlocking detachable coils (IDCs were used to create an intraaneurysmal frame or prop and then CAP was injected into 20 experimentally induced canine cervical aneurysms. Intraaneurysmal thrombosis was induced 1 week after aneurysm creation. Complete thrombosis was attempted in 12 aneurysms, and partial thrombosis was attempted in 4. Four other aneurysms served as controls. Follow-up angiography was performed for up to 8 weeks, and with the exception of 4 aneurysms, which were kept for a 2-year long-term follow-up study, the aneurysms were then harvested for histological examination. Thrombosis was successfully achieved in all cases except for 2 enlarged aneurysms that were initially partially thrombosed. No thromboembolism to distal vessels was observed. No compaction or shift of the CAP-IDC complex occurred even after 2 years. Histologically, CAP and IDCs conformed to the massive thrombotic complex without any fragmentation. By creating a frame or prop with retrievable microcoils, we were able to inject the CAP implies a comparison safely and precisely than has been previously reported. Our findings suggest that this method will be useful for the treatment of cerebral aneurysms.

  16. PORTAL VEIN THROMBOSIS-ULTRASOUND IMAGING

    Directory of Open Access Journals (Sweden)

    Trajkovska Meri

    2016-07-01

    Full Text Available Portal venous system, apart from the main portal vein, includes its tributaries: superior and inferior mesenteric vein, as well as splenic vein, so the term portal venous thrombosis encompasses a broad spectrum of pathological conditions. Usually, one or more causative factors can be recognized, either local endothelial/ flow disturbances, or systemic inherited /acquired conditions. Portal vein thrombosis can be associated with benign or malignant disorders. Weather we are speaking about acute or chronic thrombosis, the clinical presentation is different. Acute thrombosis can be presented in a wide range, from mild abdominal discomfort to a state of intestinal ischemia and life-threatening infarction. Chronic thrombosis is usually recognized when variceal bleeding or other symptoms of portal hypertension express. Fast and accurate diagnosis sometimes is a life-saving procedure, especially in acute vascular alterations. Recently, due to the improvement of imaging procedures the number of patients with diagnosed portal vein thrombosis is increasingly growing. With a negative predictive value of 98% color Doppler ultrasound is considered as imaging modality of choice in detecting portal vein thrombosis. Based on large studies it is presumed that overall risk of getting portal vein thrombosis during lifetime is 1% in general population, but much bigger 5%-15% in cirrhotic patients. Existence of specific ultrasound criteria, if fulfilled, has ensured that diagnosis of portal vein thrombosis is fast and non-invasive. Procedure is convenient for the patient and healthcare providers, and above all, allows prompt treatment preventing further deterioration.

  17. Sonographic Findings in Fetal Renal Vein Thrombosis.

    Science.gov (United States)

    Gerber, Rebecca E; Bromley, Bryann; Benson, Carol B; Frates, Mary C

    2015-08-01

    We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.

  18. Post-partum transverse sinus thrombosis presenting as acute psychosis.

    Science.gov (United States)

    Dhasmana, Devesh Janardan; Brockington, Ian F; Roberts, Ann

    2010-08-01

    Whilst cerebral vascular disease and mental illness in the post-partum period are well recognised, their co-existence and the concept of organic psychoses in pregnancy, parturition and the puerperium remains poorly appreciated (Brockington 2006; Brockington Arch Women's Ment Health 10: 177-178, 2007a; Brockington Arch Women's Ment Health 10: 305-306, b). We report a woman who was referred to the Medical team on-call with a mixed presentation of euphoria, mutism and aggressive behaviour but ultimately demonstrated to have a transverse sinus thrombosis and recovered well with anti-coagulation. This serves an important reminder of the implications of a missed medical diagnosis in this high-risk and vulnerable group of patients.

  19. Sex-specific aspects of venous thrombosis

    NARCIS (Netherlands)

    Roach, Rachel Elizabeth Jo

    2014-01-01

    Venous thrombosis is a disease that occurs in 1-2 per 1000 people per year. At the time of their first venous thrombosis, approximately 50% of women are exposed to reproductive risk factors (oral contraception, postmenopausal hormone therapy, pregnancy and the puerperium). In this thesis, we showed

  20. A Patient with Recurrent Arteriovenous Graft Thrombosis.

    Science.gov (United States)

    Allon, Michael

    2015-12-01

    Arteriovenous grafts (AVGs) are prone to frequent thrombosis that is superimposed on underlying hemodynamically significant stenosis, most commonly at the graft-vein anastomosis. There has been great interest in detecting AVG stenosis in a timely fashion and performing preemptive angioplasty, in the belief that this will prevent AVG thrombosis. Three surveillance methods (static dialysis venous pressure, flow monitoring, and duplex ultrasound) can detect AVG stenosis. Whereas observational studies have reported that surveillance with preemptive angioplasty substantially reduces AVG thrombosis, randomized clinical trials have failed to confirm such a benefit. There is a high frequency of early AVG restenosis after angioplasty caused by aggressive neointimal hyperplasia resulting from vascular injury. Stent grafts prevent AVG restenosis better than balloon angioplasty, but they do not prevent AVG thrombosis. Several pharmacologic interventions to prevent AVG failure have been evaluated in randomized clinical trials. Anticoagulation or aspirin plus clopidogrel do not prevent AVG thrombosis, but increase hemorrhagic events. Treatment of hyperhomocysteinemia does not prevent AVG thrombosis. Dipyridamole plus aspirin modestly decreases AVG stenosis or thrombosis. Fish oil substantially decreases the frequency of AVG stenosis and thrombosis. In patients who have exhausted all options for vascular access in the upper extremities, thigh AVGs are a superior option to tunneled internal jugular vein central vein catheters (CVCs). An immediate-use AVG is a reasonable option in patients with recurrent CVC dysfunction or infection. Tunneled femoral CVCs have much worse survival than internal jugular CVCs.

  1. Successful management of neonatal renal venous thrombosis.

    Science.gov (United States)

    Piscitelli, Antonio; Galiano, Rossella; Piccolo, Vincenzo; Concolino, Daniela; Strisciuglio, Pietro

    2014-10-01

    Renal vein thrombosis is the most common vascular condition involving the newborn kidney and it can result in severe renal damage. We report a newborn with renal vein thrombosis treated with continuous infusion of unfractionated heparin who had normal total renal function after 3 years of follow up, despite reduction of the functional contribution of the affected kidney.

  2. Prevention and treatment of hemodialysis access thrombosis

    NARCIS (Netherlands)

    Smits, Johannes Henricus Maria

    2001-01-01

    Thrombosis of the vascular access is the main problem in hemodialysis therapy for end-stage renal disease. In most cases, thrombosis is associated with the presence of one or more stenoses in the access. These stenoses are due to progressive neointimal hyperplasia. In this thesis, methods are descri

  3. [Aortic and cerebral trombosis caused by hypernatremic dehydration in an exclusively breast-fed infant].

    Science.gov (United States)

    Iglesias Fernández, C; Chimenti Camacho, P; Vázquez López, P; Guerrero Soler, M; Blanco Bravo, D

    2006-10-01

    Complete aortic thrombosis is rare in neonates. Because it carries high morbidity and mortality, this entity requires aggressive and early treatment. This report describes an 8-day-old healthy and exclusively breast-fed infant, without specific coagulopathy, who developed complete aortic and cerebral venous thrombosis, which was attributed to inadequate breast-feeding and severe hypernatremic dehydration. Early systemic anticoagulation and thrombolytic therapy allowed complete resolution of the problem.

  4. Prevention of stent thrombosis: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Reejhsinghani R

    2015-01-01

    Full Text Available Risheen Reejhsinghani, Amir S LotfiDivision of Cardiology, Baystate Medical Center, Springfield, MA, USAAbstract: Stent thrombosis is an uncommon but serious complication which carries with it significant mortality and morbidity. This review analyzes the entity of stent thrombosis from a historical and clinical perspective, and chronicles the evolution of this condition through the various generations of stent development, from bare metal to first-generation, second-generation, and third-generation drug-eluting stents. It also delineates the specific risk factors associated with stent thrombosis and comprehensively examines the literature related to each of these risks. Finally, it highlights the preventative strategies that can be garnered from the existing data, and concludes that a multifactorial approach is necessary to combat the occurrence of stent thrombosis, with higher risk groups, such as patients with ST segment elevation myocardial infarction, meriting further research.Keywords: stent thrombosis, preventative strategies, post-procedural myocardial infarction

  5. Detection of acute cerebral ischaemia with Tc-99m apcitide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Tepmongkol, S. [Nuclear Medicine Division, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Bangkok 10330 (Thailand)

    2002-10-01

    The established indication for Tc99m apcitide scintigraphy is for detecting deep venous thrombosis. However, due to its mechanism of binding to GP IIb/IIIa receptors on activated platelets, it can be used to image acute cerebral thrombosis. I report a patient with an acute ischaemic stroke, with right leg swelling, referred for Tc99m apcitide scintigraphy to show of deep venous thrombosis. There was no abnormal uptake in the legs but there was in the left parieto-occipital region. This correlated with the clinical and CT data, indicating an acute ischaemic stroke in this area. (orig.)

  6. Advances in diagnosis and treatment of cerebral venous system diseases

    Directory of Open Access Journals (Sweden)

    Xiao-yun LIU

    2016-11-01

    Full Text Available Cerebral venous system diseases include cerebral venous thrombosis (CVT, venous sinus stenosis, carotid cavernous fistula (CCF, intracranial arteriovenous malformation (AVM and so on. In recent years, due to the rapid development of neuroimaging and interventional technology, more and more cerebral venous system diseases have been timely diagnosed and treated, such as magnetic resonance black-blood thrombus imaging (MRBTI in the diagnosis of CVT, stenting in the treatment of venous sinus stenosis, micro coil plus Onyx glue or covered stents in the treatment of CCF, which allow us to make a deeper recognition of cerebral venous system diseases. Therefore, this paper will introduce the latest diagnosis and treatment of cerebral venous system diseases. DOI: 10.3969/j.issn.1672-6731.2016.11.006

  7. Trombose da veia de Galeno: relato de caso Galen vein thrombosis: case report

    Directory of Open Access Journals (Sweden)

    Marcio Chaves Pedro Marques

    2003-06-01

    Full Text Available A trombose venosa cerebral (TVC é doença vascular com diferentes manifestações clínicas e várias causas possíveis (locais, sistêmicas ou idiopáticas. A trombose da veia de Galeno (TVG é causa rara de TVC e geralmente está associada a alguma malformação vascular. Relatamos o caso de uma paciente de 16 anos que apresentou TVG sem malformação vascular, porém associada a trombose de seio reto e infarto venoso talâmico. Discutem-se também aspectos importantes do diagnóstico clínico, radiológico e laboratorial da TVC.Cerebral venous thrombosis (CVT is a vascular disease with many clinical manifestations and possible etiologies (local, systemic or idiopathic. Galen vein thrombosis (GVT is a rare cause of CVT and usually it is associated with some vascular malformation. We report a case of a 16 years old female patient with GVT without vascular malformation, but associated with straight sinus thrombosis and venous thalamic infarct. Relevant aspects of the clinical, radiological and laboratory diagnosis of CVT are also discussed.

  8. Risk factors of thrombosis in abdominal veins

    Institute of Scientific and Technical Information of China (English)

    Amit Kumar Durra; Ashok Chacko; Biju George; Joseph Anjilivelil Joseph; Sukesh Chandran Nair; Vikram Mathews

    2008-01-01

    AIM: To estimate the prevalence of inherited and acquired thrombophilic risk factors in patients with abdominal venous thrombosis and to compare the risk factor profiles between Budd-Chiari syndromes (BCS) and splanchnic vein thrombosis (SVT).METHODS: In this retrospective study, 36 patients with abdominal venous thrombosis were studied.The patients were divided into Budd-Chiari group (hepatic vein, IVC thrombosis) and splanchnic venous thrombosis group (portal, splenic, superior mesenteric veins) based on the veins involved. Hereditary and acquired thrombophilic risk factors were evaluated in all patients.RESULTS: Twenty patients had SVT, 14 had BCS,and 2 had mixed venous thrombosis. Ten patients (28%) had hereditary and 10 patients (28%) acquired thrombophilic risk factors. The acquired risk factors were significantly more common in the SVT group (SVT vs BCS:45% vs 7%,x2=5.7,P=0.02) while hereditary risk factors did not show significant differences between the two groups (SVT vs BCS: 25%vs 36%, x2=0.46,P=0.7). Multiple risk factors were present in one (7%) patient with BCS and in 3 patients (15%) with SVT. No risk factors were identified in 57% of patients with BCS and in 45% of patients with SVT.CONCLUSION: Hereditary and acquired risk factors play an important role in the etiopathogenesis of abdominal venous thrombosis. Acquired risk factors are significantly more common in SVT patients while hereditary factors are similar in both groups.

  9. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  10. Sagittal sinus thrombosis in adult minimal change nephrotic syndrome.

    Science.gov (United States)

    Urch, C; Pusey, C D

    1996-02-01

    Nephrotic syndrome causes a hypercoagulable state, leading to both venous and arterial thrombosis. The mechanisms are as yet unclear, but numerous alterations in coagulant and anti-coagulant factors have been reported [Llach et al. 1985, Harris and Ismail 1994]. The most common clinical features in adults are renal vein thrombosis, femoral vein thrombosis and pulmonary embolism, although thrombosis in numerous other arterial and venous sites has been described [Cameron 1984, Llach et al. 1985]. Intracranial thrombosis is rare, although in adult nephrotic syndrome arterial thrombosis is well recognized [Fuh et al. 1991]. We report a patient with minimal change nephrotic syndrome who developed venous sinus thrombosis detected by magnetic resonance (MR) scanning.

  11. Assessment of Venous Thrombosis in Animal Models.

    Science.gov (United States)

    Grover, Steven P; Evans, Colin E; Patel, Ashish S; Modarai, Bijan; Saha, Prakash; Smith, Alberto

    2016-02-01

    Deep vein thrombosis and common complications, including pulmonary embolism and post-thrombotic syndrome, represent a major source of morbidity and mortality worldwide. Experimental models of venous thrombosis have provided considerable insight into the cellular and molecular mechanisms that regulate thrombus formation and subsequent resolution. Here, we critically appraise the ex vivo and in vivo techniques used to assess venous thrombosis in these models. Particular attention is paid to imaging modalities, including magnetic resonance imaging, micro-computed tomography, and high-frequency ultrasound that facilitate longitudinal assessment of thrombus size and composition.

  12. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  13. Sinus Sigmoideus Thrombosis Secondary to Graves’ Disease:A Case Description

    Directory of Open Access Journals (Sweden)

    Ellen Hermans

    2011-09-01

    Full Text Available Cerebral venous thrombosis (CVT is a distinct cerebrovascular condition that represents 0.5–1% of all strokes in the general population. Because of its procoagulant and antifibrinolytic effects [Horne et al.: J Clin Endocrinol Metab 2004;89:4469–4473], hyperthyroidism has been proposed as a predisposing factor for CVT [Saposnik et al.: Stroke 2011;42:1158–1192]. For the first time, we describe a 22-year-old right-handed woman with a sinus sigmoideus thrombosis due to Graves’ disease. Although subclinical hyperthyroidism had been detected 2 years before the onset of neurological symptoms, she did not receive any medical follow-up. Early recognition, diagnosis and treatment are of crucial importance, as Graves’ disease is a risk factor for CVT and stroke.

  14. Superior Sagittal Sinus Thrombosis Presenting with Hallucinations in the Puerperium: A Case Report

    Directory of Open Access Journals (Sweden)

    Zylfije Hundozi

    2016-12-01

    Full Text Available Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS thrombosis (SSST developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOF-MRA demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk.

  15. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    to the condition. Malignancy and therapeutic interventions are major risk factors for the secondary deep vein thrombosis in combination with the patient's characteristics, comorbidities and prior history of deep vein thrombosis. Complications: recurrent deep venous thrombosis, pulmonary embolism and Post......Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget-Schroetter syndrome) or secondary to an underlying cause. Primary and secondary UEDVT differs in long-term sequelae and mortality. This review...... will focus on the clinical presentation, risk factors, diagnosis, and treatment strategies of UEDVT. In the period from January to October 2012 an electronic literature search was performed in the PubMed/MEDLINE database, and 27 publications were included. Clinical presentation: swelling, pain and functional...

  16. Arterial thrombosis in the antiphospholipid syndrome

    NARCIS (Netherlands)

    Urbanus, R.T

    2008-01-01

    The antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disease that mainly affects young women. The syndrome is characterized by recurrent thrombosis or pregnancy morbidity in association with the persistent serological presence of antiphospholipid antibodies. Antiphospholipid antibodi

  17. A time of change at Thrombosis Journal

    Directory of Open Access Journals (Sweden)

    ten Cate Hugo

    2012-05-01

    Full Text Available Abstract Thrombosis and hemostasis related disease have a heavy burden in cardiovascular disease and it is important to have a journal where research into this can be accessed by all.

  18. Quality Control in Laboratory Hemostasis and Thrombosis

    Institute of Scientific and Technical Information of China (English)

    周立红; 刘泽霖

    2010-01-01

    @@ Introdution Laboratory diagnosis in medical practice,the position has been established,hernostasis and thrombosis.expefimental testing is no different.Experimental test of information not only for early diagnosis and guide treatment,prognosis and estimated recurrence.

  19. Cervical Rib causing Thrombosis of Subclavian Atery

    Directory of Open Access Journals (Sweden)

    P Sharma

    2010-06-01

    Full Text Available We describe here an unusual case of thrombosis of left subclavian artery in a patient with cervical rib. The patient presented with features of ischaemia of left upper limb. X-ray chest revealed bilateral cervical ribs, longer on the left side. Color Doppler studies showed echogenic thrombus within the left subclavian artery. Angiography revealed complete occlusion of left subclavian artery. Embolectomy was done. She was planned for excision of rib. KEYWORDS: cervical rib, thrombosis of subclavian artery.

  20. Tenecteplase in prosthetic mitral valve thrombosis

    OpenAIRE

    2010-01-01

    In the few reported cases of prosthetic mitral valve thrombosis, where surgical intervention was considered as high risk, fibrinolytic therapy had proved life saving. The authors present clinical, laboratory, and imaging data from such a patient, with prosthetic mitral valve thrombosis and its successful management with tenecteplase. The use of tenecteplase as a viable fibrinolytic agent for the first time was justified, due to the lack of immunogenicity concerns compared to streptokinase.

  1. Tenecteplase in prosthetic mitral valve thrombosis.

    Science.gov (United States)

    Ayyub Ghori, Masood; Bakir, Sherif; Ellahham, Samer; Al Nassir, Adnan; Al Zubaidi, Abdulmajeed; Augustin, Norbert; Abdelaziz, Moataz Ayman; Turrin, Nicolas Patrick; Al Mahmeed, Wael Abdulrahman

    2011-04-01

    In the few reported cases of prosthetic mitral valve thrombosis, where surgical intervention was considered as high risk, fibrinolytic therapy had proved life saving. The authors present clinical, laboratory, and imaging data from such a patient, with prosthetic mitral valve thrombosis and its successful management with tenecteplase. The use of tenecteplase as a viable fibrinolytic agent for the first time was justified, due to the lack of immunogenicity concerns compared to streptokinase.

  2. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  3. Fibrinolytic therapy for mechanical pulmonary valve thrombosis.

    Science.gov (United States)

    Khajali, Zahra; Mohammadzadeh, Shabnam; Maleki, Majid; Peighambari, Mohammad Mehdi; Sadeghpoor, Anita; Ghavidel, Alireza; Elahi, Behrad; Mirzaaghayan, Mohammadreza

    2015-01-01

    Treatment of prosthetic heart valve thrombosis using intravenous thrombolytics, although an acceptable alternative to surgery, is not complication free, and the literature has a dearth of data on the subject. This study analyzed the results of fibrinolytic treatment (FT) among a single-center group of patients with mechanical pulmonary valve thrombosis. Between 2000 and 2013, 23 consecutive patients with 25 episodes of pulmonary valve thrombosis received FT. The diagnosis of mechanical pulmonary valve thrombosis was established by fluoroscopy and echocardiography. Streptokinase (SK) was used in 24 cases and alteplase in 1 case. The FT was continued a second day for 14 patients (58.3%), a third day for 1 patient, and a fourth day for 1 patient. Echocardiography and fluoroscopy were performed every day until improvement of malfunction was achieved. Of the 23 patients, 19 had complete resolution of hemodynamic abnormalities after FT, 1 had partial resolution, and 2 showed no change. No patient had major complications. Five minor complications were detected, namely, fever, nausea, thrombophlebitis, epistaxi, and pain. Seven patients (30%) experienced recurrence of thrombosis, whereas four patients had surgery (biological pulmonary valve replacement) without re-thrombolytic therapy, one patient was treated with Alteplase, one patient received SK, and one patient received intense anticoagulation using heparin and warfarin. Overall, FT had a success rate of 84%. The results indicate that regardless of the time to pulmonary valve replacement and echocardiographic and fluoroscopic findings, FT was effective in most cases of mechanical pulmonary valve thrombosis. The efficacy increased with second-day thrombolytic therapy. Major complications were not common after lytic therapy for mechanical pulmonary valve thrombosis.

  4. Intrauterine extremity gangrene and cerebral infarction at term

    DEFF Research Database (Denmark)

    Tanvig, M; Jørgensen, J S; Nybo, M;

    2011-01-01

    Intrauterine extremity gangrene in combination with cerebral infarction is a serious and rare event. We present a case with a healthy mother who gave birth to a child with this condition. At term, the mother presented at the antenatal clinic with decreased fetal movements. Cardiotocography (CTG......) showed signs of fetal distress and a caesarean section was performed. The left arm of the newborn was found gangrenous. Amputation of the arm was necessary and the child was subsequently treated with anticoagulant therapy due to thrombosis and cerebral infarction in the left hemisphere found by magnetic...

  5. Nonclinical aspects of venous thrombosis in pregnancy.

    Science.gov (United States)

    Struble, Evi; Harrouk, Wafa; DeFelice, Albert; Tesfamariam, Belay

    2015-09-01

    Pregnancy is a hypercoagulable state which carries an excess risk of maternal venous thrombosis. Endothelial injury, alterations in blood flow and activation of the coagulation pathway are proposed to contribute to the hypercoagulability. The risk for thrombosis may be accentuated by certain drugs and device implants that directly or indirectly affect the coagulation pathway. To help ensure that these interventions do not result in adverse maternal or fetal outcomes during pregnancy, gravid experimental animals can be exposed to such treatments at various stages of gestation and over a dosage range that would identify hazards and inform risk assessment. Circulating soluble biomarkers can also be evaluated for enhancing the assessment of any increased risk of venous thrombosis during pregnancy. In addition to traditional in vivo animal testing, efforts are under way to incorporate reliable non-animal methods in the assessment of embryofetal toxicity and thrombogenic effects. This review summarizes hemostatic balance during pregnancy in animal species, embryofetal development, biomarkers of venous thrombosis, and alterations caused by drug-induced venous thrombosis.

  6. Very late bare-metal stent thrombosis, rare but stormy!

    LENUS (Irish Health Repository)

    Ali, Mohammed

    2011-08-01

    Recurrent in-stent thrombosis is rarely reported, with catastrophic clinical consequences of either acute coronary syndrome or death. We present a case of recurrent in-stent thrombosis with its outcome and a concise literature review.

  7. Upper-extremity deep venous thrombosis: a review.

    Science.gov (United States)

    Mai, Cuc; Hunt, Daniel

    2011-05-01

    Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with similar adverse consequences and is becoming more common in patients with complex medical conditions requiring central venous catheters or wires. Although guidelines suggest that this disorder be managed using approaches similar to those for lower-extremity deep venous thrombosis, studies are refining the prognosis and management of upper-extremity deep venous thrombosis. Physicians should be familiar with the diagnostic and treatment considerations for this disease. This review will differentiate between primary and secondary upper-extremity deep venous thromboses; assess the risk factors and clinical sequelae associated with upper-extremity deep venous thrombosis, comparing these with lower-extremity deep venous thrombosis; and describe an approach to treatment and prevention of secondary upper-extremity deep venous thrombosis based on clinical evidence.

  8. Role of surgery in iliofemoral venous thrombosis.

    Science.gov (United States)

    Rutherford, R B

    1986-05-01

    Thrombectomy has a limited but definite role in the clinical management of patients with iliofemoral venous thrombosis. It is best applied selectively to achieve specific goals in two different groups of patients at either end of the disease spectrum. In relatively active healthy young patients with phlegmasia alba dolens operated on relatively soon after thrombosis, better protection against the late postthrombotic sequelae can be achieved. Patients with malignancy, underlying coagulopathy, or those who are inactive or have a limited life expectancy due to age or concurrent disease should not be operated on for bland thrombosis. At the other extreme, when phlegmasia cerulea dolens causes painful tense swelling, increases compartmental or decreases ankle pressures, and threatens limb viability in spite of heparinization and leg elevation, thrombectomy should be performed.

  9. Current perspective of venous thrombosis in the upper extremity

    OpenAIRE

    Flinterman, L.E.; Meer, van der, D; Rosendaal, F.R.; Doggen, C. J. M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous thrombosis. In this review an overview of the different risk factors, possible treatments and the complications for patients with a venous thrombosis of the upper extremity is given

  10. Risk factors for a first and recurrent venous thrombosis

    OpenAIRE

    Flinterman, Linda Elisabeth

    2013-01-01

    The aim of this thesis was to identify new risk factors for first and recurrent venous thrombosis of both the upper and lower extremity, and assess the incidence of recurrence and mortality after a first venous thrombosis. An overview was provided of the current literature on risk factors and treatment for a first venous thrombosis of the upper extremity (chapter 2). We investigated the association between levels of coagulation factors, blood group and a first venous thrombosis of the upper e...

  11. Nutcracker Syndrome Complicated by Left Renal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Faouzi Mallat

    2013-01-01

    Full Text Available Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

  12. Nutcracker syndrome complicated by left renal vein thrombosis.

    Science.gov (United States)

    Mallat, Faouzi; Hmida, Wissem; Jaidane, Mehdi; Mama, Nadia; Mosbah, Faouzi

    2013-01-01

    Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

  13. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  14. Sickle Cell Trait Causing Splanchnic Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Priyanka Saxena

    2015-01-01

    Full Text Available Sickle cell trait is considered as a benign condition as these individuals carry only one defective gene and typically have their life span similar to the normal population without any health problems related to sickle cell. Only under extreme conditions, red cells become sickled and can cause clinical complications including hematuria and splenic infarction. Although twofold increased risk of venous thrombosis has been described in African Americans, there is no data available from Indian population. We here report a case of sickle cell trait from India whose index presentation was thrombosis of unusual vascular territory.

  15. Paradoxical embolism following thromboaspiration of an arteriovenous fistula thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Amara Brahim

    2010-10-01

    Full Text Available Abstract Introduction Paradoxical embolism is an increasingly reported cause of arterial embolism. Several embolic sources have been described, but thrombosis of an arteriovenous fistula as a paradoxical emboligenic source has not, to the best of our knowledge, been reported. Case presentation A 50-year-old Caucasian woman received a renal graft for primary hyperoxaluria. After transplantation, she was maintained on daily hemodialysis. Thrombosis of her arteriovenous fistula occurred two weeks post-transplantation and was treated by thromboaspiration, which was partially successful. During a hemodialysis session immediately following thromboaspiration, she developed a coma with tetraplegia requiring intensive cardiorespiratory resuscitation. Brain magnetic resonance imaging revealed various hyperdense areas in the vertebrobasilar territory resulting from bilateral occlusion of posterior cerebral arteries. Transesophageal echocardiographic examination showed a patent foramen ovale, while pulse echography of the arteriovenous fistula revealed the persistence of extensive clots that were probably the embolic source. A paradoxical embolus through a patent foramen ovale was suggested because of the proximity of the neurological event to the thrombectomy procedure. Conclusions The risk of paradoxical embolism in a hemodialyzed patient with a patent foramen ovale deserves consideration and requires careful evaluation in situations of arteriovenous fistula thrombosis.

  16. Physical activity, immobilization and the risk of venous thrombosis

    NARCIS (Netherlands)

    Stralen, Karlijn Janneke van

    2008-01-01

    Deep venous thrombosis is a common disease. Already in 1856 it was suggested that immobilization could cause venous thrombosis. However, so far little research has shown whether exercise or ambulation could decrease the risk of venous thrombosis. We performed a historical review regarding the role o

  17. Pleural mesothelioma and venous thrombosis: the eosinophilia link

    Directory of Open Access Journals (Sweden)

    Aye Win

    2008-04-01

    Full Text Available Abstract Peripheral blood eosinophilia and vascular occlusions are rare occurrences in patients with pleural mesothelioma whereas eosinophilia may associate with thrombosis. We describe a patient with mesothelioma who developed peripheral blood eosinophilia followed by deep vein thrombosis despite being on low molecular weight heparin prophylaxis. We discuss the genesis of peripheral blood eosinophilia and thrombosis in pleural mesothelioma.

  18. A rare complication of Ramsey Hunt Syndrome: Sınus vein thrombosis

    Directory of Open Access Journals (Sweden)

    Ramiz Ahmedov

    2011-03-01

    Full Text Available Ramsay-Hunt Syndrome (RHS is a rare affection characterized by peripheral facial paralysis (PFP, skin eruption in the auricular canal and cochleovestibular symptoms. It is produced by varicella-zoster virus(VZV reactivation at the geniculate ganglia. In elderly and immunocompromised individuals, the virus may reactivate to produce shingles (zoster. After zoster resolves, many elderly patients experience postherpetic neuralgia. Uncommonly, VZV can spread to large cerebral arteries to cause a spectrum of large-vessel vascular damage, ranging from vasculopathy to vasculitis, with stroke. In immunocompromised individuals, especially those with cancer or acquired immunodeficiency syndrome, deeper tissue penetration of the virus may occur (as compared with immunocompetent individuals, with resultant myelitis, small-vessel vasculopathy, ventriculitis, and meningoencephalitis. The polymerase chain reaction (PCR analysis of cerebrospinal fluid remains the mainstay for diagnosing the neurologic complications of VZV during life. We report a case of Ramsay Hunt syndrome complicated with cerebral venous thrombosis. Patient received treatment with acyclovir and anticoagulation. Early treatment with acyclovir therapy and anticoagulation could improve the recovery rate of facial nerve palsy and sinus vein thrombosis.

  19. Fibrinolytic therapy for thrombosis in cardiac valvular prosthesis short and long term results

    Directory of Open Access Journals (Sweden)

    Auristela I. O. Ramos

    2003-10-01

    Full Text Available OBJECTIVE: To assess the short- and long-term results of the use of streptokinase (SK for the treatment of thromboses in cardiac valvular prostheses. METHODS: Seventeen patients with cardiac prosthetic thrombosis diagnosed by clinical, echocardiographic, and radioscopic findings underwent fibrinolytic treatment with a streptokinase bolus of 250,000 U followed by 100.000 U/hour. Short- and long-term results were assessed by radioscopy and echocardiography. RESULTS: Of the 17 patients, 12 had mechanical double-disk prostheses (4 aortic, 6 mitral, 2 tricuspid, 4 had single-disk prostheses (2 aortic, 1 mitral, and 1 tricuspid, and 1 had a tricuspid bioprosthesis. The success rate was 64.8%, the partial success rate was 17.6%, and the nonsuccess rate was 17.6%. All patients with a double-disk prosthesis responded, completely or partially, to the treatment. None of the patients with a single-disk prosthesis had complete resolution of the thrombosis. The time of streptokinase infusion ranged from 6 to 80 hours (mean of 56 h. The mortality rate due to the use of streptokinase was 5.8% and was secondary to cerebral bleeding. During streptokinase infusion, 3 (17.6% embolic episodes occurred as follows: 1 cerebral, 1 peripheral, and 1 coronary. The rethrombosis index was 33% in a mean follow-up of 42 months. CONCLUSION: The use of fibrinolytic agents was effective and relatively safe in patients with primary thrombosis of a double-disk prosthesis. A fatal hemorrhagic complication occurred in 1 (5.8% patient, and embolic complications occurred in 3 (17.6% patients. In a mean 42-month follow-up, 67% of the patients were free from rethrombosis.

  20. Incidence and predictors of coronary stent thrombosis

    DEFF Research Database (Denmark)

    D'Ascenzo, Fabrizio; Bollati, Mario; Clementi, Fabrizio;

    2013-01-01

    Stent thrombosis remains among the most feared complications of percutaneous coronary intervention (PCI) with stenting. However, data on its incidence and predictors are sparse and conflicting. We thus aimed to perform a collaborative systematic review on incidence and predictors of stent thrombo...

  1. Diagnosing deep venous thrombosis in primary care

    NARCIS (Netherlands)

    Oudega, Rudolphus

    2005-01-01

    In patients suspected of deep venous thrombosis (DVT) in primary care, it is a challenge to discriminate the patients with DVT from those without DVT. The risk of missing the diagnosis and the risk of unnecessary referral and treatment with a potential harmful therapy has to be balanced by the prima

  2. Gene Variants Associated With Deep Vein Thrombosis

    NARCIS (Netherlands)

    Bezemer, Irene D.; Bare, Lance A.; Doggen, Carine J.M.; Arellano, Andre R.; Tong, Carmen; Rowland, Charles M.; Catanese, Joseph; Young, Bradford A.; Reitsma, Pieter H.; Devlin, James J.; Rosendaal, Frits R.

    2008-01-01

    Context The genetic causes of deep vein thrombosis (DVT) are not fully understood. Objective To identify single-nucleotide polymorphisms (SNPs) associated with DVT. Design, Setting, and Patients We used 3 case-control studies of first DVT. A total of 19 682 gene-centric SNPs were genotyped in 44

  3. Complement component 5 promotes lethal thrombosis

    Science.gov (United States)

    Mizuno, Tomohiro; Yoshioka, Kengo; Mizuno, Masashi; Shimizu, Mie; Nagano, Fumihiko; Okuda, Tomoyuki; Tsuboi, Naotake; Maruyama, Shoichi; Nagamatsu, Tadashi; Imai, Masaki

    2017-01-01

    Extracellular histones promote platelet aggregation and thrombosis; this is followed by induction of coagulation disorder, which results in exhaustion of coagulation factors. Complement component 5 (C5) is known to be associated with platelet aggregation and coagulation system activation. To date, the pathological mechanism underlying liver injury has remained unclear. Here, we investigated whether C5 promotes liver injury associated with histone-induced lethal thrombosis. C5-sufficient and C5-deficient mice received single tail vein injections of purified, unfractionated histones obtained from calf thymus (45–75 μg/g). Subsequently, the mice were monitored for survival for up to 72 h. Based on the survival data, the 45 μg/g dose was used for analysis of blood cell count, liver function, blood coagulation ability, and promotion of platelet aggregation and platelet/leukocyte aggregate (PLA) production by extracellular histones. C5-deficient mice were protected from lethal thrombosis and had milder thrombocytopenia, consumptive coagulopathy, and liver injury with embolism and lower PLA production than C5-sufficient mice. These results indicate that C5 is associated with coagulation disorders, PLA production, and embolism-induced liver injury. In conclusion, C5 promotes liver injury associated with histone-induced lethal thrombosis. PMID:28205538

  4. Portal Vein Thrombosis in non cirrhotic patients

    NARCIS (Netherlands)

    M.C.W. Spaander (Manon)

    2010-01-01

    textabstractExtrahepatic portal vein thrombosis (EPVT) is the most common cause of portal hypertension in non- cirrhotic patients. EPVT has been defined as an obstruction of the extrahepatic portal vein with or without involvement of the intrahepatic portal veins. Although the portal vein accounts f

  5. Circadian Variation in Coronary Stent Thrombosis

    NARCIS (Netherlands)

    Mahmoud, Karim D.; Lennon, Ryan J.; Ting, Henry H.; Rihal, Charanjit S.; Holmes, David R.

    2011-01-01

    Objectives We sought to determine the circadian, weekly, and seasonal variation of coronary stent thrombosis. Background Other adverse cardiovascular events such as acute myocardial infarction are known to have higher incidences during the early morning hours, Mondays, and winter months. Methods The

  6. Ulcerative colitis flare with splenic ven thrombosis.

    Science.gov (United States)

    Bozkurt, Huseyin Sancar; Kara, Banu; Citil, Serdal

    2015-01-01

    Patients with ulcerative colitis (UC) have an increased risk of thromboembolic events. Here, we present a 28-year-old man with active ulcerative pancolitis presenting via splenic vein thrombosis and left renal superior infarct that was not associated with a surgical procedure.

  7. Image Diagnosis: Inferior Mesenteric Vein Thrombosis.

    Science.gov (United States)

    Aggarwal, Avin; Garg, Shashank

    2015-01-01

    A 59-year-old man presented to the gastroenterology clinic with 2 weeks of worsening lower back pain. There was associated poor appetite, fatigue, night sweats, and chills. The patient's medical history was significant for well-controlled hypertension and sigmoid diverticulosis. The thrombosis probably resulted from inflammation in the adjacent diverticulum.

  8. Puzzles in practice: splenic vein thrombosis.

    Science.gov (United States)

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology.

  9. Acute cytomegalovirus infection complicated by venous thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Parola Philippe

    2005-08-01

    Full Text Available Abstract Background CMV-induced vasculopathy and thrombosis have been reported, but they are rare conditions usually encountered in immunocompromised patients. However more and more complications of CMV infections are recognized in immunocompetent patients. Case presentation We present a case report of a previously healthy adult with cytomegalovirus infection that was complicated by tibiopopliteal deep venous thrombosis and in whom Factor V Leiden heterozygous mutation was found. Conclusion This new case report emphasizes the involvement of cytomegalovirus in induction of vascular thrombosis in patients with predisposing risk factors for thrombosis. It is necessary to screen for CMV infection in patients with spontaneous thrombosis and an history of fever.

  10. Thrombosis in vasculitic disorders-clinical manifestations, pathogenesis and management.

    Science.gov (United States)

    Katz, Ofrat Beyar; Brenner, Benjamin; Horowitz, Netanel A

    2015-09-01

    Inflammation and coagulation are known to affect each other in many ways. Vasculitis represents a group of disorders where blood vessels (small, medium, large or variable) are infiltrated with inflammatory cells. Accumulating evidence in the literature suggests both clinical and physiological association between vasculitis and thrombosis. Vasculitis-associated thrombosis involves arteries and veins, and a tight connection has been reported between the activity of vasculitis and the appearance of thrombosis. Pathophysiology of these relations is complex and not completely understood. While thrombophilic factors are associated with vasculitis, it remains unclear whether a true association with clinical thrombosis is present. Furthermore, several factors leading to hemostasis, endothelial injury and induction of microparticles were described as possibly accounting for thrombosis. Management of thrombosis in vasculitis patients is challenging and should be further assessed in randomized controlled studies. The current review describes clinical manifestations, pathogenesis and management of thrombosis associated with different vasculitides.

  11. Evaluation of cerebral perfusion imaging with N-isopropyl-p-[{sup 123}I]iodoamphetamine (IMP) in the cases of antiphospholipid syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Toru; Nanbu, Ichiro; Tohyama, Junko; Ohba, Satoru [Nagoya City Univ. (Japan). Faculty of Medicine

    1995-01-01

    Five cases of antiphospholipid syndrome with mild headache, but without any neurological deficits and abnormal findings by CT and MRI, were examined by cerebral blood perfusion SPECT using N-isopropyl-p-[{sup 123}I] iodoamphetamine (IMP). Although three cases were performed quantification of cerebral blood flow with a microsphere method simultaneously, their values were within normal limits. Two of them showed focal low perfusion areas. One case had relatively low perfusion areas in the bilateral occipital lobes and the right temporal lobe, which improved after treatment. One of two had low perfusion in the bilateral occipital lobes. Other three cases only showed ununiformity of radioisotope uptake on the cerebral blood perfusion SPECT. Low perfusion areas in antiphospholipid syndrome might be caused by microarterial thrombosis, microvenous thrombosis or spasms, although they could be reversible. As early irreversible progress of cerebral blood flow, cerebral blood flow SPECT should be performed in cases of antiphospholipid syndrome with neurological complainments. (author).

  12. Diagnosis and management of cerebral venous thrombosis A statement for healthcare professionals from the American Heart Association/American Stroke Association%脑静脉血栓形成的诊断和处理美国心脏协会/美国卒中协会对医疗专业人员的声明

    Institute of Scientific and Technical Information of China (English)

    Gustavo Saposnik; 张沈阳; 韩丽娟; 叶丹; 徐运; Femando Barinagarrementeria; Robert D.Brown; Cheryl D.Bushnell; Brett Cucchiara; Mary Cushman; Gabrielle deVeber; Jose M.Ferro; Fong Y.Tsai

    2011-01-01

    背景 本指南旨在对脑静脉窦血栓形成(cerefal venous sinus thrombosis,CVT)进行概述,并提供其诊断、处理和治疗的推荐意见,目标读者为涉及CVT患者诊断和处理的临床医生和其他医疗工作者.方法和结果 作为不同专业领域的代表,专家小组成员由美国心脏协会(American Heart Association,AHA)卒中委员会科学声明监督委员会任命.专家小组回顾了相关文献,重点为1966年以来公开发表的报道,并使用AHA证据水平分级方案对证据进行评定并制定推荐意见.本指南经专家小组认可后,由AHA科学咨询和协调委员会进行同行评议并批准.结论 本指南为CVT的诊断、处理和复发的预防提供了循证推荐,同时还提供了妊娠期妇女和儿童CVT评估和处理的推荐意见,对临床并发症((癎)性发作、脑积水、颅内压增高和神经功能恶化)的处理进行了总结,并描述了CVT患者诊断和治疗的流程图.

  13. [Calcified deep vein thrombosis in a patient with recurrent deep vein thrombosis and sarcoidosis].

    Science.gov (United States)

    Krmek, Dubravka Zupanić; Brajković, Ivana; Bekić, Dinko; Krnić, Antun; Jurković, Petar; Pavlović, Tomislav

    2013-12-01

    In this article, we present a rare case of calcified deep vein thrombosis in a 42-year-old female patient with frequent relapses of pulmonary sarcoidosis since 1995, for which she was on maintenance therapy with corticosteroids and with consequential secondary diabetes. Recent femoral vein thrombosis was diagnosed with color Doppler in 2012. At the same time, calcified occlusive thrombus in vena cava inferior from the level of renal vein to the confluence of hepatic veins was diagnosed on abdominal multi-slice computed tomography (MSCT). Digital subtraction venography (DSV) revealed a well-developed collateral circulation through the paravertebral veins, azygos and hemiazygos vein. There were no risk factors for thrombosis other than sarcoidosis and diabetes. Deep vein thrombosis is rarely described with sarcoidosis, but according to literature reports, it usually appears as a recurrence and simultaneously at multiple locations. According to the current knowledge, we cannot say for sure whether it is a disease with an increased risk of deep vein thrombosis or there is a combination of multiple risk factors present simultaneously.

  14. MRI of cerebral rheumatoid pachymeningitis: report of two cases with follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Cellerini, M.; Gabbrielli, S. [Florence Univ. (Italy). Dept. of Clinical Pathophysiology; Maddali Bongi, S.; Cammelli, D. [Section of Rheumatology, Department of Internal Medicine, School of Medicine, Univ. of Florence (Italy)

    2001-02-01

    We report the clinical and neuroradiological features of cerebral rheumatoid pachymeningitis with 1 year follow-up in two patients. MRI of the head enabled noninvasive diagnosis of both the meningeal abnormality and its complications, consisting of hypertensive hydrocephalus and superior sagittal sinus thrombosis, respectively. Dural sinus thrombosis, very uncommon in rheumatoid arthritis, was confirmed by phase-contrast MRA. Worsening of the pachymeningitis at follow-up was observed in both patients despite regression or stability of the clinical picture and long-term therapy. (orig.)

  15. Specific treatment for cancer-associated thrombosis.

    Science.gov (United States)

    Laffan, Mike; Westcott, Gemma

    2015-11-01

    Mike Laffan speaks to Gemma Westcott, Commissioning Editor: Michael Laffan is Professor of Haemostasis and Thrombosis in the Department of Haematology at Imperial College, London, UK, and Director of the Hammersmith Hospital Haemophilia Centre. He trained in medicine at Oxford University and hematology at the Hammersmith and Royal Free hospitals in London. His principal research interests are the structure-function relationship of von Willebrand factor, in particular the role of glycosylation, and the mechanisms and regulation of thrombin generation. He has published extensively on hemostasis and recently edited the 11th edition of Practical Haematology. He also served on NEQAS and the British Committee for Standards in Haematology Task force on Haemostasis and Thrombosis.

  16. CD147 in cardiovascular disease and thrombosis.

    Science.gov (United States)

    Pennings, Gabrielle J; Kritharides, Leonard

    2014-10-01

    Thrombotic and inflammatory pathways play a key role in coronary artery disease (CAD) development. Extracellular matrix metalloproteinase (aka CD147) is a member of the immunoglobulin superfamily that is expressed on many cell types including hematopoietic, endothelial cells, leukocytes, keratinocytes, platelets, and others. The binding partners of CD147 are numerous and diverse, and give some indication to the various roles that CD147 can play; these include homophilic interactions, integrins, cyclophilins, glycoprotein VI (GPVI), caveolin 1, and monocarboxylate transporters. Recent evidence suggests a role for CD147 in both thrombosis and inflammation, as well as involvement in CAD and cancer. In this review, we summarize the role of CD147 and its binding partners in platelets, thrombosis, and arterial disease and assess mechanistic aspects of CD147 biology.

  17. Prosthetic Valve Thrombosis: Diagnosis and Management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Pinnamaneni, Sowmya; Sarungbam, Judy; Jain, Diwakar

    2016-01-01

    St. Jude mechanical prosthesis is the most commonly used prosthetic device with least valvular complications with excellent hemodynamics. However, prosthetic valve thrombosis is one of the serious complications, with rates between 0.03% and 0.13% per patient-year depending on the type of anticoagulation used and compliance to the therapy. Transthoracic echocardiography (TTE) is the initial screening tool (class I) that would provide clues for the assessment of valvular hemodynamics. Fluoroscopy is an alternate imaging modality for the assessment of mechanical leaflet motion, especially in patients when prosthetic valves are difficult to image on TTE or transesophageal echocardiography. A complete fluoroscopic evaluation of a prosthetic valve includes assessment of valvular motion and structural integrity. Opening and closing angles can be measured fluoroscopically to determine whether a specific valve is functioning properly. We discuss a case of a 91-year-old man with thrombosis of bileaflet mechanical mitral prosthesis that was demonstrated on real-time fluoroscopy (not evident on TTE). An algorithmic approach to diagnosis and management of prosthetic heart valve thrombosis is outlined.

  18. Immediate retransplantation for pancreas allograft thrombosis.

    Science.gov (United States)

    Hollinger, E F; Powelson, J A; Mangus, R S; Kazimi, M M; Taber, T E; Goble, M L; Fridell, J A

    2009-04-01

    Early pancreas allograft failure most commonly results from thrombosis and requires immediate allograft pancreatectomy. Optimal timing for retransplantation remains undefined. Immediate retransplantation facilitates reuse of the same anatomic site before extensive adhesions have formed. Some studies suggest that early retransplantation is associated with a higher incidence of graft loss. This study is a retrospective review of immediate pancreas retransplants performed at a single center. All cases of pancreas allograft loss within 2 weeks were examined. Of 228 pancreas transplants, 12 grafts were lost within 2 weeks of surgery. Eleven of these underwent allograft pancreatectomy for thrombosis. One suffered anoxic brain injury and was not a retransplantation candidate, one was retransplanted at 3.5 months and nine patients underwent retransplantation 1-16 days following the original transplant. Of the nine early retransplants, one pancreas was lost to heparin-induced thrombocytopenia, one recipient died with function at 2.9 years and the other grafts continue to function at 76-1137 days (mean 572 days). One-year graft survival for early retransplantation was 89% compared to 91% for all pancreas transplants at our center. Immediate retransplantation following pancreatic graft thrombosis restores durable allograft function with outcomes comparable to first-time pancreas transplantation.

  19. Arterial and Venous Thrombosis in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Andrew D. Blann

    2011-01-01

    Full Text Available The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver enough oxygenated red cells to the cardiomyocytes. The principle reason for this is occlusive thrombosis, either by isolated circulating thrombi, or by rupture of upstream plaque. However, an additionally serious pathology causing potentially fatal stress to the heart is extra-cardiac disease, such as pulmonary hypertension. A primary cause of the latter is pulmonary embolus, considered to be a venous thromboembolism. Whilst the thrombotic scenario has for decades been the dominating paradigm in cardiovascular disease, these issues have, until recently, been infrequently considered in cancer. However, there is now a developing view that cancer is also a thrombotic disease, and notably a disease predominantly of the venous circulation, manifesting as deep vein thrombosis and pulmonary embolism. Indeed, for many, a venous thromboembolism is one of the first symptoms of a developing cancer. Furthermore, many of the standard chemotherapies in cancer are prothrombotic. Accordingly, thromboprophylaxis in cancer with heparins or oral anticoagulation (such as Warfarin, especially in high risk groups (such as those who are immobile and on high dose chemotherapy, may be an important therapy. The objective of this communication is to summarise current views on the epidemiology and pathophysiology of arterial and venous thrombosis in cancer.

  20. Thrombosis in the uremic milieu--emerging role of "thrombolome".

    Science.gov (United States)

    Shashar, Moshe; Francis, Jean; Chitalia, Vipul

    2015-01-01

    Chronic kidney disease (CKD) is characterized by retention of a number of toxins, which unleash cellular damage. CKD environment with these toxins and a host of metabolic abnormalities (collectively termed as uremic milieu) is highly thrombogenic. CKD represents a strong and independent risk factor for both spontaneous venous and arterial (postvascular injury) thrombosis. Emerging evidence points to a previously unrecognized role of some of the prothrombotic uremic toxins. Here, we provide an overview of thrombosis in CKD and an update on indolic uremic toxins, which robustly increase tissue factor, a potent procoagulant, in several vascular cell types enhancing thrombosis. This panel of uremic toxins, which we term "thrombolome" (thrombosis and metabolome), represents a novel risk factor for thrombosis and can be further explored as biomarker for postvascular interventional thrombosis in patients with CKD.

  1. [Treatment of renal vein thrombosis associated with nephrotic syndrome].

    Science.gov (United States)

    Funami, M; Takaba, T; Tanaka, H; Murakami, A; Kadokura, M; Hori, G; Ishii, J

    1988-06-01

    Renal vein thrombosis is a rare entity in which true incidence is unknown. The disease occurs most frequently in patients with nephrotic syndrome, but it also can occur in the presence of other hypercoagulable state. Two cases of renal vein thrombosis with nephrotic syndrome which were treated by thrombectomy are reported here. One patient was successfully treated by renal vein and inferior vena cava thrombectomy before developing severe pulmonary embolism. The other was treated by renal vein thrombectomy by which fatal shock was able to be prevented. In those cases, immediate operation was indicated, primarily to prevent additional, possibly fatal, pulmonary embolism and also to improve perfusion of the kidney. In the hope of salvaging the kidney, thrombectomy may be the treatment of choice for acute renal vein thrombosis, complication of pulmonary embolism and inferior vena cava thrombosis, right renal vein thrombosis without collateral flow and acute renal vein thrombosis with shock.

  2. Serum Indoxyl Sulfate Associates with Postangioplasty Thrombosis of Dialysis Grafts.

    Science.gov (United States)

    Wu, Chih-Cheng; Hsieh, Mu-Yang; Hung, Szu-Chun; Kuo, Ko-Lin; Tsai, Tung-Hu; Lai, Chao-Lun; Chen, Jaw-Wen; Lin, Shing-Jong; Huang, Po-Hsun; Tarng, Der-Cherng

    2016-04-01

    Hemodialysis vascular accesses are prone to recurrent stenosis and thrombosis after endovascular interventions.In vitro data suggest that indoxyl sulfate, a protein-bound uremic toxin, may induce vascular dysfunction and thrombosis. However, there is no clinical evidence regarding the role of indoxyl sulfate in hemodialysis vascular access. From January 2010 to June 2013, we prospectively enrolled patients undergoing angioplasty for dialysis access dysfunction. Patients were stratified into tertiles by baseline serum indoxyl sulfate levels. Study participants received clinical follow-up at 6-month intervals until June 2014. Primary end points were restenosis, thrombosis, and failure of vascular access. Median follow-up duration was 32 months. Of the 306 patients enrolled, 262 (86%) had symptomatic restenosis, 153 (50%) had access thrombosis, and 25 (8%) had access failure. In patients with graft access, free indoxyl sulfate tertiles showed a negative association with thrombosis-free patency (thrombosis-free patency rates of 54%, 38%, and 26% for low, middle, and high tertiles, respectively;P=0.001). Patients with graft thrombosis had higher free and total indoxyl sulfate levels. Using multivariate Cox regression analysis, graft thrombosis was independently predicted by absolute levels of free indoxyl sulfate (hazard ratio=1.14;P=0.01) and free indoxyl sulfate tertiles (high versus low, hazard ratio=2.41;P=0.001). Results of this study provide translational evidence that serum indoxyl sulfate is a novel risk factor for dialysis graft thrombosis after endovascular interventions.

  3. Necrotizing Fasciitis of the Nose Complicated with Cavernous Sinus Thrombosis

    Directory of Open Access Journals (Sweden)

    D. Swaminath

    2014-01-01

    Full Text Available Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia. We present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis. Few cases of septic cavernous sinus thrombosis have been reported to be caused by cellulitis of the face but necrotizing fasciitis of the nose is rare. It is very important to recognize the early signs of cavernous thrombosis. Treatment for septic cavernous sinus thrombosis is controversial but early use of empirical antibiotics is imperative.

  4. Employees with Cerebral Palsy

    Science.gov (United States)

    ... problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture (United Cerebral Palsy, 2010). "Cerebral" refers to the ...

  5. United Cerebral Palsy

    Science.gov (United States)

    ... be sure to follow us on Twitter . United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  6. [FEATURES LIVER TRANSPLANTATION IN PORTAL VEIN THROMBOSIS].

    Science.gov (United States)

    Abbasov, P A

    2015-07-01

    In 2012 - 2013 years in 265 patients for liver transplantation was performed, including in 224 (84.5%)--from a living donor, in 41 (15.5%)--from the dead body. Using a Foley catheter to stop bleeding, and the imposition of vascular sutures during endovenectomy in portal vein thrombosis (PVT) and its possible damage under all conditions. In particular, PVT IV degree (Grade IV) in order to restore blood flow in the graft using the left gastric and renal vein is an alternative, if they are cryopreserved vein may be suitably used.

  7. Intracardiac Thrombosis during Adult Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Marina Moguilevitch

    2013-01-01

    Full Text Available Intracardiac thrombosis (ICT and pulmonary embolism (PE during adult liver transplantation are rare but potentially lethal complications. They are often overlooked because of significant diagnostic challenges. The combination of hemodynamic compromise and transesophageal echocardiography (TEE findings allows for correct diagnosis. A large variety of putative risk factors for ICT and PE have been suggested, but these events are considered to be multifactorial. There are different proposed treatment modalities for these devastating complications. Unfortunately, in spite of growing knowledge in this area, intraoperative and postoperative mortalities remain very high. The retrospective nature of the study of these events makes the case reports extremely valuable.

  8. Cerebrovascular endothelin receptor upregulation in cerebral ischemia

    DEFF Research Database (Denmark)

    Edvinsson, Lars

    2009-01-01

    leading to the enhanced expression of vascular endothelin receptors show that both protein kinase C (PKC) and mitogen activating protein kinase (MAPK) play important roles. The results from this work provide new perspectives on the pathophysiology of ischemic stroke, and give a possible explanation......Stroke is a serious neurological disease and the third leading cause of death in the western world. In roughly 15 % of the cases, the cause is due to an intracranial haemorrhage, and the remaining 85 % represent ischemic strokes. Ischemic stroke is caused by the occlusion of a cerebral artery...... either by an embolus or by local thrombosis. Several studies have shown an involvement of the endothelin system in ischemic stroke. This review aims to examine the alterations of vascular endothelin receptor expression in ischemic stroke. Furthermore, studies of the intracellular signalling pathways...

  9. Glue embolization of the giant aneurysm by reducing thrombosis-induced volume expansion effect

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Yoo Kyung; Suh, Dae Chul [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2015-04-15

    A giant aneurysm due to a large intra-aneurysmal volume can be complicated by a delayed massive volume expansion caused by thrombus formation. To prevent such a severe mass effect, we obliterated the aneurysmal lumen by gluing and prevented further development of thrombosis. A 52-year-old female with a giant aneurysm at the cavernous segment of the internal carotid artery presented with tinnitus and intermittent diplopia. After confirming with a negative occlusion test, the right internal carotid artery was trapped by coiling and with further obliteration of the aneurysmal lumen by gluing. She developed a mild diplopia after the procedure and recovered without any deficit. The magnetic resonance angiography showed a stable occlusion of the aneurysm and good collateral filling of the cerebral vessel 15 months later.

  10. Validation of the revised International Prognostic Score of Thrombosis for Essential Thrombocythemia (IPSET-thrombosis) in 585 Mayo Clinic patients.

    Science.gov (United States)

    Haider, Mahnur; Gangat, Naseema; Lasho, Terra; Abou Hussein, Ahmed K; Elala, Yoseph C; Hanson, Curtis; Tefferi, Ayalew

    2016-06-01

    The primary objective of treatment in essential thrombocythemia (ET) is to prevent thromboembolic complications. In this regard, advanced age and thrombosis history have long distinguished "low" from "high" risk patients. More recently, JAK2V617F and cardiovascular (CV) risk factors were identified as additional modifiers, leading to the development of a 3-tiered International Prognostic Score of Thrombosis for ET (IPSET-thrombosis): "low," "intermediate," and "high". The international data set used to develop IPSET-thrombosis was recently re-analyzed in order to quantify the additional pro-thrombotic effect of JAK2V617F and CV risk factors in specific risk subcategories. The revised IPSET-thrombosis identified four risk categories based on three adverse variables (thrombosis history, age >60 years and JAK2V617F): very low (no adverse features), low (presence of JAK2V617F), intermediate (age >60 years) and high (presence of thrombosis history or presence of both advanced age and JAK2V617F). In this study of 585 patients with ET (median age 68 years; 61% female), we validated the revised IPSET-thrombosis by confirming significant differences in thrombosis risk between "very low" and "low" (HR 2.4, 95% CI 1.1 - 5.3) and between "intermediate" and "high" (HR 2.3, 95% CI 1.1 - 5.2) risk patients. Furthermore, in multivariable analysis, only JAK2V617F (HR=1.8, CI= 1.07 - 2.94) and history of thrombosis (HR=2.1, CI= 1.20 - 3.58) were independently predictive of future thrombotic events. The revised IPSET-thrombosis needs confirmation in prospective studies, especially in terms of risk-adapted therapy that includes the need for aspirin therapy in very low risk, twice-daily aspirin therapy for low risk and cytoreductive therapy for low or intermediate risk patients.

  11. Current perspective of venous thrombosis in the upper extremity

    NARCIS (Netherlands)

    Flinterman, L.E.; Meer, van der F.J.M.; Rosendaal, F.R.; Doggen, C.J.M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous

  12. Risk factors for a first and recurrent venous thrombosis

    NARCIS (Netherlands)

    Flinterman, Linda Elisabeth

    2013-01-01

    The aim of this thesis was to identify new risk factors for first and recurrent venous thrombosis of both the upper and lower extremity, and assess the incidence of recurrence and mortality after a first venous thrombosis. An overview was provided of the current literature on risk factors and treatm

  13. [The fibrinolytic treatment with urokinase of acute arterial thrombosis].

    Science.gov (United States)

    Ballester, A; Donato di Paola, M; Saccà, A; Cappello, I; D'Addato, M

    1993-01-01

    We present our experiences on 86 patients with acute arterial thrombosis of the legs, undergoing a fibrinolytic treatment with urokinase. Results from the treatment are analyzed according to: the administration way (systemic, locoregional, intrathrombotic), the level of thrombosis (upper or lower legs), the associated morbidity and mortality.

  14. Acute abdominal aortic thrombosis following the Heimlich maneuver.

    Science.gov (United States)

    Ayerdi, Juan; Gupta, Sushil K; Sampson, Lawrence N; Deshmukh, Narayan

    2002-04-01

    Complications from the Heimlich maneuver are relatively infrequent. Two fatal cases of abdominal aortic thrombosis have been reported following this technique. We report on the first patient that suffered an acute thrombosis of the abdominal aorta and survived. Prompt recognition of this complication provides the only hope of survival from this rare and catastrophic complication.

  15. Thrombin Avtivable Fibrinolysis Inhibitor in Venous and Arterial Thrombosis

    NARCIS (Netherlands)

    E.L.E. de Bruijne

    2011-01-01

    textabstractVenous and arterial thromboses are major causes of morbidity and mortality. Venous thrombosis is the result of pathological occlusive clot formation in the veins. It occurs mainly in the deep veins of the leg (deep vein thrombosis), from which parts of the clot frequently embolize to the

  16. The Plot Thickens: Diet Microbe Interactions May Modulate Thrombosis Risk.

    Science.gov (United States)

    Martínez-Del Campo, Ana; Romano, Kymberleigh A; Rey, Federico E; Balskus, Emily P

    2016-04-12

    Thrombosis plays an important role in cardiovascular disease (CVD). Platelet activation is an essential step in the genesis and propagation of atherothrombotic complications. In a recent publication, Zhu and colleagues report that gut microbe-derived TMAO enhances platelet responsiveness and thrombosis, providing a novel mechanistic connection between microbes and CVD (Zhu et al., 2016).

  17. Rhino-orbito-cerebral mucormycosis: Magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Parveen A Lone

    2015-01-01

    Full Text Available Rhino-orbito-cerebral mucormycosis (ROCM is a potentially fatal fungal infection that commonly affects diabetic and other immunocompromised patients. Necrotizing and angioinvasive features of this class of pathogenic fungi facilitate spread from sinuses into orbit and brain with devastating consequences like cavernous sinus thrombosis. We describe magnetic resonance, including diffusion weighted imaging findings in a case of micobiologically documented ROCM in a 50-year-old diabetic man. Restricted diffusion was demonstrated in the distribution of infiltrating lesion right from soft issue facial component through left orbit and in the cavernous sinus. Favorable outcome was achieved with surgical debridement and prolonged amphotericin therapy.

  18. Increased venous thrombosis incidence in pregnancies after in vitro fertilization

    DEFF Research Database (Denmark)

    Hansen, Anette Tarp; Kesmodel, U S; Juul, S;

    2014-01-01

    STUDY QUESTION Is venous thrombosis risk increased in pregnancies after in vitro fertilization? SUMMARY ANSWER The venous thrombosis incidence was significantly increased in pregnancies after in vitro fertilization; especially in the first trimester and in the first 6 weeks post-partum. WHAT...... IS KNOWN ALREADY In vitro fertilization without pregnancy is not associated with increased venous thrombosis incidence. STUDY DESIGN, SIZE, DURATION This national register-based cohort study covered the period from 1995 to 2005. PARTICIPANTS/MATERIALS, SETTING, METHODS All Danish pregnancies conceived...... by in vitro fertilization (n = 18 787) were included. Venous thrombosis incidence rates in pregnancies after in vitro fertilization were compared with venous thrombosis incidence rates in reference pregnancies, by calculating incidence rate ratios. MAIN RESULTS AND THE ROLE OF CHANCE In total, 48 cases were...

  19. Gut Microbial Metabolite TMAO Enhances Platelet Hyperreactivity and Thrombosis Risk.

    Science.gov (United States)

    Zhu, Weifei; Gregory, Jill C; Org, Elin; Buffa, Jennifer A; Gupta, Nilaksh; Wang, Zeneng; Li, Lin; Fu, Xiaoming; Wu, Yuping; Mehrabian, Margarete; Sartor, R Balfour; McIntyre, Thomas M; Silverstein, Roy L; Tang, W H Wilson; DiDonato, Joseph A; Brown, J Mark; Lusis, Aldons J; Hazen, Stanley L

    2016-03-24

    Normal platelet function is critical to blood hemostasis and maintenance of a closed circulatory system. Heightened platelet reactivity, however, is associated with cardiometabolic diseases and enhanced potential for thrombotic events. We now show gut microbes, through generation of trimethylamine N-oxide (TMAO), directly contribute to platelet hyperreactivity and enhanced thrombosis potential. Plasma TMAO levels in subjects (n > 4,000) independently predicted incident (3 years) thrombosis (heart attack, stroke) risk. Direct exposure of platelets to TMAO enhanced sub-maximal stimulus-dependent platelet activation from multiple agonists through augmented Ca(2+) release from intracellular stores. Animal model studies employing dietary choline or TMAO, germ-free mice, and microbial transplantation collectively confirm a role for gut microbiota and TMAO in modulating platelet hyperresponsiveness and thrombosis potential and identify microbial taxa associated with plasma TMAO and thrombosis potential. Collectively, the present results reveal a previously unrecognized mechanistic link between specific dietary nutrients, gut microbes, platelet function, and thrombosis risk.

  20. Ovarian vein thrombosis in Behçet disease.

    Science.gov (United States)

    Tan, Justina Wei Lynn; Howe, Hwee Siew; Chng, Hiok Hee

    2012-03-01

    We describe a 35-year-old Chinese woman with Behçet disease complicated by recurrent gastrointestinal flares. During admission for acute lower abdominal pain, a computed tomographic scan of the abdomen showed thrombosis of the left ovarian vein. She was treated with increased immunosuppressant and oral anticoagulant. Although she was not compliant to oral anticoagulant with her international normalized ratio frequently subtherapeutic, her symptoms abated and the thrombosis resolved. There has been only 1 reported case of a patient with Behçet disease presenting with postpartum ovarian vein thrombosis and pulmonary embolism and no reported case of Behçet disease with ovarian vein thrombosis occurring outside pregnancy and the puerperium. Ovarian vein thrombosis is a rare cause of abdominal pain that should be considered in patients with Behçet disease.

  1. Acute scrotal pain: an uncommon manifestation of renal vein thrombosis.

    Science.gov (United States)

    Jou, Yeong-Chin; Jong, Ing-Chin; Hsieh, Ying-Chen; Kang, Chun-Hsiung

    2014-03-01

    The clinical manifestation of renal vein thrombosis varies with the speed and degree of venous occlusion. Such patients may be asymptomatic, have minor nonspecific symptoms such as nausea or weakness, or have more specific symptoms such as upper abdominal pain, flank pain, or hematuria. Acute scrotal pain is a very uncommon clinical expression of renal vein thrombosis. Here, we report a case of membranous glomerulonephritis-induced renal vein thrombosis presented with the symptom of acute scrotal pain caused by thrombosis-induced varicocele. This case report suggests that renal vein thrombosis should be considered in the diagnosis of acute scrotal pain; it also emphasizes that an investigation of retroperitoneum should be performed for adult patients with the sudden onset of varicocele.

  2. Thrombosis warning in children suffering from Henoch-Schonlein Purpura

    Directory of Open Access Journals (Sweden)

    Luan Li

    2013-01-01

    Full Text Available Henoch-Schonlein Purpura (HSP is one of the most common types of vasculitis in children. The characteristic clinical manifestations include non-thrombocytopenic purpura, arthritis or arthralgia, abdominal pain, gastrointestinal hemorrhage and renal abnormalities. Thrombosis has been reported as, a rare complication of HSP. We present the case of a 14-year-old boy who was diagnosed with HSP and suspected superior mesenteric vein thrombosis. We reviewed the relevant literature and found eight similar reported cases. HSP is associated with thrombosis and HSP itself and some risk factors may result in thrombosis. We suggest that physicians should monitor patients with HSP who are at a higher risk of developing thrombosis more closely.

  3. Discrepant ratios of arterial versus venous thrombosis in hemophilia A as compared with hemophilia B.

    Science.gov (United States)

    Girolami, Antonio; Bertozzi, Irene; de Marinis, Giulia Berti; Tasinato, Valentina; Sambado, Luisa

    2014-04-01

    The occurrence of thrombosis in patients with congenital bleeding disorders represents an exceptional event. Hemophilia A and hemophilia B patients have been showed to present both arterial and venous thrombosis (85 cases of arterial thrombosis and 34 cases of venous thrombosis). The great majority of arterial thrombosis are myocardial infarction or other acute coronary syndromes, whereas the majority of venous thrombosis are deep vein thrombosis and/or pulmonary embolisms. However there are discrepancies in the proportion of arterial and venous thrombosis seen in hemophilia A versus hemophilia B. The ratio of arterial versus venous thrombosis in hemophilia A is 3.72 whereas that for hemophilia B is 1.12. This indicates that arterial thrombosis is more frequent in hemophilia A as compared to hemophilia B and the opposite is true for venous thrombosis. The potential significance of this discrepancy is discussed.

  4. Kaempferol inhibits thrombosis and platelet activation.

    Science.gov (United States)

    Choi, Jun-Hui; Park, Se-Eun; Kim, Sung-Jun; Kim, Seung

    2015-08-01

    The objectives of the present study were to investigate whether kaempferol affects pro-coagulant proteinase activity, fibrin clot formation, blood clot and thrombin (or collagen/epinephrine)-stimulated platelet activation, thrombosis, and coagulation in ICR (Imprinting Control Region) mice and SD (Sprague-Dawley) rats. Kaempferol significantly inhibited the enzymatic activities of thrombin and FXa by 68 ± 1.6% and 52 ± 2.4%, respectively. Kaempferol also inhibited fibrin polymer formation in turbidity. Microscopic analysis was performed using a fluorescent conjugate. Kaempferol completely attenuated phosphorylation of extracellular signal-regulated kinase (ERK) 1/2, p38, c-Jun N-terminal kinase (JNK) 1/2, and phosphoinositide 3-kinase (PI3K)/PKB (AKT) in thrombin-stimulated platelets and delayed aggregation time (clotting) by 34.6% in an assay of collagen/epinephrine-stimulated platelet activation. Moreover, kaempferol protected against thrombosis development in 3 animal models, including collagen/epinephrine- and thrombin-induced acute thromboembolism models and an FeCl3-induced carotid arterial thrombus model. The ex vivo anticoagulant effect of kaempferol was further confirmed in ICR mice. This study demonstrated that kaempferol may be clinically useful due to its ability to reduce or prevent thrombotic challenge.

  5. The aetiology of deep venous thrombosis.

    Science.gov (United States)

    Malone, P C; Agutter, P S

    2006-09-01

    Most ideas about the pathogenesis of deep venous thrombosis (DVT) are dominated by a 'consensus model' first articulated around 1962. This model invokes 'Virchow's triad' and attributes thrombogenesis in veins to some combination of 'hypercoagulability', 'stasis' and 'intimal injury'. This arose as a by-product of studies on the mechanisms of haemostasis and bleeding diatheses that were at best only indirectly relevant to thrombosis, and there are reasons for doubting the causal significance of 'hypercoagulability' and 'stasis' in the aetiology of DVT. Proponents of the consensus model make little reference to a substantial literature, mostly historical, that: (a) emphasizes the significance of the venous valve pockets (VVP) and blood rheology in DVT pathogenesis; and (b) describes morphological features specific to venous thrombi that a valid aetiological model must explain. This literature provides the basis for an alternative hypothesis of DVT aetiology, published some 30 years ago, which has been experimentally corroborated and is compatible with recent cell and molecular biological studies of the venous endothelium. We review this alternative hypothesis, considering its potential value for future research on DVT and embolism, and its significance for clinical practice.

  6. Purinergic Receptors in Thrombosis and Inflammation.

    Science.gov (United States)

    Hechler, Béatrice; Gachet, Christian

    2015-11-01

    Under various pathological conditions, including thrombosis and inflammation, extracellular nucleotide levels may increase because of both active release and passive leakage from damaged or dying cells. Once in the extracellular compartment, nucleotides interact with plasma membrane receptors belonging to the P2 purinergic family, which are expressed by virtually all circulating blood cells and in most blood vessels. In this review, we focus on the specific role of the 3 platelet P2 receptors P2Y1, P2Y12, and P2X1 in hemostasis and arterial thrombosis. Beyond platelets, these 3 receptors, along with the P2Y2, P2Y6, and P2X7 receptors, constitute the main P2 receptors mediating the proinflammatory effects of nucleotides, which play important roles in various functions of circulating blood cells and cells of the vessel wall. Each of these P2 receptor subtypes specifically contributes to chronic or acute vascular inflammation and related diseases, such as atherosclerosis, restenosis, endotoxemia, and sepsis. The potential for therapeutic targeting of these P2 receptor subtypes is also discussed.

  7. Cerebral microangiopathies; Zerebrale Mikroangiopathien

    Energy Technology Data Exchange (ETDEWEB)

    Linn, Jennifer [Klinikum der Universitaet Muenchen (Germany). Abt. fuer Neuroradiologie

    2011-03-15

    Cerebral microangiopathies are a very heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 - 30 % of all ischemic strokes. Degenerative microangiopathy and sporadic cerebral amyloid angiography represent the typical acquired cerebral microangiopathies, which are found in over 90 % of cases. Besides, a wide variety of rare, hereditary microangiopathy exists, as e.g. CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), Fabrys disease and MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes). (orig.)

  8. The risk of venous thrombosis in individuals with a history of superficial vein thrombosis and acquired venous thrombotic risk factors.

    Science.gov (United States)

    Roach, Rachel E J; Lijfering, Willem M; van Hylckama Vlieg, Astrid; Helmerhorst, Frans M; Rosendaal, Frits R; Cannegieter, Suzanne C

    2013-12-19

    Superficial vein thrombosis (SVT) increases the risk of venous thrombosis fourfold to sixfold. As most individuals with SVT do not develop venous thrombosis, additional risk factors may explain the risk of developing a venous thrombosis. In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study, we assessed the risk of venous thrombosis in individuals with previous SVT and a mild thrombotic risk factor (smoking or overweight/obesity), a strong risk factor (surgery, hospitalization, plaster cast immobilization, or malignancy), or a reproductive factor in women (oral contraception, postmenopausal hormone therapy, or pregnancy/puerperium). Individuals with previous SVT alone had a 5.5-fold (95% confidence interval [CI], 4.4-6.8) increased risk of venous thrombosis. This was 9.3 (95% CI, 7.2-12.1) combined with a mild thrombotic risk factor, 31.4 (95% CI, 14.6-67.5) with a strong risk factor, and 34.9 (95% CI, 19.1-63.8) in women with a reproductive risk factor. The highest separate risk estimates were found for SVT with surgery (42.5; 95% CI, 10.2-177.6), hospitalization (49.8; 95% CI, 11.9-209.2), or oral contraception (43.0; 95% CI, 15.5-119.3 in women). In conclusion, the risk of venous thrombosis is markedly increased in individuals with previous SVT who have an acquired thrombotic risk factor.

  9. Association of varicosities and concomitant deep venous thrombosis in patients with superficial venous thrombosis, a systematic review

    NARCIS (Netherlands)

    Baggen, Vivan J M; Chung, Kaman; Koole, Koos; Sarneel, Michelle H J; Rutten, Frans H; Hajer, Gideon R

    2015-01-01

    BACKGROUND: In patients with superficial venous thrombosis (SVT) co-existence of deep venous thrombosis (DVT) can be present. Varicosities are considered as a risk factor for both SVT and DVT separately. However, current evidence is contradictory whether varicosities are associated with an increased

  10. Occlusion of the pig superior sagittal sinus, bridging and cortical veins: multistep evolution of sinus-vein thrombosis.

    Science.gov (United States)

    Fries, G; Wallenfang, T; Hennen, J; Velthaus, M; Heimann, A; Schild, H; Perneczky, A; Kempski, O

    1992-07-01

    Cerebral sinus-vein thrombosis may lead to severe hemodynamic changes, elevated intracranial pressure (ICP), and brain edema. It is supposed that progression of the thrombus from the sinus into bridging and cortical veins plays a key role in the development of these pathophysiological changes, but this hypothesis lacks experimental proof. The aim of this study, using a novel animal model of sinus-vein thrombosis, was to evaluate the effects of a standardized occlusion of the superior sagittal sinus and its bridging and cortical veins on hemodynamic alterations, on brain water content, and on ICP in domestic pigs. In 10 animals, the middle third of the superior sagittal sinus was occluded with a catheter-guided balloon. Five of these pigs received an additional injection of 1 ml fibrin glue into the superior sagittal sinus anterior to the inflated balloon, leading to an obstruction of bridging and cortical veins. In five control animals the balloon was inserted but not inflated. Five pigs underwent cerebral angiography. Four hours after occlusion, the brains were frozen in liquid nitrogen, and coronal slices were examined for Evans blue dye extravasation, regional water content, and histological changes. Occlusion of the superior sagittal sinus alone did not affect ICP or cerebral perfusion pressure (CPP). The additional injection of fibrin glue caused an obstruction of cortical and bridging veins as well as severe increases in mean (+/- standard deviation) ICP to 49.4 +/- 14.3 mm Hg, compared with 8.3 +/- 4.5 mm Hg in sham-treated controls and 7.1 +/- 3.9 mm Hg in animals with occlusion of the superior sagittal sinus alone. There was also a steep fall in the mean CPP to 34.2 +/- 19.6 mm Hg compared with 96.4 +/- 13.8 mm Hg in the control group. White-matter water content anterior to the occlusion site was elevated to 81.9 +/- 3.7 gm/100 gm frozen weight in the fibrin group as compared to 70.7 +/- 2.2 gm/100 gm in controls. Posterior to the occlusion site, water

  11. Progressive Deconstruction of a Distal Posterior Cerebral Artery Aneurysm Using Competitive Flow Diversion.

    Science.gov (United States)

    Johnson, Andrew K; Tan, Lee A; Lopes, Demetrius K; Moftakhar, Roham

    2016-03-01

    Progressive deconstruction is an endovascular technique for aneurysm treatment that utilizes flow diverting stents to promote progressive thrombosis by diverting blood flow away from the aneurysm's parent vessel. While the aneurysm thromboses, collateral blood vessels develop over time to avoid infarction that can often accompany acute parent vessel occlusion. We report a 37-year-old woman with a left distal posterior cerebral artery aneurysm that was successfully treated with this strategy. The concept and rationale of progressive deconstruction are discussed in detail.

  12. COMMUNICATING ARTERY NOT VISUALIZED BY CEREBRAL ANGIOGRAPHY-REPORT OF FOUR CASES

    Institute of Scientific and Technical Information of China (English)

    张俊延; 王忠诚; 石祥恩

    1994-01-01

    Four cases of anterior communicating aneurysms are reported with clinical presentations of recurrent intracranial hemorrhage undisclosed in their cerbral angiography.Operative exploration revealed anterior communicating aneurysms in these patients.It is thought possible that these patients harbored aneurysms which failed to exhibit on angiograms due to temporary thrombosis or development of abnormal cerebral vessels.CT scanning was important for tdiagnosis of these patients.

  13. A new non-human primate model of photochemically induced cerebral infarction.

    Directory of Open Access Journals (Sweden)

    Satoshi Ikeda

    Full Text Available BACKGROUND AND PURPOSE: Rat models of photochemically induced cerebral infarction have been readily studied, but to date there are no reports of transcranial photochemically induced infarctions in the marmoset. In this report, we used this non-human primate as a model of cerebral thrombosis and observed the recovery process. METHODS: Five common marmosets were used. Cerebral ischemia was produced via intravascular thrombosis induced by an intravenous injection of Rose Bengal and irradiation with green light. After inducing cerebral infarction, we observed the behavior of marmosets via a continuous video recording. We evaluated maximum speed, mean speed, and distance traveled in 1 min. In addition, we evaluated scores for feeding behavior, upper limb grip, and lower limb grip. We confirmed the infarct area after cerebral infarction using 2,3,5-triphenyltetrazolium chloride staining in a separate marmoset. RESULTS: We found functional decreases 2 days after creating the cerebral infarction in all measurements. Total distance traveled, average speed, upper limb score, and feeding behavior score did not recover to pre-infarction levels within 28 days. Maximum speed in 1 min and lower limb score recovered 28 days after infarction as compared to pre-infarction levels. We confirmed the infarct area of 11.4 mm × 6.8 mm as stained with 2,3,5-triphenyltetrazolium chloride. CONCLUSION: We were able to create a primate photothrombosis-induced cerebral infarction model using marmosets and observe functional recovery. We suggest that this is a useful model for basic research of cerebral infarction.

  14. Cerebral sinus venous thromboses in children with acute lymphoblastic leukaemia - a multicentre study from the Nordic Society of Paediatric Haematology and Oncology

    DEFF Research Database (Denmark)

    Ranta, Susanna; Tuckuviene, Ruta; Mäkipernaa, Anne

    2014-01-01

    We present a prospective multicentre cohort of 20 children with acute lymphoblastic leukaemia (ALL) and cerebral sinus venous thrombosis (CSVT). The study covers a period of 5 years and comprises 1038 children treated according to the Nordic Society of Paediatric Haematology and Oncology (NOPHO...

  15. Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology

    Energy Technology Data Exchange (ETDEWEB)

    Parellada, Antoni J.; Reiter, Sean B.; Glickman, Peter L.; Kloss, Linda A. [Frankford Hospitals, DII - Diagnostic Imaging, Inc., Department of Radiology, Philadelphia, PA (United States); Morrison, William B. [Thomas Jefferson University, Philadelphia, PA (United States); Carrino, John A. [Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Patel, Pinecca [Frankford Hospitals, Jefferson Health System, Philadelphia, PA (United States)

    2006-09-15

    The purpose of this study was to highlight the critical role that MRI may play in diagnosing unsuspected lower extremity deep venous thrombosis and to stress the importance of scrutinizing MRI studies of the lower extremity showing apparently non-specific muscle edema for any evidence of intramuscular venous thrombosis. The imaging studies of four patients in whom deep venous thrombosis was unsuspected on clinical grounds, and first diagnosed on the basis of MRI findings, were reviewed by two musculoskeletal radiologists in consensus. In all four patients the initial clinical suspicion was within the scope of musculoskeletal injuries (gastrocnemius strain, n=3; ruptured Baker cyst, n=1), explaining the choice of MRI over ultrasound as the first diagnostic modality. All patients showed marked reactive edema in the surrounding soft tissues or muscles. Three patients showed MR evidence of branching rim-enhancing structures within intramuscular plexuses characteristic of venous thrombosis (gastrocnemius, n=1; sural, n=2); one patient showed a distended popliteal vein. Ultrasound was able to duplicate the MRI findings in three patients: one patient showed above-the-knee extension on ultrasound; neither of the two patients with intramuscular thrombosis demonstrated on ultrasound showed extension to the deep venous trunks. Intramuscular venous thrombosis can present as marked edema-like muscle changes on MRI, simulating primary musculoskeletal conditions. In the absence of clinical suspicion for deep venous thrombosis, only the identification of rim-enhancing branching intramuscular tubular structures will allow the correct diagnosis to be made. (orig.)

  16. Ovarian vein thrombosis in a polytrauma patient.

    Science.gov (United States)

    Toman, Emma; Beaven, Alastair; Balogun, Moji; Porter, Keith

    2015-12-18

    A young mother presented to a major trauma centre following a road traffic collision. Her admission CT traumagram demonstrated liver and renal lacerations, spinal and pelvic fractures with no abnormalities of the ovarian veins. Her inpatient course was uncomplicated other than a sustained, isolated raised C reactive protein. CT of the abdomen 1 week after injury demonstrated stable solid organ injuries and the additional, unexpected finding of a right ovarian vein thrombosis (OVT). A pragmatic approach was taken towards the management of the OVT given the haemorrhagic risk from her traumatic injuries. A multidisciplinary, consultant-led plan was made to slowly increase enoxaparin to a therapeutic dose under close surveillance and to then switch to warfarin following an outpatient consultation with a consultant haematologist. A MR venogram was performed after 3 months of anticoagulation, and this demonstrated complete resolution of the OVT and normal appearances of the ovary.

  17. Internal Jugular Vein Thrombosis following Oropharyngeal Infection

    Directory of Open Access Journals (Sweden)

    Asli Bostanci

    2015-01-01

    Full Text Available Internal jugular vein thrombosis (IJVT is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications.

  18. LATERAL SINUS THROMBOSIS IN OTOLOGY: A REVIEW

    Directory of Open Access Journals (Sweden)

    B Visavanatha

    2010-09-01

    Full Text Available Lateral sinus thrombosis (LST is usually occurs as a complication of middle ear infection .The involvement of lateral sinus during the course of ear infection was a well known complication in preantibiotic days .The decrease in the incidence of LST is due to the introduction of broad-spectrum antibiotics, early diagnosis and surgical treatment. Now, it is a rare complication of otitis media and poses a serious threat that warrants immediate medical and surgical treatment. The classical clinical picture is often changed by previous antibiotic therapy. An awareness of this rare potentially devastating condition and its varied presentations is necessary for early diagnosis and treatment. LST can also occur after head injury.

  19. 抗磷脂综合征患者血栓事件的危险因素分析%Analysis of risk factors in development of thrombosis in patients with antiphospholipid syndrome

    Institute of Scientific and Technical Information of China (English)

    李茹; 周云杉; 贾园; 栗占国

    2012-01-01

    目的:探讨影响抗磷脂综合征( antiphospholipid syndrome,APS)患者血栓事件发生的危险因素.方法:回顾性分析北京大学人民医院收治的61例APS患者血栓事件的发生特点,评价血栓事件与患者临床及免疫学指标的相关性,包括性别、年龄、有无血小板减少、吸烟、高血压、糖尿病、高脂血症和抗磷脂抗体等.结果:70.49% APS患者发生血栓事件,其中动脉血栓发生率36.67%,静脉血栓发生率39.34%,下肢静脉血栓和脑梗塞最常见,分别占37.7%和24.59%,其次为肺栓塞、血栓性微血管病、肾梗死和脾梗死.抗心磷脂抗体阳性和高血压分别是静脉和动脉血栓事件的独立危险因素.结论:抗心磷脂抗体阳性者易发生静脉血栓,而合并高血压的APS患者易发生动脉血栓.%Objective: To analyze the risk factors in the development of thrombosis in antiphospholipid syndrome (APS) patients. Methods: We retrospectively analyzed the characteristics of thrombosis in 61 APS patients. Clinical and laboratory parameters such as sex, age, thrombocytopenia, smoking, hypertension, diabetes mellitus, hyperlipidemia and anti-phospholipid antibodies were investigated to find out the risk factors of thrombosis. Results: Thrombosis was found in 70.49% APS patients, of whom, the prevalence of arterial and venous thrombosis were 36. 67% and 39. 34% , respectively. Deep vein thrombosis of lower extremity (37. 7% ) and cerebral infarction (24. 59% ) were the most common thrombosis events, and then pulmonary embolism, thrombotic microangiopathy and renal artery thrombosis were also common in APS patients. The positive anti-cardiolipin antibody and hypertension were the independent risk factors for venous and arterial thrombosis, respectively. Conclusion: Anti-cardiolipin antibody is associated with a higher risk of venous thrombosis, and hypertension is associated with arterial thrombosis.

  20. Ovarian Vein Thrombosis as a Complication of Laparoscopic Surgery.

    Science.gov (United States)

    Gupta, Anu; Gupta, Natasha; Blankstein, Josef; Trester, Richard

    2015-01-01

    Ovarian vein thrombosis (OVT) is an extremely rare but life-threatening complication of the postpartum period. It has never been reported as a complication of laparoscopic surgery. We report a case of right ovarian vein thrombosis that occurred in the postoperative period after patient underwent laparoscopic salpingectomy for a right side ectopic pregnancy. She presented with 1-week history of abdominal pain and fever. A complete workup for fever was performed and was found negative. Computed tomography of the abdomen and pelvis revealed right ovarian vein thrombosis. The patient was treated with anticoagulant therapy and responded well.

  1. Ovarian Vein Thrombosis as a Complication of Laparoscopic Surgery

    Directory of Open Access Journals (Sweden)

    Anu Gupta

    2015-01-01

    Full Text Available Ovarian vein thrombosis (OVT is an extremely rare but life-threatening complication of the postpartum period. It has never been reported as a complication of laparoscopic surgery. We report a case of right ovarian vein thrombosis that occurred in the postoperative period after patient underwent laparoscopic salpingectomy for a right side ectopic pregnancy. She presented with 1-week history of abdominal pain and fever. A complete workup for fever was performed and was found negative. Computed tomography of the abdomen and pelvis revealed right ovarian vein thrombosis. The patient was treated with anticoagulant therapy and responded well.

  2. Unusual Presentation of Renal Vein Thrombosis in a Preterm Infant.

    Science.gov (United States)

    Yang, Chang-Yo; Fu, Ren-Huei; Lien, Reyin; Yang, Peng-Hong

    2014-05-01

    Neonatal renal vein thrombosis is the most common vascular condition in the newborn kidney, which could lead to serious complication in infants undergoing intensive care. In this study, we report the case of a preterm infant with left renal vein and inferior vena cava thrombosis, presented with gross hematuria, thrombocytopenia, transient hypertension, and adrenal hemorrhage. Supportive care was offered instead of heparin therapy or thrombolytic agents. In conclusion, our case teaches that, despite the lack of a clinically obvious shock event, renal vein thrombosis should be considered in a macrohematuric newborn without renal failure.

  3. Thrombosis modeling in intracranial aneurysms: a lattice Boltzmann numerical algorithm

    Science.gov (United States)

    Ouared, R.; Chopard, B.; Stahl, B.; Rüfenacht, D. A.; Yilmaz, H.; Courbebaisse, G.

    2008-07-01

    The lattice Boltzmann numerical method is applied to model blood flow (plasma and platelets) and clotting in intracranial aneurysms at a mesoscopic level. The dynamics of blood clotting (thrombosis) is governed by mechanical variations of shear stress near wall that influence platelets-wall interactions. Thrombosis starts and grows below a shear rate threshold, and stops above it. Within this assumption, it is possible to account qualitatively well for partial, full or no occlusion of the aneurysm, and to explain why spontaneous thrombosis is more likely to occur in giant aneurysms than in small or medium sized aneurysms.

  4. Postpartum ovarian vein thrombosis after cesarean delivery: a case report

    Directory of Open Access Journals (Sweden)

    Royo Pedro

    2008-04-01

    Full Text Available Abstract Introduction Postpartum ovarian vein thrombosis is an uncommon complication; incidence varies between 0.002% and 0.05%. It most often occurs during the 2–15 days following delivery. Case presentation A 22-year-old pregnant woman at term presented to hospital with uterine contractions, abdominal pain, nausea and vomiting. After delivery an ovarian vein thrombosis was diagnosed. Conclusion Low-molecular weight heparin with broad-spectrum antibiotics are the accepted therapy in non-complicated cases of postpartum ovarian vein thrombosis.

  5. Postpartum ovarian vein thrombosis after cesarean delivery: a case report

    Science.gov (United States)

    Royo, Pedro; Alonso-Burgos, Alberto; García-Manero, Manuel; Lecumberri, Ramón; Alcázar, Juan Luis

    2008-01-01

    Introduction Postpartum ovarian vein thrombosis is an uncommon complication; incidence varies between 0.002% and 0.05%. It most often occurs during the 2–15 days following delivery. Case presentation A 22-year-old pregnant woman at term presented to hospital with uterine contractions, abdominal pain, nausea and vomiting. After delivery an ovarian vein thrombosis was diagnosed. Conclusion Low-molecular weight heparin with broad-spectrum antibiotics are the accepted therapy in non-complicated cases of postpartum ovarian vein thrombosis. PMID:18400095

  6. Incidence and diagnosis of deep vein thrombosis associated with pregnancy.

    Science.gov (United States)

    Kierkegaard, A

    1983-01-01

    The incidence of deep vein thrombosis (DVT), diagnosed by ascending phlebography, has been calculated retrospectively in a group of 14 869 obstetrical patients. The incidence was calculated to 0.13 per thousand antepartum and 0.61 per thousand postpartum. The study revealed that clinical signs and symptoms of thrombosis are very unreliable in pregnant women but more reliable in puerperal women. It is concluded that objective diagnosis of thrombosis is important in pregnant women, and ascending phlebography is a rewarding objective method to use in pregnant women.

  7. Primary leiomyosarcoma of saphenous vein presenting as deep venous thrombosis.

    Science.gov (United States)

    Fremed, Daniel I; Faries, Peter L; Schanzer, Harry R; Marin, Michael L; Ting, Windsor

    2014-12-01

    Only a small number of venous leiomyosarcomas have been previously reported. Of these tumors, those of saphenous origin comprise a minority of cases. A 59-year-old man presented with symptoms of deep vein thrombosis and was eventually diagnosed with primary leiomyosarcoma of great saphenous vein origin. The tumor was treated with primary resection and femoral vein reconstruction with autologous patch. Although extremely rare, saphenous leiomyosarcoma can present as deep vein thrombosis. Vascular tumors should be included in the differential diagnosis of atypical extremity swelling refractory to conventional deep vein thrombosis management.

  8. Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

    Directory of Open Access Journals (Sweden)

    Wesley Eilbert

    2014-07-01

    Full Text Available Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. [West J Emerg Med. 2014;15(4:395-397.

  9. Strategies in the treatment for intracranial venous sinus thrombosis

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    JIA Qiang

    2013-03-01

    Full Text Available Background Cerebral venous sinus thrombosis (CVST is a special type of cerebrovascular disease with high morbidity and mortality which often has an unpredictable outcome. It is usually misdiagnosed because of different causes and variable clinical manifestations. How to improve the diagnosis and therapy of CVST is always the hotspot in clinic. This article aims to investigate the effective and safe strategies in the treatment for CVST. Methods Clinical data of 52 patients diagnosed with CVST were retrospectively analyzed. These patients were subdivided into mild type and severe type according to the features of symptoms, signs, lumbar puncture pressure and imaging. The patients with mild type were treated with systemic anticoagulant therapy combined with intravenous thrombolysis [continuous intravenous infusion of heparin (12.50-25 × 103 U/d for 7-10 d followed by a continuous infusion of urokinase (0.50-0.75 ×106 U/d for 5-7d]. The patients with severe type were treated with endovascular thrombolysis [injection of urokinase (0.50-1 × 106 U, 0.10 × 106 U/min via carotid or vertebral artery; or intravenous infusion of urokinase 1 ×106 U/d and heparin 25 ×103 U/d for 5-7 d], and superior sagittal sinus cut-open/ intrasinus thrombolysis separately. All the patients took oral warfarin for 6-12 months, and follow-up was performed after operation by the method of magnetic resonance venography (MRV. Results Among the 27 cases of mild type receiving systemic anticoagulant agents and intravenous thrombolysis, 14 were cured; 9 were improved; 4 were ineffective. Among the 22 cases of severe type receiving systemic anticoagulant drugs and endovascular thrombolysis, 18 were cured; 3 were improved; 1 was dead. The left 3 cases with gravis type received superior sagittal sinus cut-open/intrasinus thrombolysis and were cured. The period of follow-up was between 6 months and 60 months (the median time was 36 months, and no recurrence happened. Conclusion

  10. New insights into the mechanisms of venous thrombosis.

    Science.gov (United States)

    Mackman, Nigel

    2012-07-01

    Venous thrombosis is a leading cause of morbidity and mortality in industrialized countries, especially in the elderly. Many risk factors have been identified for venous thrombosis that alter blood flow, activate the endothelium, and increase blood coagulation. However, the precise mechanisms that trigger clotting in large veins have not been fully elucidated. The most common site for initiation of the thrombus appears to be the valve pocket sinus, due to its tendency to become hypoxic. Activation of endothelial cells by hypoxia or possibly inflammatory stimuli would lead to surface expression of adhesion receptors that facilitate the binding of circulating leukocytes and microvesicles. Subsequent activation of the leukocytes induces expression of the potent procoagulant protein tissue factor that triggers thrombosis. Understanding the mechanisms of venous thrombosis may lead to the development of new treatments.

  11. Acute stent thrombosis after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Wiberg, Sebastian; Van't Hof, Arnoud;

    2015-01-01

    OBJECTIVES: This study sought to determine clinical, procedural, and treatment factors associated with acute stent thrombosis (AST) in the EUROMAX (European Ambulance Acute Coronary Syndrome Angiography) trial. BACKGROUND: Bivalirudin started during transport for primary percutaneous coronary int...

  12. Plantar vein thrombosis: a rare cause of plantar foot pain

    Energy Technology Data Exchange (ETDEWEB)

    Siegal, Daniel S.; Wu, Jim S.; Brennan, Darren D.; Hochman, Mary G. [Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA (United States); Challies, Tracy [Beth Israel Deaconess Medical Center, Department of Pathology, Boston, MA (United States)

    2008-03-15

    Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound. The symptoms resolved with conservative treatment and evaluation revealed the presence of a prothrombin gene mutation and use of oral contraceptive pills. To our knowledge, this is the first case of plantar vein thrombosis diagnosed initially by MRI. Moreover, this case suggests that plantar vein thrombosis should be considered in patients with hypercoagulable states and plantar foot pain. (orig.)

  13. Anti-GBM disease and renal vein thrombosis.

    Science.gov (United States)

    Bailey, Phillippa; Sarfraz, Farook; Ravanan, Rommel

    2011-11-15

    A 23-year-old female who presented with advanced renal failure was subsequently diagnosed with renal vein thrombosis and antiglomerular basement membrane (GBM) antibody disease. A previous case of renal vein thrombosis has been reported in association with anti-GBM disease, but to our knowledge, this is the first reported case in which the presentation of anti-GBM disease and renal vein thrombosis was concurrent. Further study is essential to understand if the association of anti-GBM disease and renal vein thrombosis as seen in our case was pure coincidence or is in fact occurs more frequently. It may be that the dual diagnosis is not made as establishing one sufficient diagnosis for renal failure may halt further investigations for additional diagnoses.

  14. Inflammation, thrombosis and atherosclerosis: results of the Glostrup study

    DEFF Research Database (Denmark)

    Maat, M de; Bladbjerg, E-M; Drivsholm, T;

    2003-01-01

    Inflammation and thrombosis are important mechanisms in cardiovascular disease, as illustrated by the consistent association between inflammatory and hemostatic variables and the risk of cardiovascular events in epidemiological studies. However, the relationship between plasma concentrations of i...

  15. Ligustrazine monomer against cerebral ischemia-reperfusion injury

    Directory of Open Access Journals (Sweden)

    Hai-jun Gao

    2015-01-01

    Full Text Available Ligustrazine (2,3,5,6-tetramethylpyrazine is a major active ingredient of the Szechwan lovage rhizome and is extensively used in treatment of ischemic cerebrovascular disease. The mechanism of action of ligustrazine use against ischemic cerebrovascular diseases remains unclear at present. This study summarizes its protective effect, the optimum time window of administration, and the most effective mode of administration for clinical treatment of cerebral ischemia/reperfusion injury. We examine the effects of ligustrazine on suppressing excitatory amino acid release, promoting migration, differentiation and proliferation of endogenous neural stem cells. We also looked at its effects on angiogenesis and how it inhibits thrombosis, the inflammatory response, and apoptosis after cerebral ischemia. We consider that ligustrazine gives noticeable protection from cerebral ischemia/reperfusion injury. The time window of ligustrazine administration is limited. The protective effect and time window of a series of derivative monomers of ligustrazine such as 2-[(1,1-dimethylethyloxidoimino]methyl]-3,5,6-trimethylpyrazine, CXC137 and CXC195 after cerebral ischemia were better than ligustrazine.

  16. Ovarian Vein Thrombosis as a Complication of Laparoscopic Surgery

    OpenAIRE

    Anu Gupta; Natasha Gupta; Josef Blankstein; Richard Trester

    2015-01-01

    Ovarian vein thrombosis (OVT) is an extremely rare but life-threatening complication of the postpartum period. It has never been reported as a complication of laparoscopic surgery. We report a case of right ovarian vein thrombosis that occurred in the postoperative period after patient underwent laparoscopic salpingectomy for a right side ectopic pregnancy. She presented with 1-week history of abdominal pain and fever. A complete workup for fever was performed and was found negative. Computed...

  17. Vena porta thrombosis in patient with inherited factor VII deficiency

    DEFF Research Database (Denmark)

    Klovaite, Jolanta; Friis-Hansen, Lennart Jan; Larsen, Fin S;

    2010-01-01

    with inherited FVII deficiency and chronic vena porta thrombosis. She presented at 32 weeks of gestation with spontaneously increased international normalized ratio, severe thrombocytopenia and very few unspecific symptoms. The extensive examination of the patient revealed cavernous transformation of the portal...... vein with well expressed portosystemic collaterals, heterozygosity for three common polymorphisms in FVII gene, associated with reduction in plasma FVII levels, and no other factors predisposing to thrombosis....

  18. Upper extremity thrombosis in Behçet’s disease

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    Adem Küçük

    2013-09-01

    Full Text Available Behçet’s disease (BD is a systemic disease characterizedby oral aphthosis, genital ulcers, ocular lesions andalso gastrointestinal, musculoskeletal, neurological andvessel involvements may develop. Venous manifestationsare more common than arterial involvement. Venousinvolvement often occurs in the veins of lower extremity.Upper extremity venous involvement is rare. In this paperwe report a case of BH presenting with upper extremitysuperficial vein thrombosis.Key words: Behçet’s disease, upper extremity, superficialvein thrombosis

  19. Gonadal vein tumor thrombosis due to renal cell carcinoma

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    Hamidreza Haghighatkhah

    2015-01-01

    Full Text Available Renal cell carcinoma (RCC had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC

  20. Acute celiac trunk thrombosis revealed by biliary peritonitis.

    Science.gov (United States)

    Jerraya, H; Sbaï, A; Khalfallah, M; Dziri, C

    2015-11-01

    Acute thrombosis of the celiac trunk is a very uncommon condition, which is a life-threatening emergency. The clinical presentation is highly variable depending on the extent of the ischemic territory. We report a case of biliary peritonitis related to an acute thrombosis of the celiac trunk. This case highlights the role of abdominal computed tomography in the diagnosis of acute upper abdominal pain.

  1. Abdominal aortic thrombosis in a patient with nephrotic syndrome.

    Science.gov (United States)

    Nakamura, M; Ohnishi, T; Okamoto, S; Yamakado, T; Isaka, N; Nakano, T

    1998-01-01

    We report a patient who presented with severe nephrotic syndrome complicated with infrarenal aortic and right renal arterial thrombosis. The nephrotic syndrome frequently causes thromboembolic complications in veins, but arterial thrombosis is relatively rare, especially in the aorta. Various predisposing factors leading to thromboembolic complications are discussed. In this case, the thromboembolic complication may have some clinical association with the hypercoagulable state in nephrotic syndrome.

  2. Gonadal vein tumor thrombosis due to renal cell carcinoma.

    Science.gov (United States)

    Haghighatkhah, Hamidreza; Karimi, Mohammad Ali; Taheri, Morteza Sanei

    2015-01-01

    Renal cell carcinoma (RCC) had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC.

  3. Plantar Vein Thrombosis: An Unusual Cause of Plantar Pain

    OpenAIRE

    Vansevenant, Milan; Vanhoenacker, Filip M.

    2015-01-01

    We present a case of an 80-year-old man with progressive pain for 5 days at the medial and plantar aspect of the left heel. Wearing shoes aggravated the pain. Ultrasound and magnetic resonance imaging (MRI) revealed thrombosis of the medial plantar veins. Plantar vein thrombosis is a rare condition. The clinical symptoms are non-specific and can be confused with plantar fasciitis. It has been associated with hypercoagulable conditions, foot trauma and recent surgery. The imaging modality of c...

  4. Chylous ascites caused by acute pancreatitis with portal vein thrombosis

    OpenAIRE

    Park, Dong Eun; Chae, Kwon Mook

    2011-01-01

    Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also rev...

  5. [Portal vein thrombosis in patients with thrombophilia--own observations].

    Science.gov (United States)

    Swiatkowska-Stodulska, Renata; Kazimierska, Ewa; Weyer-Hepka, Jolanta; Dworakowska, Dorota; Lubińska, Monika; Gnacińska, Maria; Bakowska, Alicja; Czestochowska, Eugenia

    2005-04-01

    Portal vein thrombosis is one of the main prehepatic causes of portal hypertension. The most frequent causes of thrombosis in this localization, apart from hepatic cirrhosis, are the following: acute inflammatory diseases and abdominal cancers, traumas, proliferative diseases of the hematopoietic system. In recent years attention was given to disorders in hemostasis, such as thrombophilia, in the course of which thrombosis development is particularly common. The authors present 10 patients after an incident of portal vein thrombosis, in which primary hepatic pathology was excluded and tests directed at thrombophilia were performed. In seven patients abnormalities in the examined parameters were found, and what is more, in two cases they had a complex character and involved more than one parameter. In five patients hyperhomocysteinemia was found. Among them, in two patients there was also a decreased protein S activity and in one of them there was also APC-resistance. In the next two patients there were abnormalities in one of the examined parameters - APC-resistance. Hyperhomocysteinemia was found in all patients with idiopathic thrombosis, and in one of them there were concurrent changes in protein S activity and APC-resistance. In patients with the history of portal vein thrombosis diagnostics of thrombophilia should be performed.

  6. Correlation Between C677T and A1298C Mutations on the MTHFR Gene With Plasma Homocysteine Levels and Venous Thrombosis in Pregnant Women at Risk of Thrombosis

    OpenAIRE

    Kazem Ghaffari; Ali Ghasemi; Abbas Ghotaslou; Mohsen Mohammadi; Zeynal Salmanpour

    2015-01-01

    Background: Deep venous thrombosis (DVT) is a common disease with a high morbidity, mortality and increase in miscarriages. Objectives: The purpose of this study was to assessment the correlation between C677T and A1298C mutations on the methylenetetrahydrofolate reductase (MTHFR) gene with total plasma homocysteine levels and deep venous thrombosis in pregnant women at risk of thrombosis. Pati...

  7. Integrated laboratory coagulation tests in hypercoagulation diagnosis and thrombosis risk assessment. Part I. The pathophysiology of thrombosis and hypercoagulation

    Directory of Open Access Journals (Sweden)

    E. N. Lipets

    2015-01-01

    Full Text Available Thrombosis is a fatal hemostatic disorders occurring in various conditions ranging from pregnancy and surgery to cancer, sepsis and heart attack. Despite the availability of different anticoagulants and accumulated clinical experience, proving their effectiveness, thrombosis remains a major cause of morbidity and mortality. This is largely due to the fact that conventional laboratory coagulation tests are not sufficiently sensitive to the hypercoagulable state, and they are difficult to use for assessing the risk of thrombosis. Specific molecular markers (D-dimers, fibrinopeptide, thrombin-antithrombin complex are more effective, but also have a large number of disadvantages. A possible solution is the use of integrated test, which simulate in vitro the majority of the physiological coagulation processes. In the first part of this paper the biochemical processes that cause the risk of thrombosis were discussed.

  8. Deep vein thrombosis: a clinical review

    Directory of Open Access Journals (Sweden)

    Kesieme EB

    2011-04-01

    Full Text Available Emeka Kesieme1, Chinenye Kesieme2, Nze Jebbin3, Eshiobo Irekpita1, Andrew Dongo11Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 2Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 3Department of Surgery, University of Port Harcourt Teaching Hospital, Port-Harcourt, NigeriaBackground: Deep vein thrombosis (DVT is the formation of blood clots (thrombi in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.Aim: To present an update on the causes and management of DVT.Methods: A review of publications obtained from Medline search, medical libraries, and Google.Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran and selective

  9. [Pain in venous thrombosis of the leg].

    Science.gov (United States)

    Henriet, J P

    1992-01-01

    According to D. Reinharez, pain and edema are the commonest presenting symptoms in phlebology. Pain is one of the most classical symptoms of an ordinary deep venous thrombosis, a valuable feature when present, in the form of deep tension, heaviness, swelling and a feeling of dead weight. It is often absent or slight. It may consist merely of a dull cramp, or of an "undefinable" (C. Bourde) odd, heavy leg. It generally affects the calf but may involve the sole of the foot, the heel, the thigh, the groin or even the true pelvis. This feeling, although "imprecise and variable" (P. Wallois, P. Griton) is highly suggestive. It increases on standing and walking in the form of unilateral uncomfortable tension, heaviness or painful swelling, which maybe a source of worry or even anxiety to the patient. Tenderness on palpation of venous tracts and their stretching is more suggestive. In the opinion of M. Duruble, Neuhof's sign (feeling of tender fullness of the calf) is more reliable than Homans' sign (pain in the calf caused by passive dorsiflexion of the foot, with the lower limb in extension) which essentially stretches only the posterior tibial venous system. The value of Sigg's sign (pain in the popliteal fossa on passive extension of the knee) is controversial. Far more rare is phlegmasia coerulea dolens or Grégoire's blue leg, complicating phlegmasia alba dolens or of sudden onset, with initial very severe or even "intolerable" pain (J.J. Pinot) in Scarpa's triangle, rapidly spreading to the limb. In varicose phlebitis (M. Perrin) or superficial thrombophlebitis or varico-phlebitis (A.A. Ramelet) or superficial venitis (J.P. Henriet), pain most often consists of moderate burning tension overlying the thrombosed vein(s), increased by palpation and mobilisation. Sometimes severe initially, it is exacerbated by the slightest touch. In total, pain, regardless of its characteristics, its site and/or its severity, is one of the most constant clinical features of venous

  10. Reversible cerebral vasoconstriction syndrome

    Directory of Open Access Journals (Sweden)

    Saini Monica

    2009-01-01

    Full Text Available Reversible cerebral vasoconstriction syndromes (RCVS are a group of disorders that have in common an acute presentation with headache, reversible vasoconstriction of cerebral arteries, with or without neurological signs and symptoms. In contrast to primary central nervous system vasculitis, they have a relatively benign course. We describe here a patient who was diagnosed with RCVS.

  11. Deep Vein Thrombosis Prophylaxis in Trauma Patients

    Directory of Open Access Journals (Sweden)

    Serdar Toker

    2011-01-01

    Full Text Available Deep vein thrombosis (DVT and pulmonary embolism (PE are known collectively as venous thromboembolism (VTE. Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of\t5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC filters. The available pharmacologic agents include low-dose heparin (LDH, low molecular weight heparin (LMWH, and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs, pneumatic compression devices (PCDs, and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  12. Trousseau's syndrome: cancer-associated thrombosis.

    Science.gov (United States)

    Ikushima, Soichiro; Ono, Ryu; Fukuda, Kensuke; Sakayori, Masashi; Awano, Nobuyasu; Kondo, Keisuke

    2016-03-01

    Trousseau's syndrome (cancer-associated thrombosis) is the second leading cause of death in cancer patients, after death from cancer itself. The risk of a venous thromboembolism is 4- to 7-fold higher in patients with cancer than in those without cancer. The causes of this impaired coagulation are associated with general patient-related risk factors, and other factors that are specific to the particular cancer or treatment. It is important to assess the risk of thrombotic events in cancer patients and administer effective prophylaxis and treatment. Effective prophylaxis and treatment of venous thromboembolism reduces morbidity and mortality, and improves patients' quality of life. Low molecular weight heparin is the first-line treatment for venous thromboembolism, as an effective and safe means for prophylaxis and treatment, according to guidelines released by international scientific societies. Oral anticoagulation therapy with warfarin is preferable to no therapy. However, warfarin has low efficacy and is associated with high rates of recurrence. If low molecular weight heparin is unavailable, some guidelines recommend the use of vitamin K antagonists that have a target international normalized ratio in the range of 2-3, as acceptable alternatives. Novel oral anticoagulants that directly inhibit factor Xa or thrombin are promising for the prophylaxis of high-risk cancer patients and in the long-term treatment of venous thromboembolism. However, to date, there is insufficient evidence to support the use of these new anticoagulants.

  13. Deep vein thrombosis prophylaxis in trauma patients.

    Science.gov (United States)

    Toker, Serdar; Hak, David J; Morgan, Steven J

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  14. Platelet thrombosis in cardiac-valve prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Dewanjee, M.K.

    1989-01-01

    The contribution of platelets and clotting factors in thrombosis on cardiovascular prostheses had been quantified with several tracers. Thrombus formation in vivo could be measured semiquantitatively in animal models and patients with indium-111, Technetium-99m labeled platelets, iodine-123, iodine-131 labeled fibrinogen, and In-111 and Tc-99m labeled antibody to the fibrinogen-receptor on the platelet- membrane, or fibrin. The early studies demonstrated that certain platelet-inhibitors, e.g. sulfinpyrazone, aspirin or aspirin- persantine increased platelet survival time with mechanical valves implanted in the baboon model and patients. Thrombus localization by imaging is possible for large thrombus on thrombogenic surface of prosthesis in the acute phase. The majority of thrombus was found in the sewing ring (Dacron) in the acute phase in both the mechanical and tissue valves. The amount of retained thrombus in both mechanical and tissue valves in our one-day study in the dog model was similar (< 1% if injected In-111 platelets = 5 billion platelets). As the fibrous ingrowth covered the sewing ring, the thrombus formation decreased significantly. Only a small amount of thrombus was found on the leaflets at one month in both the dog and calf models. 38 refs., 9 figs., 5 tabs.

  15. Imaging Diagnosis of Splanchnic Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    S. Rajesh

    2015-01-01

    Full Text Available Splanchnic vein thrombosis (SVT is a broad term that includes Budd-Chiari syndrome and occlusion of veins that constitute the portal venous system. Due to the common risk factors involved in the pathogenesis of these clinically distinct disorders, concurrent involvement of two different regions is quite common. In acute and subacute SVT, the symptoms may overlap with a variety of other abdominal emergencies while in chronic SVT, the extent of portal hypertension and its attendant complications determine the clinical course. As a result, clinical diagnosis is often difficult and is frequently reliant on imaging. Tremendous improvements in vascular imaging in recent years have ensured that this once rare entity is being increasingly detected. Treatment of acute SVT requires immediate anticoagulation. Transcatheter thrombolysis or transjugular intrahepatic portosystemic shunt is used in the event of clinical deterioration. In cases with peritonitis, immediate laparotomy and bowel resection may be required for irreversible bowel ischemia. In chronic SVT, the underlying cause should be identified and treated. The imaging manifestations of the clinical syndromes resulting from SVT are comprehensively discussed here along with a brief review of the relevant clinical features and therapeutic approach.

  16. Pancreatic Pseudocyst Causing Celiac Artery Trunk Thrombosis

    Directory of Open Access Journals (Sweden)

    Christopher Challand

    2008-07-01

    Full Text Available Context Vascular complications of pancreatitis are more common in alcoholrather than gallstone-induced pancreatitis. Such complications are an important cause of mortality and morbidity, although peripancreatic vessel obstruction is a rare consequence. Patients with peripancreatic arterial obstruction can present with sudden and unexplained clinical deterioration requiring prompt diagnosis and intervention. Case report A 42-year-old woman with a proven pancreatic pseudocyst presented with acute abdominal pain. Initial investigations were non-diagnostic. A gastroscopy revealed patchy necrosis of the proximal stomach. Following sudden clinical deterioration, a contrast-enhanced CT scan was performed. The CT scan demonstrated a thickened gastric wall with intramural gas. The decision was taken to proceed to laparotomy, which revealed both gastric and splenic infarction. A total gastrectomy with Roux-en-Y reconstruction and splenectomy was performed. She made a successful recovery. Conclusion Arterial thrombosis should be considered in any patient with chronic pancreatitis who presents with an acute clinical deterioration. Successful outcomes can be achieved with prompt diagnosis using contrast-enhanced CT scanning and early surgical intervention.

  17. Epidemiology of venous thrombosis in children with cancer.

    Science.gov (United States)

    Piovesan, Dana; Attard, Chantal; Monagle, Paul; Ignjatovic, Vera

    2014-06-01

    There has been an extensive body of research focusing on the epidemiology of thrombosis in adult cancer populations; however, there is significantly less knowledge about thrombosis in paediatric cancer populations. Thrombosis is diagnosed with increasing frequency in children being treated for cancer, and there is an urgent need to increase our understanding of the epidemiology of thrombosis in this population. Currently, there are no guidelines for identification of high-risk groups, prophylaxis or management of thrombotic complications in paediatric cancer patients. We reviewed the available literature regarding the epidemiology, mechanisms, risk factors, prophylaxis and outcomes of thrombosis in children with cancer and identified areas that require further research. The reported incidence of symptomatic venous thromboembolism (VTE) in children with cancer ranges between 2.1% and 16%, while the incidence of asymptomatic events is approximately 40%. Approximately 30% of VTE in this population is associated with central venous lines (CVL). The most common location of VTE is upper and lower extremity deep venous thrombosis (43 to 50% of events, respectively), while 50% of events in ALL patients occur in the central nervous system. Key characteristics that increase the risk of thrombosis include the type of cancer, age of the patient, the presence of a CVL, presence of pulmonary/intra thoracic disease, as well as the type of chemotherapy. Outcomes for paediatric cancer patients with VTE include post-thrombotic syndrome, pulmonary embolism, recurrent thromboembolism, destruction of upper venous system and death. Prospective studies aimed at enabling risk stratification of patients are required to facilitate development of paediatric specific recommendations related to thromboprophylaxis in this population.

  18. Contribution of recurrent venous thrombosis and inherited thrombophilia to the pathogenesis of postthrombotic syndrome.

    Science.gov (United States)

    Kreidy, Raghid

    2015-01-01

    Postthrombotic syndrome (PTS) is a common complication of deep vein thrombosis. This study aims to assess the role of recurrent venous thrombosis and inherited thrombophilia in the pathogenesis of PTS. A series of 206 patients diagnosed with lower extremity venous thrombosis were retrospectively reviewed. The PTS was observed in 30.58% of the patients. Recurrent venous thrombosis was identified in 3.4% of the patients without PTS and in 33.3% of patients with PTS (P thrombophilia alone or in association with recurrent venous thrombosis was more commonly detected when PTS was moderate to severe (P = .04 and thrombophilia is present either alone or in association with recurrent venous thrombosis.

  19. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  20. Color Doppler US of normal cerebral venous sinuses in neonates: a comparison with MR venography

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Elka [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Children' s Hospital of Eastern Ontario (CHEO), Diagnostic Imaging Department, Ottawa (Canada); Daneman, Alan; Doria, Andrea S.; Blaser, Susan; Traubici, Jeffrey; Jarrin, Jose; Shroff, Manohar [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Moineddin, Rahim [University of Toronto, Toronto (Canada); Moore, Aideen [Hospital for Sick Children, Department of Neonatology, Toronto (Canada)

    2012-09-15

    Color Doppler US (CDUS) has been used for evaluation of cerebral venous sinuses in neonates. However, there is very limited information available regarding the appearance of superficial and deep normal cerebral venous sinuses using CDUS and the specificity of the technique to rule out disease. To determine the specificity, inter-modality and inter-reader agreement of color Doppler US (CDUS). To evaluate normal cerebral venous sinuses in neonates in comparison to MR venography (MRV). Newborns undergoing a clinically indicated brain MRI were prospectively evaluated. All underwent a dedicated CDUS of the cerebral venous sinuses within 10 h (mean, 3.5 h, range, and 2-7.6 h) of the MRI study using a standard protocol. Fifty consecutive neonates participated in the study (30 males [60%]; 25-41 weeks old; mean, 37 weeks). The mean time interval between the date of birth and the CDUS study was 19.1 days. No cases showed evidence of thrombosis. Overall agreement for US reading was 97% (range, 82-100%), for MRV reading, 99% (range, 96-100%) and for intermodality, 100% (range, 96-100%). Excellent US-MRI agreement was noted for superior sagittal sinus, cerebral veins, straight sinus, torcular Herophili, sigmoid sinus, superior jugular veins (94-98%) and transverse sinuses (82-86%). In 10 cases (20%), MRV showed flow gaps whereas normal flow was demonstrated with US. Visualization of the inferior sagittal sinus was limited with both imaging techniques. Excellent reading agreement was noted for US, MRV and intermodality. CDUS is highly specific to rule out cerebral venous thrombosis in neonates and holds potential for clinical application as part of clinical-laboratory-imaging algorithms of pre/post-test probabilities of disease. (orig.)

  1. Anestesia e paralisia cerebral

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC) é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório n...

  2. Computer-assisted venous thrombosis volume quantification.

    Science.gov (United States)

    Puentes, John; Dhibi, Mounir; Bressollette, Luc; Guias, Bruno; Solaiman, Basel

    2009-03-01

    Venous thrombosis (VT) volume assessment, by verifying its risk of progression when anticoagulant or thrombolytic therapies are prescribed, is often necessary to screen life-threatening complications. Commonly, VT volume estimation is done by manual delineation of few contours in the ultrasound (US) image sequence, assuming that the VT has a regular shape and constant radius, thus producing significant errors. This paper presents and evaluates a comprehensive functional approach based on the combination of robust anisotropic diffusion and deformable contours to calculate VT volume in a more accurate manner when applied to freehand 2-D US image sequences. Robust anisotropic filtering reduces image speckle noise without generating incoherent edge discontinuities. Prior knowledge of the VT shape allows initializing the deformable contour, which is then guided by the noise-filtering outcome. Segmented contours are subsequently used to calculate VT volume. The proposed approach is integrated into a system prototype compatible with existing clinical US machines that additionally tracks the acquired images 3-D position and provides a dense Delaunay triangulation required for volume calculation. A predefined robust anisotropic diffusion and deformable contour parameter set enhances the system usability. Experimental results pertinence is assessed by comparison with manual and tetrahedron-based volume computations, using images acquired by two medical experts of eight plastic phantoms and eight in vitro VTs, whose independently measured volume is the reference ground truth. Results show a mean difference between 16 and 35 mm(3) for volumes that vary from 655 to 2826 mm(3). Two in vivo VT volumes are also calculated to illustrate how this approach could be applied in clinical conditions when the real value is unknown. Comparative results for the two experts differ from 1.2% to 10.08% of the smallest estimated value when the image acquisition cadences are similar.

  3. [Treatment of nontumoral portal vein thrombosis in cirrhosis].

    Science.gov (United States)

    Bañares, Rafael; Catalina, María-Vega

    2014-07-01

    Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis. The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function, might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure. There is controversy concerning the most effective treatment of portal vein thrombosis, which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency. Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications. There are no proven data on the type of anticoagulant (low-molecular-weight heparins or dicoumarin agents) and the treatment duration. The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases. Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety; its use is therefore not supported for this indication. The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives.

  4. Thrombosis and morphology of plaque rupture using optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    GUO Jun; CHEN Yun-dai; TIAN Feng; LIU Hong-bin; CHEN Lian; SUN Zhi-jun; REN Yi-hong

    2013-01-01

    Background Thrombosis following plaque rupture is the main cause of acute coronary syndrome,but not all plaque ruptures lead to thrombosis.There are limited in vivo data on the relationship between the morphology of ruptured plaque and thrombosis.Methods We used optical coherence tomography (OCT) to investigate the morphology of plaque rupture and its relation to coronary artery thrombosis in patients with coronary heart disease.Forty-two patients with coronary artery plaque rupture detected by OCT were divided into two groups (with or without thrombus) and the morphological characteristics of ruptured plaque,including fibrous cap thickness and broken cap site,were recorded.Results The fibrous cap of ruptured plaque with thrombus was significantly thinner compared to caps without thrombus ((57.00±17.00) μm vs.(96.00±48.00) μm; P=0.0076).Conclusions Plaque rupture associated with thrombosis occurs primarily in plaque covered by a thin fibrous cap.Thick fibrous caps are associated with greater stability of ruptured plaque.

  5. Immediate re-transplantation following early kidney transplant thrombosis.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2012-02-01

    Allograft thrombosis is a devastating early complication of renal transplantation that ultimately leads to allograft loss. We report here on our experience of nine cases of immediate re-transplantation following early kidney transplant thrombosis at a single centre between January 1990 and June 2009. The mean age was 42.9 years at time of transplant. For seven patients, the allograft thrombosis was their first kidney transplant and seven of the nine cases had a deceased donor transplant. The initial transplants functioned for a mean of 1.67 days and the patients received a second allograft at a mean of 3.1 days after graft failure. All of the re-transplants worked immediately. Four allografts failed after a mean of 52.5 months (2-155 months). Two of these died with a functioning allograft, one failed owing to chronic allograft nephropathy and one owing to persistent acute cellular rejection. The remaining five patients still have a functioning allograft after a mean of 101.8 months (7-187 months). One year allograft and patient survival after re-transplantation were 87.5% and 100% respectively (after 5 years, both were 57%). Immediate re-transplantation following early kidney transplant thrombosis can be a success. It may be considered in selected cases after allograft thrombosis.

  6. Immediate re-transplantation following early kidney transplant thrombosis.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2011-08-01

    Allograft thrombosis is a devastating early complication of renal transplantation that ultimately leads to allograft loss. We report here on our experience of nine cases of immediate re-transplantation following early kidney transplant thrombosis at a single centre between January 1990 and June 2009. The mean age was 42.9 years at time of transplant. For seven patients, the allograft thrombosis was their first kidney transplant and seven of the nine cases had a deceased donor transplant. The initial transplants functioned for a mean of 1.67 days and the patients received a second allograft at a mean of 3.1 days after graft failure. All of the re-transplants worked immediately. Four allografts failed after a mean of 52.5 months (2-155 months). Two of these died with a functioning allograft, one failed owing to chronic allograft nephropathy and one owing to persistent acute cellular rejection. The remaining five patients still have a functioning allograft after a mean of 101.8 months (7-187 months). One year allograft and patient survival after re-transplantation were 87.5% and 100% respectively (after 5 years, both were 57%). Immediate re-transplantation following early kidney transplant thrombosis can be a success. It may be considered in selected cases after allograft thrombosis.

  7. Air pollution and venous thrombosis: a meta-analysis

    Science.gov (United States)

    Tang, Liang; Wang, Qing-Yun; Cheng, Zhi-Peng; Hu, Bei; Liu, Jing-Di; Hu, Yu

    2016-09-01

    Exposure to air pollution has been linked to cardiovascular and respiratory disorders. However, the effect of air pollution on venous thrombotic disorders is uncertain. We performed a meta-analysis to assess the association between air pollution and venous thrombosis. PubMed, Embase, EBM Reviews, Healthstar, Global Health, Nursing Database, and Web of Science were searched for citations on air pollutants (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and particulate matters) and venous thrombosis. Using a random-effects model, overall risk estimates were derived for each increment of 10 μg/m3 of pollutant concentration. Of the 485 in-depth reviewed studies, 8 citations, involving approximately 700,000 events, fulfilled the inclusion criteria. All the main air pollutants analyzed were not associated with an increased risk of venous thrombosis (OR = 1.005, 95% CI = 0.998-1.012 for PM2.5; OR = 0.995, 95% CI = 0.984-1.007 for PM10; OR = 1.006, 95% CI = 0.994-1.019 for NO2). Based on exposure period and thrombosis location, additional subgroup analyses provided results comparable with those of the overall analyses. There was no evidence of publication bias. Therefore, this meta analysis does not suggest the possible role of air pollution as risk factor for venous thrombosis in general population.

  8. SPLANCHNIC VEIN THROMBOSIS IN THE MEDITERRANEAN AREA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Hanaa El-Karaksy

    2011-07-01

    Full Text Available Abdominal venous thrombosis may present as splanchnic venous thrombosis (SVT (occlusion of portal, splenic, superior or inferior mesenteric veins or Budd- Chiari Syndrome (BCS (thrombosis of inferior vena cava and/or hepatic veins. The aim of this review is to report the scanty data available for splanchnic vein thrombosis in the South Mediterranean area. In one Egyptian study, the possible circumstantial risk factors for portal vein thrombosis were found in 30% of cases:  19% neonatal sepsis, 8.7% umbilical catheterization, 6% severe gastroenteritis and dehydration. Another Egyptian study concluded that hereditary thrombophilia was common in children with PVT (62.5%, the commonest being factor V Leiden mutation (FVL (30%. Concurrence of more than one hereditary thrombophilia was not uncommon (12.5%. The first international publication on hepatic veno-occlusive disease (VOD in Egypt was in 1965 in children who rapidly develop abdominal distention with ascites and hepatomegaly. This disease was more frequent in malnourished children coming from rural areas; infusions given at home may contain noxious substances that were hepatotoxic and Infections might play a role. VOD of childhood is rarely seen nowadays. Data from South Mediterranean area are deficient and this may be attributable to reporting in local medical journals that are difficult to access. Medical societies concerned with this topic could help distribute this information.

  9. Validation of hyperintense middle cerebral artery sign in acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Gang Guo; Yonggui Yang; Weiqun Yang

    2012-01-01

    We performed a retrospective analysis of non-contrast computed tomography (CT) scans, immediately subsequent magnetic resonance imaging (MRI), and cerebral angiography data from 30 consecutive patients with acute ischemic stroke within 6 hours after symptom onset. Results showed that eleven patients developed subsequent hemorrhagic transformation at follow-up. A hyperintense middle cerebral artery sign on MRI was found in six hemorrhagic patients, all of who had acute thrombosis formation on magnetic resonance angiography and digital subtraction angiography. No patients in the non-hemorrhagic group had hyperintense middle cerebral artery sign on MRI. The sensitivity, specificity, and positive predictive values of the hyperintense middle cerebral artery sign on MRI T1-weighted image for subsequent hemorrhagic transformation were 54.5%, 100%, and 100% respectively. Hyperdense middle cerebral artery sign on non-contrast CT was observed in nine patients, five of who developed hemorrhagic transformation. These data suggest that hyperintense middle cerebral artery sign on MRI T1-weighted image is a highly specific and moderately sensitive indicator of subsequent hemorrhagic transformation in patients after acute ischemic stroke, and its specificity is superior to CT.

  10. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    Energy Technology Data Exchange (ETDEWEB)

    Asari S.; Satch, T.; Sakurai, M.; Yamamoto, Y. (Matsuyama Shimin Hospital, Matsuyama (Japan)); Sadamoto, K.

    1981-06-01

    1. Cerebral arteries and veins were demonstrated by multiplane computed cerebral angiotomography (combination of axial, modified coronal, half axial (Towne), and semisagittal planes). The vessels which were demonstrated by various planes were as follows: Axial plane: Willis ring, middle cerebral arteries (horizontal and insular portions), anterior cerebral arteries (Horizontal and ascending portions), posterior cerebral arteries, basal vein of Rosenthal, internal cerebral veins (and the subependymal veins which join the ICV), and vein of Galen. Coronal plane: intermal carotid arteries (supraclinoid portion), anterior cerebral arteries (horizontal portion), middle cerebral arteries (horizontal and insular portions), lenticulostriate arteries, basal vein of Rosenthal (and the subependymal veins which join this vessel), internal cerebral veins, and vein of Galen. Half axial plane (Towne projection): basilar artery, vertebral arteries, posterior cerebral arteries, superior cerebellar arteries, middle cerebral arteries (horizontal portion), and anterior cerebral arteries (horizontal and ascending portions). Semisagittal plane: internal carotid artery (supraclinoid portion), posterior communicating artery, posterior carebral artery, superior cerebellar artery, internal cerebral vein, basal vein of Rosenthal, vein of Galen, and straight shinus. 2. A detailed knowledge of normal cerebrovascular structures acquired by computed tomography (CT) is essential in detecting and more precisely localizing lesions such as cerebrovascular disease, neoplasm or abscess, in differentiating these lesions from the normal contrast-enhanced structures, and in understanding the spatial relationship between the mass lesion and the neighboring vessels. In addition, it will be possible to discover such asymptomatic cerebrovascular diseases as non-ruptured aneurysms, arteriovenous malformations, and Moyamoya disease by means of computed cerebral angiotomography.

  11. Is thrombosis a contributor to heart failure pathophysiology? Possible mechanisms, therapeutic opportunities, and clinical investigation challenges

    NARCIS (Netherlands)

    Zannad, F.; Stough, W.G.; Regnault, V.; Gheorghiade, M.; Deliargyris, E.; Gibson, C.M.; Agewall, S.; Berkowitz, S.D.; Burton, P.; Calvo, G.; Goldstein, S.; Verheugt, F.W.A.; Koglin, J.; O'Connor, C.M.

    2013-01-01

    Thrombotic events (coronary thrombosis, venous thromboembolism, intraventricular thrombosis, intracranial and systemic thromboembolism) occur frequently in patients with heart failure. These events may be precipitated by several mechanisms including hypercoagulability through enhancement of procoagu

  12. MR imaging of dural sinus thrombosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Si Kyung; Han, Chun Hwan; Lee, Moon Ok; Park, Kyung Joo; Lee, Joo Hyuk [Kang Nam General HosPital, Public Corporation, Seoul (Korea, Republic of)

    1993-01-15

    We present a case of angiographically confirmed transverse and sigmoid sinus thrombosis, image with MR, in a 20 year old male with a history of otitis media and maxillary sinusitis. T1-weighted image demonstrated an iso signal intensity mass with tubular-shaped low signal intensity in right transverse and sigmoid sinus. The thrombus had high signal intensity on T2-weighted image. The signal intensity of the thrombus on Gd-DTPA enhanced T1-weighted image was unusually high similar to that of transverse sinus. Although dural sinus thrombosis has a non-specific MR signal intensity, findings of MRI in this case may serve as an aid in future evaluation of venous thrombosis.

  13. HIV associated deep vein thrombosis: Case reports from Jos, Nigeria

    Directory of Open Access Journals (Sweden)

    C A Daniyam

    2011-01-01

    Full Text Available Deep vein thrombosis (DVT has been reported to be 2-10 times commoner in HIV infected patients than in the general population. We report two cases of extensive unilateral deep vein thrombosis involving the lower limb in HIV infected patients on highly active antiretroviral therapy (HAART. Doppler ultrasound in the two patients revealed evidence of venous thrombosis from the femoral vein down to the posterior tibial veins. None of the patients had a history of acquired risk factors for DVT. Both patients responded well to anti-coagulants. A high index of suspicion may therefore be required to make the diagnosis and institute adequate management for this condition which has potentially life threatening consequences.

  14. Neonatal haemostasis and the management of neonatal thrombosis.

    Science.gov (United States)

    Will, Andrew

    2015-05-01

    Two detailed reviews of the management of neonatal thrombosis were published in 2012; one was an up-dated version of guidance first issued in 2004 and the other was a comprehensive review. Both of these publications gave very similar advice regarding the practical aspects of the indications, dosage and management of antithrombotic therapy. The authors stated that the evidence supporting most of their recommendations for anti-thrombotic therapy in neonates remained weak and so the therapy for a neonate with a thrombosis has to be based on an individualized assessment of estimated risk versus potential benefit. The aim of this present review is to give the treating physician an outline of the unique physiology of neonatal coagulation and how this affects the monitoring, dosing and even the choice of therapeutic strategy for the management of thrombosis in the neonate.

  15. Upper extremity deep vein thrombosis in a military patient.

    Science.gov (United States)

    Bullock, Charlotte; Johnston, A McD

    2016-08-01

    We describe the case of a 23-year-old serviceman on overseas deployment who presented with a painful, swollen arm. Investigations showed an upper extremity deep vein thrombosis (UEDVT) of the right arm with an associated asymptomatic pulmonary embolism, which was treated with warfarin anticoagulation. Further investigation identified positional obstruction at the thoracic outlet, and the patient was diagnosed with Paget-Schroetter syndrome. He underwent elective resection of the first rib, and has now returned to normal duties. After review of the literature on UEDVT, it is suggested that in this military patient, the occurrence of an anatomical variant put him at risk of upper limb venous thrombosis, which was probably potentiated by the occupational factor of carrying a rifle. The external compression of the subclavian vein from the rifle butt and hypertrophied muscles, in addition to the anatomical variation, caused repetitive microtrauma of the vessel intima, which precipitated venous thrombosis.

  16. Eosinophilia and thrombosis in parasitic diseases: an overview.

    Science.gov (United States)

    Ames, Paul R J; Aloj, Giuseppina; Gentile, Fabrizio

    2011-02-01

    It is known that peripheral blood eosinophilia (PBE) is a normal hematopoietic response to several parasitic diseases, but it is less known that PBE promotes a hypercoagulable state that may favor thrombosis. Scope of this article is to explore which parasitic infestations are most likely to be complicated by thrombosis and to highlight the pathogenetic contribution of PBE to vascular occlusions in this setting. A review of the world literature revealed 18 cases in which PBE was associated with vascular occlusion though no specific surveys were dedicated to this topic. The eosinophil exerts its thrombogenic potential by inhibition of the natural anticoagulant pathways and release of tissue factor with enhanced coagulation activation leading to vascular occlusion. It is hoped that this review contributes to the awareness of the link between PBE and thrombosis in parasitic disorders to foster research in this area.

  17. A case of neonatal arterial thrombosis mimicking interrupted aortic arch.

    Science.gov (United States)

    Gürsu, Hazım Alper; Varan, Birgül; Oktay, Ayla; Özkan, Murat

    2015-06-01

    Neonatal arterial thrombosis is a very rare entity with clinical findings resembling coarctation of aorta or interrupted aortic arch. A two day-old male newborn was admitted to a different hospital with difficulty in sucking and sleepiness. On echocardiographic examination, a diagnosis of interrupted aortic arch was made and he was treated with prostoglandin E2. When the patient presented to our center, physical examination revealed that his feet were bilaterally cold. The pulses were not palpable and there were ecchymotic regions in the lower extremities. Echocardiography ruled out interrupted aortic arch. Computerized tomographic angiography revealed a large thrombosis and total occlusion of the abdominal aorta. Since there was no response to treatment with tissue plasminogen activator, we performed thrombectomy. Homozygous Factor V Leiden and Methylenetetrahydrofolate reductase mutations were found in this patient. Neonatal aortic thrombosis which is observed very rarely and fatal should be considered in the differential diagnosis of coarctation of aorta and interrupted aortic arch.

  18. Portal vein thrombosis with renal cell carcinoma: a case report.

    Science.gov (United States)

    D'Elia, Carolina; Cerruto, Maria Angela; Molinari, Alberto; Piovesan, Raffaella; Cavicchioli, Francesca; Minja, Anila; Novella, Giovanni; Artibani, Walter

    2014-01-01

    Portal vein thrombosis refers to an obstruction of blood flow in the portal vein; this rare disease can be both local and systemic. Local risk factors, accounting for about 70% of cases, can be abdominal cancers, inflammatory of infective diseases, surgical procedures or cirrhosis. A 62-year-old man, affected by hypertension and taking acetylsalicylic acid after a myocardial infarction in 1994, developed deep venous thrombosis on the right leg. Six months later the patient was admitted to the emergency unit due to abdominal pain. A CT scan revealed the presence of a complete splanchnic vein thrombosis and a primary tumor on the right kidney. The patient was treated with total parenteral nutrition and intravenous solution of heparin sodium first and then, because of occurrence of allergy, fondaparinux, with improvement of the abdominal pain. Subsequently he underwent right radical nephrectomy.

  19. Infrahepatic inferior vena cava agenesis with bilateral renal vein thrombosis.

    Science.gov (United States)

    Skeik, Nedaa; Wickstrom, Kelly K; Schumacher, Clark W; Sullivan, Timothy M

    2013-10-01

    Congenital anomalies of the inferior vena cava (IVC) are rare and are estimated to be present in 0.07-8.7% of the general population. IVC agenesis (IVCA) is found in approximately 5% of cases of unprovoked lower extremity deep vein thrombosis in patients Renal vein thrombosis (RVT) is an extremely rare and unusual presentation of IVCA. We report a unique case of a 23-year-old previously healthy man presenting with infrahepatic IVCA-induced bilateral RVT with azygos and hemiazygos continuation. To our knowledge, this is the third reported case in the literature of IVCA-induced RVT and the first to affect the bilateral renal veins in the absence of any other thrombogenic risk factors or any lower extremity venous complications. We also present a literature review of IVCA-induced vein thrombosis and highlight the lack of literature to manage this condition.

  20. Acute aortic thrombosis following incorrect application of the Heimlich maneuver.

    Science.gov (United States)

    Mack, Lloyd; Forbes, Thomas L; Harris, Kenneth A

    2002-01-01

    The Heimlich maneuver has been widely accepted as a safe and effective method of relieving life-threatening foreign-body upper airway obstruction. When applied incorrectly, however, it may result in direct trauma to the intraabdominal viscera. Only two cases of major aortic complications have been reported. Both have involved thrombosis of an abdominal aortic aneurysm. We report two further instances of aortic thrombotic complications due to the incorrect application of the Heimlich maneuver. The first case resulted in thrombosis of an abdominal aortic aneurysm. In the second case the abdominal thrusts caused dislodgement of thrombus from an atherosclerotic nonaneurysmal aorta, which resulted in thromboembolic occlusion of both lower extremities. In both cases, as with the two previously reported instances, massive reperfusion injury resulted, which eventually proved fatal. When applied incorrectly, the Heimlich maneuver may result in direct trauma to the abdominalaorta and is an unusual cause of acute aortic thrombosis.

  1. Uterine myomatosis and portal vein thrombosis: a rare association

    Directory of Open Access Journals (Sweden)

    Elamurugan Sujindra

    2016-09-01

    Full Text Available Uterine leiomyomas are the most common pelvic tumors in women and occur in 20 and ndash;30% of women over 30 years of age. Many complications are seen with fibroid. We report a rare case of a large uterine leiomyoma associated with portal vein thrombosis. 50-year patient presented lower abdomen swelling associated with pain and breathlessness, diagnosed as multiple fibroids. She had massive splenomegaly. Abdomen Doppler revealed splenomegaly with thrombosis of portal, splenic and superior mesenteric vein. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Iron deficiency anaemia with thrombocytosis caused by fibroid was the identified cause for portal vein thrombosis. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3265-3267

  2. Portal hypertension due to portal venous thrombosis: Etiology, clinical outcomes

    Institute of Scientific and Technical Information of China (English)

    Ozgur Harmanci; Yusuf Bayraktar

    2007-01-01

    The thrombophilia in adult life has major implications in the hepatic vessels. The resulting portal vein thrombosis has various outcomes and complications. Esophageal varices, portal gastropathy, ascites, severe hypersplenism and liver failure needing liver transplantation are known well. The newly formed collateral venous circulation showing itself as pseudocholangicarcinoma sign and its possible clinical reflection as cholestasis are also known from a long time. The management strategies for these complications of portal vein thrombosis are not different from their counterpart which is cirrhotic portal hypertension, but the prognosis is unquestionably better in former cases. In this review we present and discuss the portal vein thrombosis, etiology and the resulting clinical pictures. There are controversial issues in nomenclature,management (including anticoagulation problems), follow up strategies and liver transplantation. In the light of the current knowledge, we discuss some controversial issues in literature and present our experience and our proposals about this group of patients.

  3. Deep venous thrombosis and postthrombotic syndrome: invasive management.

    Science.gov (United States)

    Comerota, A J

    2015-03-01

    Invasive management of postthrombotic syndrome encompasses the two ends of the deep vein thrombosis spectrum, patients with acute iliofemoral deep vein thrombosis and those with chronic postthrombotic iliofemoral venous obstruction. Of all patients with acute deep vein thrombosis, those with involvement of the iliofemoral segments have the most severe chronic postthrombotic morbidity. Catheter-based techniques now permit percutaneous treatment to eliminate thrombus, restore patency, potentially maintain valvular function, and improve quality of life. Randomized trial data support an initial treatment strategy of thrombus removal. Failure to eliminate acute thrombus from the iliofemoral system leads to chronic postthrombotic obstruction of venous outflow. Debilitating chronic postthrombotic symptoms of the long-standing obstruction of venous outflow can be reduced by restoring unobstructed venous drainage from the profunda femoris vein to the vena cava.

  4. Postoperative Cervical Haematoma Complicated by Ipsilateral Carotid Thrombosis and Aphasia after Anterior Cervical Fusion: A Case Report

    Directory of Open Access Journals (Sweden)

    Kingsley R. Chin

    2013-01-01

    Full Text Available Hematoma alone is the most common vascular complication reported after anterior cervical decompression and fusion (ACDF. We present this case to report the occurrence of postoperative cervical hematoma complicated by ipsilateral carotid thrombosis and aphasia after an uncomplicated C4–6 ACDF. This is a case of a 65-year-old woman who underwent revision fusions of the C4-5 and C6-7 levels complicated by postoperative cervical hematoma and carotid thrombosis. The patient's history, clinical examination, imaging findings, and treatment are reported. The revision fusions were performed and deemed routine. Approximately eight hours later 200 mL of blood was evacuated from a postoperative cervical hematoma. The patient became unresponsive and disoriented a few hours after evacuating the hematoma. Computed tomography and magnetic resonance imaging of the brain were normal, but magnetic resonance angiography demonstrated total occlusion of the left carotid artery. Thrombectomy was performed and the patient was discharged without residual deficits. At the latest followup she is fully functional and asymptomatic in her neck. We suggest, after evacuating a cervical hematoma, an evaluation of the carotids be made with MRA or cerebral angiography, as this may demonstrate a clot before the patient develops symptoms.

  5. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  6. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge;

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  7. Thrombosis of orbital varices; Trombosis de varices orbitarias

    Energy Technology Data Exchange (ETDEWEB)

    Boschi Oyhenart, J.; Tenyi, A.; Boschi Pau, J. [Hospital Italiano, Montevideo (Uruguay)

    2002-07-01

    Orbital varices are venous malformations produced by an abnormal dilatation of one or more orbital veins, probably associated with congenital weakness of the vascular wall. They are rare lesions, usually occurring in young patients, that produce intermittent proptosis related to the increase in the systemic venous pressure. The presence of hemorrhage or thrombosis is associated with rapid development of proptosis, pain and decreased ocular motility. We report the cases of two adult patients with orbital varices complicated by thrombosis in whom the diagnosis was based on computed tomography. The ultrasound and magnetic resonance findings are also discussed. (Author) 16 refs.

  8. Combined arteriovenous thrombolytic infusion for refractory renal vein thrombosis.

    Science.gov (United States)

    Heafner, Thomas A; Scott, Daniel; Watson, J Devin; Propper, Brandon; Johnson, Chatt; Arthurs, Zachary M

    2014-08-01

    Acute renal vein thrombosis can rapidly lead to significant impairment and eventual loss of renal function. Classically presenting with flank pain, hematuria, and laboratory markers consistent with acute kidney injury, therapeutic anticoagulation is the mainstay of treatment. However, endovascular surgery offers a safe and effective alternative for renal salvage in the setting of acute renal vein thrombosis. Described is the use of combined arteriovenous thrombolytic infusion for refractory renal vein thromboses to quickly and effectively decrease clot burden in the micro- and macrovenous circulations while limiting systemic exposure.

  9. Acute scrotum in a neonate caused by renal vein thrombosis.

    Science.gov (United States)

    Maas, C; Müller-Hansen, I; Flechsig, H; Poets, C F

    2011-03-01

    The authors report on a rare case of neonatal scrotal oedema occurring concurrently with pain upon palpation of the spermatic cord on the first day of life. An ultrasound examination showed poor perfusion of the left testicle and a thrombosis of the left renal vein; intraoperative exploration indicated necrosis of the left testicle without signs of torsion. Gorged vessels with paravasal bleeding were found in the spermatic cord. The authors hypothesise that necrosis of the testicle may result from haemorrhagic infarction caused by renal venous thrombosis. Acute scrotal discolouration with pain upon palpation in neonates is usually attributed to testicular torsion. The authors report a case where these symptoms had a different cause.

  10. MANAGEMENT OF DEEP VEIN THROMBOSIS AT PAEDIATRIC POPULATION

    Directory of Open Access Journals (Sweden)

    Alina-Costina LUCA

    2016-06-01

    Full Text Available Deep vein thrombosis (DVT was considered a rare condition in the pediatric population, more recent data show a significant increase in incidence. DVT occurs due to an imbalance of hemeostasis. There are incriminated multiple risk factors, of which the most common is the central venous catheter. Imaging evaluation plays a crucial role in early diagnosis of the disease. Anticoagulant therapy is the first line of treatment, adapted existing protocols for adults. This article addresses the assessment and treatment of pediatric patients with deep vein thrombosis.

  11. Chylous ascites caused by acute pancreatitis with portal vein thrombosis.

    Science.gov (United States)

    Park, Dong Eun; Chae, Kwon Mook

    2011-12-01

    Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also review the relevant literature about chylous ascites with particular reference to the management of this rare disease.

  12. Anatomical Variations of Cerebral MR Venography: Is Gender Matter?

    Science.gov (United States)

    Singh, Rambir; Bansal, Nikhil; Paliwal, Vimal Kumar

    2016-01-01

    Purpose Knowledge of variations in the cerebral dural venous sinus anatomy seen on magnetic resonance (MR) venography is essential to avoid over-diagnosis of cerebral venous sinus thrombosis (CVST). Very limited data is available on gender difference of the cerebral dural venous sinus anatomy variations. Materials and Methods A retrospective study was conducted to study the normal anatomy of the intracranial venous system and its normal variation, as depicted by 3D MR venography, in normal adults and any gender-related differences. Results A total of 1654 patients (582 men, 1072 women, age range 19 to 86 years, mean age: 37.98±13.83 years) were included in the study. Most common indication for MR venography was headache (75.4%). Hypoplastic left transverse sinus was the most common anatomical variation in 352 (21.3%) patients. Left transverse sinus was hypoplastic in more commonly in male in comparison to female (24.9% versus 19.3%, p = 0.009). Most common variation of superior sagittal sinus (SSS) was atresia of anterior one third SSS (15, 0.9%). Except hypoplastic left transverse sinus, rest of anatomical variations of the transverse and other sinuses were not significantly differ among both genders. Conclusion Hypoplastic left transverse sinus is the most common anatomical variation and more common in male compared to female in the present study. Other anatomical variations of dural venous sinuses are not significantly differ among both genders. PMID:27621945

  13. The Incidence of Peripheral Catheter-Related Thrombosis in Surgical Patients

    Directory of Open Access Journals (Sweden)

    Amy Leung

    2016-01-01

    Full Text Available Background. Central venous catheters and peripherally inserted central catheters are well established risk factors for upper limb deep vein thrombosis. There is limited literature on the thrombosis rates in patients with peripheral catheters. A prospective observational study was conducted to determine the incidence of peripheral catheter-related thrombosis in surgical patients. Methods. Patients deemed high risk for venous thrombosis with a peripheral catheter were considered eligible for the study. An ultrasound was performed on enrolment into the study and at discharge from hospital. Participants were reviewed twice a day for clinical features of upper limb deep vein thrombosis during their admission and followed up at 30 days. Results. 54 patients were included in the study. The incidence of deep vein thrombosis and superficial venous thrombosis was 1.8% and 9.2%, respectively. All cases of venous thrombosis were asymptomatic. Risk factor analysis was limited by the low incidence of thrombosis. Conclusion. This study revealed a low incidence of deep vein thrombosis in surgical patients with peripheral catheters (1.8%. The study was underpowered; therefore the association between peripheral catheters and thrombosis is unable to be established. Future studies with larger sample sizes are required to determine the association between peripheral catheters and thrombosis.

  14. Air travel and venous thrombosis : results of the WRIGHT study : Part I: Epidemiology

    NARCIS (Netherlands)

    Kuipers, Saskia

    2009-01-01

    In venous thrombosis, a blood clot develops in a vein, usually a deep vein of the leg, causing obstruction of the blood flow. Venous thrombosis is a multicausal disease, in which genes and environment interact. One of the environmental factors that increases the risk of venous thrombosis is long dis

  15. Are pulmonary embolism and deep-vein thrombosis always one disease?

    NARCIS (Netherlands)

    Langevelde, Kirsten van

    2012-01-01

    Pulmonary embolism is traditionally, since autopsy studies by Virchow in the mid 1800s, thought to originate from embolization of a deep-vein thrombosis, resulting in two clinical manifestations of one disease: venous thrombosis. The incidence of deep-vein thrombosis in the population is twice as hi

  16. External iliac vein thrombosis in an athletic cyclist with a history of external iliac artery endofibrosis and thrombosis.

    Science.gov (United States)

    Nakamura, Kelly M; Skeik, Nedaa; Shepherd, Roger F; Wennberg, Paul W

    2011-11-01

    External iliac artery endofibrosis describes an intimal subendothelial fibrosis leading to wall thickening and stenosis that has been described in high-performance athletes. There are anatomical, mechanical, and probably metabolic factors that may contribute to this pathology. Ankle-brachial index (ABI) measurement with exercise testing, duplex ultrasound, computed tomography (CT) or magnetic resonance (MR) angiogram, and ultimately arteriography help to make the diagnosis. Management can be conservative, but most cases require surgical intervention. External iliac vein stenosis and thrombosis in cyclists has rarely been described in the literature. We report a case of extensive left lower limb deep venous thrombosis (DVT) including the external iliac vein diagnosed in a 57-year-old athletic cyclist with a history of external iliac artery thrombosis.

  17. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  18. [Bilateral renal vein thrombosis and acute renal failure due to inferior vena cava filter thrombosis. Report of one case].

    Science.gov (United States)

    Vega, Jorge; Díaz, Rienzi

    2014-11-01

    Bilateral renal vein thrombosis is an unusual etiology of acute renal failure and usually is associated with nephrotic syndrome. We report a 77-year-old man, consulting in the emergency room for anuria that appeared 24 hours after a syncope. The patient was carrier of an inferior vena cava filter prophylactically installed 17 months earlier and was not receiving anticoagulation. Serum creatinine on admission was 5.45 mg/dl and blood urea nitrogen was 54 mg/dl. Computed tomography and Doppler ultrasonography showed an extensive thrombosis of inferior vena cava and both renal veins. Heparin therapy was started with a rapid recovery of renal function and diuresis.

  19. Nanomedicine in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  20. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  1. Idiopathic extensive spontaneous venous thrombosis (a case report.

    Directory of Open Access Journals (Sweden)

    Pathare A

    1989-04-01

    Full Text Available Two patients with extensive spontaneous venous thrombosis are reported. Both had documented evidence of polyserositis, transient abnormalities of liver function tests along with normal coagulograms. Although one patient had a short, self-limiting illness, the other required treatment with coumarin derivatives. The relevant literature is discussed.

  2. [Blood groups as a risk factor in venous thrombosis].

    Science.gov (United States)

    Hernández Cañete, C M; Alvarez Dieguez, R; González Sánchez M de la, C; Díaz Hernández, C; Sánchez Montiel, M E

    1993-01-01

    We report 173 patients with venous thrombosis (or post-thrombotic syndrome) demonstrated by phlebography. We show up the importance of blood groups as risk factor, being very significant the A group. Female sex is associated with a high incidence of this pathology. A frequent location is the left lower limb.

  3. Deep venous thrombosis and pulmonary embolism in psychiatric settings

    Directory of Open Access Journals (Sweden)

    Els G. Van Neste

    2009-03-01

    Full Text Available Background and objectives: Deep venous thrombosis and pulmonary embolism are serious, possibly life-threatening events which are often ignored in psychiatric settings. This article investigates which psychiatric patients are at increased risk of developing a venous thromboembolism. To our knowledge we are the first to perform a literature review of clinical studies relating venous thrombosis and pulmonary embolism to psychotropic drugs and mental disorders. Methods: A Medline search for English studies using the appropriate search terms was performed. In addition, cross references of the relevant articles` literature references were considered. We withheld 12 observational studies, 29 case-reports and one review-article. Results: We found evidence that low potency antipsychotic drugs like chlorpromazine and thioridazine, and clozapine for treatment of resistant schizophrenia have an increased risk of venous thromboembolism. There is no evidence that antidepressants, benzodiazepines or mood stabilizers have a similar effect. Also psychiatric conditions like physical restraint, catatonia and neuroleptic malignant syndrome are related to a higher incidence of deep venous thrombosis. Conclusions: Limitations of the studies and hypotheses about underlying biological mechanisms are reviewed. The rationale for prophylactic measures is discussed and recommendations to prevent deep venous thrombosis and pulmonary embolism are given.

  4. Prospective screening for deep vein thrombosis in high risk patients.

    Science.gov (United States)

    Barnes, R W

    1977-08-01

    In 257 patients undergoing total hip replacement, gastric bypass for morbid obesity, major abdominal surgery, and major leg amputation, Doppler ultrasonic screening revealed only five instances of deep vein thrombosis. The present study suggests that Doppler screening of high risk patients is a useful alternative to routine anticoagulant prophylaxis of venous thromboembolic disease.

  5. Deep vein thrombosis in primary care : possible malignancy?

    NARCIS (Netherlands)

    Oudega, Ruud; Moons, Karel G. M.; Nieuwenhuis, H. Karel; van Nierop, Fred L.; Hoes, Arno W.

    2006-01-01

    Background The increased prevalence of unrecognised malignancy in patients with deep vein thrombosis (DVT) has been well established in secondary care settings. However, data from primary care settings, needed to tailor the diagnostic workup, are lacking. Aim To quantify the prevalence of unrecognis

  6. Detection of occult cancer in patients with idiopathic venous thrombosis

    DEFF Research Database (Denmark)

    Holt, Marianne Ingerslev; Knudsen, Søren Tang; Andersen, Birthe Søgaard;

    2015-01-01

    Idiopathic venous thrombosis (VTE) is frequently associated with underlying malignancy. Thus, it is tempting to search for underlying cancer in these patients. However, extensive screening is cost-intensive and no survival benefit has been demonstrated. Based on a review of the literature, we rec...

  7. Thrombosis: Novel nanomedical concepts of diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    Iwona; Cicha

    2015-01-01

    Intravascular thrombosis, a critical pathophysiological feature of many cardiovascular disorders, leads to the formation of life-threatening obstructive blood clots within the vessels. Rapid recanalization of occluded vessels is essential for the patients’ outcome, but the currently available systemic fibrinolytic therapy is associated with low efficacy and tremendous side effects. Additionally, many patients are ineligible for systemic thrombolytic therapy, either due to delayed admission to the hospital after symptom onset, or because of recent surgery, or bleeding. In order to improve the treatment efficacy and to limit the risk of hemorrhagic complications, both precise imaging of the affected vascular regions, and the localized application of fibrinolytic agents, are required. Recent years have brought about considerable advances in nanomedical approaches to thrombosis. Although these thrombustargeting imaging agents and nanotherapies are not yet implemented in humans, substantial amount of successful in vivo applications have been reported, including animal models of stroke, acute arterial thrombosis, and pulmonary embolism. It is evident that the future progress in diagnosis and treatment of thrombosis will be closely bound with the development of novel nanotechnology-based strategies. This Editorial focuses on the recently reported approaches, which hold a great promise for personalized, disease-targeted treatment and reduced side effects in the patients suffering from this life-threatening condition.

  8. Detection of occult cancer in patients with idiopathic venous thrombosis

    DEFF Research Database (Denmark)

    Holt, Marianne Ingerslev; Knudsen, Søren Tang; Andersen, Birthe Søgaard

    2015-01-01

    Idiopathic venous thrombosis (VTE) is frequently associated with underlying malignancy. Thus, it is tempting to search for underlying cancer in these patients. However, extensive screening is cost-intensive and no survival benefit has been demonstrated. Based on a review of the literature, we...

  9. [Cortical venous thrombosis after a diagnostic lumbar puncture].

    Science.gov (United States)

    Pfeilschifter, W; Neumann-Haefelin, T; Hattingen, E; Singer, O C

    2009-10-01

    We present the case of a 49-year-old female patient who underwent a lumbar puncture in the context of an extended diagnostic work-up after a transient ischemic attack. A few days later the patient who suffered from severe post-lumbar puncture headache, developed a lobar hemorrhage due to a cortical venous thrombosis requiring decompression surgery.

  10. Etiology and consequences of thrombosis in abdominal vessels

    Institute of Scientific and Technical Information of China (English)

    Yusuf Bayraktar; Ozgur Harmanci

    2006-01-01

    The thrombophilia which can be either congenital or acquired in adult life has major implications in the abdominal vessels. The resulting portal vein thrombosis,Budd-Chiari syndrome and mesenteric vein thrombosis have a variety of consequences ranging from acute abdomen to chronic hepatomegaly and even totally asymptomatic patient in whom the only finding is pancytope nia. The complications like esophageal varices, portal gastropathy, ascites, severe hypersplenism, liver failure requiring liver transplantation are well known. Interesting features of collateral venous circulation showing itself as pseudocholangiocarcinoma sign and its possible clinical reflection as cholestasis are also known from a long time. The management strategies for these complications of intraabdominal vessel thrombosis are not different from their counterpart which is cirrhotic portal hypertension, but the prognosis is unquestionably better in former cases. In this review we presented and discussed the abdominal venous thrombosis, etiology and the resulting clinical pictures. There are controversial issues both in nomenclature, and management including anticoagulation problems and follow up strategies. In light of the current knowledge, we discussed some controversial issues in literature and presented our experience and our proposals about this group of patients.

  11. Venous Thrombosis and Atherosclerosis is There a link

    Institute of Scientific and Technical Information of China (English)

    LIU MIN-JUAN; LiU Ze-lin

    2008-01-01

    @@ Venous thrombosis and arterial thrombotic disorders have long been viewed as separate pathophysiological entities, partly as a result of the obvious anatomical differences, as well as their distinct clinical presentations. Recently, the potential association between venous thromboembolism(VTE) and atherosclerosis was described for the first time in 2003. Subsequently, numerous investigations have addressed the topic.

  12. Use of tenecteplase in recurrent prosthetic valve thrombosis.

    Science.gov (United States)

    Hariram, Vuppaladadhiam; Sharma, Nuthi Prashanthi

    2013-11-01

    Prosthetic valve thrombosis (PVT) is a serious complication of mechanical prosthetic heart valves, the available treatment options for which are either thrombolytic therapy or surgery. In patients who have already received streptokinase to treat a previous episode of PVT, the therapeutic options are limited. Herein, the case is reported of an elderly female patient with a second episode of PVT treated successfully with tenecteplase.

  13. Basilar artery thrombosis in the setting of antiphospholipid syndrome.

    Science.gov (United States)

    Saad, Amin F; Nickell, Larry T; Heithaus, R Evans; Shamim, Sadat A; Opatowsky, Michael J; Layton, Kennith F

    2014-07-01

    Antiphospholipid syndrome is an autoimmune disorder characterized by arterial or venous thrombosis, recurrent first-trimester pregnancy loss, and multiple additional clinical manifestations. We describe a man with severe atherosclerotic basilar artery stenosis and superimposed in situ thrombus who was found to have antiphospholipid syndrome.

  14. Acute Carotid Artery Stent Thrombosis Due to Dual Antiplatelet Resistance

    Energy Technology Data Exchange (ETDEWEB)

    Köklü, Erkan, E-mail: drerkankoklu@gmail.com; Arslan, Şakir; Yüksel, İsa Öner; Bayar, Nermin [Antalya Education and Research Hospital, Clinic of Cardiology (Turkey); Koç, Pınar [Antalya Education and Research Hospital, Clinic of Radiology (Turkey)

    2015-08-15

    Carotid artery stenting (CAS) is a revascularization modality that is an alternative to carotid endarterectomy. The efficacy of CAS in primary and secondary prevention from ischemic stroke has been demonstrated in various trials. Acute thrombosis of CAS is a rare complication that can lead to dramatic and catastrophic consequences. We discuss a case of acute CAS thrombosis in a patient who had previously undergone successful CAS. CAS was performed in a 73-year-old man who had had dysarthria lasting 2 weeks with 95 % stenosis in his left internal carotid artery. An acute cerebrovascular event resulting in right-sided hemiplegia developed 24 h after the procedure. Computed tomographic carotid angiography revealed complete occlusion of the stent with thrombus. The cause of stent thrombosis was thought to be antiaggregant resistance to both acetylsalicylic acid and clopidogrel. The most important cause of acute CAS thrombosis is inadequate or ineffective antiaggregant therapy. Evaluating patients who are candidates for CAS for acetylsalicylic acid and clopidogrel resistance may preclude this complication.

  15. The diagnosis of left ventricular assist device thrombosis

    NARCIS (Netherlands)

    Gerds, H. Z. R.; Brugemann, J.; Rienstra, M.; Erasmus, M. E.

    2015-01-01

    The clinical course of a patient with a left ventricular assist device is described. A total of 6 weeks after device insertion, the lactate dehydrogenase (LDH) level increased to 2801 U/l despite adding low-molecular-weight heparin to acenocoumarol and aspirin. Pump thrombosis was suspected but unco

  16. Correlation Between C677T and A1298C Mutations on the MTHFR Gene With Plasma Homocysteine Levels and Venous Thrombosis in Pregnant Women at Risk of Thrombosis

    OpenAIRE

    Ali Ghasemi; Kazem Ghaffari; Abbas Ghotaslou; Mohsen Mohammadi; Zeynal Salmanpour

    2015-01-01

    Background: Deep venous thrombosis (DVT) is a common disease with a high morbidity, mortality and increase in miscarriages. Objectives: The purpose of this study was to assessment the correlation between C677T and A1298C mutations on the methylenetetrahydrofolate reductase (MTHFR) gene with total plasma homocysteine levels and deep venous thrombosis in pregnant women at risk of thrombosis. Patients and Methods: In this case-control study, 120 pregnant women with risk of DVT and 100 preg...

  17. Multiple abdominal veins thrombosis secondary to protein s deficiency - a case report.

    Science.gov (United States)

    Kodali, Venkata Umakant; Borra, Seshulakshmi; Mandarapu, Surendra Babu; Sanda, Mallikarjuna Rao; Bolla, Srinivasa Rao

    2014-06-01

    Abdominal venous thrombosis may present either as Budd-Chiari syndrome (BCS) caused by hepatic vein or proximal inferior vena cava (IVC) obstruction or as an extra hepatic portal obstruction (EHPVO) caused by Portal vein thrombosis or mesenteric vein thrombosis, but a mixed involvement is uncommon. Multiple abdominal venous obstructions presenting with thrombosis of hepatic vein, IVC, portal vein and renal vein are very rarely seen . We are reporting a rare case with thrombosis of IVC, hepatic vein, portal vein and renal vein, with protein S and protein C deficiencies, which was managed by giving anticoagulant therapy.

  18. Cerebral phaeohyphomycosis by Exophiala dermatitidis

    Directory of Open Access Journals (Sweden)

    S Sood

    2014-01-01

    Full Text Available Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  19. Cerebral phaeohyphomycosis by Exophiala dermatitidis.

    Science.gov (United States)

    Sood, S; Vaid, V K; Sharma, M; Bhartiya, H

    2014-01-01

    Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  20. Microfluidic thrombosis under multiple shear rates and antiplatelet therapy doses.

    Directory of Open Access Journals (Sweden)

    Melissa Li

    Full Text Available The mainstay of treatment for thrombosis, the formation of occlusive platelet aggregates that often lead to heart attack and stroke, is antiplatelet therapy. Antiplatelet therapy dosing and resistance are poorly understood, leading to potential incorrect and ineffective dosing. Shear rate is also suspected to play a major role in thrombosis, but instrumentation to measure its influence has been limited by flow conditions, agonist use, and non-systematic and/or non-quantitative studies. In this work we measured occlusion times and thrombus detachment for a range of initial shear rates (500, 1500, 4000, and 10000 s(-1 and therapy concentrations (0-2.4 µM for eptifibatide, 0-2 mM for acetyl-salicylic acid (ASA, 3.5-40 Units/L for heparin using a microfluidic device. We also measured complete blood counts (CBC and platelet activity using whole blood impedance aggregometry. Effects of shear rate and dose were analyzed using general linear models, logistic regressions, and Cox proportional hazards models. Shear rates have significant effects on thrombosis/dose-response curves for all tested therapies. ASA has little effect on high shear occlusion times, even at very high doses (up to 20 times the recommended dose. Under ASA therapy, thrombi formed at high shear rates were 4 times more prone to detachment compared to those formed under control conditions. Eptifibatide reduced occlusion when controlling for shear rate and its efficacy increased with dose concentration. In contrast, the hazard of occlusion from ASA was several orders of magnitude higher than that of eptifibatide. Our results show similar dose efficacy to our low shear measurements using whole blood aggregometry. This quantitative and statistically validated study of the effects of a wide range of shear rate and antiplatelet therapy doses on occlusive thrombosis contributes to more accurate understanding of thrombosis and to models for optimizing patient treatment.

  1. Etiology and portal vein thrombosis in Budd-Chiari syndrome

    Institute of Scientific and Technical Information of China (English)

    Oguz Uskudar; Meral Akdogan; Nurgul Sasmaz; Sevinc Yilmaz; Muharrem Tola; Burhan Sahin

    2008-01-01

    AIM: To research the etiology, portal vein thrombosis and other features of Budd-Chiari syndrome (BCS)patients prospectively.METHODS: A total of 75 patients (40 female, 35 male) who were diagnosed between January 2002 and July 2004 as having BCS were studied prospectively.Findings from on physical examination, ultrasonography,duplex ultrasonography and venography were analyzed.Hemogram and blood chemistry were studied at the time of diagnosis and on each hospital visit. Bone marrow examination and immune phenotyping were performed by a hematologist when necessary. Protein C, S, antithrombin Ⅲ, activated protein C resistance,and anticardiolipin antibodies, antinuclear antibodies,and anti ds-DNA were studied twice. The presence of ascite, esophageal varices, and portal thrombosis were evaluated at admission and on every visit.RESULTS: At least one etiological factor was determined in 54 (72%) of the patients. The etiology could not be defined in 21 (28%) patients. One etiological factor was found in 39, 2 factors in 14 and 3 factors in 1 patient.The most common cause was the web (16%), the second was Hydatid disease (11%), the third was Behcet's disease (9%). Portal vein thrombosis was present in 11 patients and at least one etiology was identified in 9 of them (82%).CONCLUSION: Behcet's disease and hydatid disease are more prominent etiological factors in Turkey than in other countries. Patients with web have an excellent response to treatment without signs of portal vein thrombosis while patients having thrombofilic factors more than one are prone to develop portal vein thrombosis with worse clinical outcome.

  2. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

    Cerebral ischemia induces excess release of glutamate and an increase in the intracellular Ca2+ concentration, which provoke catastrophic enzymatic processes leading to irreversible neuronal injury. Histamine plays the role of neurotransmitter in the central nervous system, and histaminergic fibers are widely distributed in the brain. In cerebral ischemia, release of histamine from nerve endings has been shown to be enhanced by facilitation of its activity. An inhibition of the histaminergic activity in ischemia aggravates the histologic outcome. In contrast, intracerebroventricular administration of histamine improves the aggravation, whereas blockade of histamine H2 receptors aggravates ischemic injury. Furthermore, H2 blockade enhances ischemic release of glutamate and dopamine. These findings suggest that central histamine provides beneficial effects against ischemic neuronal damage by suppressing release of excitatory neurotransmitters. However, histaminergic H2 action facilitates the permeability of the blood-brain barrier and shows deleterious effects on cerebral edema.

  3. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

    Hachinski, V C; Olesen, Jes; Norris, J W

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...... prodromal symptoms, a decrease in cerebral blood flow has been demonstrated during the aura. Occasionally, this flow decrease persists during the headache phase. In common migraine, where such prodromata are not seen, a flow decrease has not been demonstrated. During the headache phase of both types...... of migraine, rCBF has usually been found to be normal or in the high range of normal values. The high values may represent postischemic hyperemia, but are probably more frequently secondary to arousal caused by pain. Thus, during the headache phase rCBF may be subnormal, normal or high. These findings do...

  4. Relationship between venous and arterial thrombosis: a review of the literature from a causal perspective.

    Science.gov (United States)

    Lijfering, Willem M; Flinterman, Linda E; Vandenbroucke, Jan P; Rosendaal, Frits R; Cannegieter, Suzanne C

    2011-11-01

    Venous thrombosis and arterial thrombosis are traditionally regarded as two different diseases with respect to pathophysiology, epidemiology, and treatment strategies. Research findings of the past few years suggest that this categorical distinction may be too strict. However, whether the described relationship between venous and arterial thrombosis is real or a result of other factors such as confounding, chance, or bias is still unclear. In this review, we discuss the current literature while using causal diagrams to better understand possible causal relations between cardiovascular risk factors, atherosclerosis, arterial thrombosis, and venous thrombosis. Furthermore, we propose study designs to investigate the causal link between venous and arterial thrombosis. In addition, we comment on the effect of statin use on the occurrence of both arterial and venous thrombosis. The possible clinical implications of these findings are discussed.

  5. Residual vein thrombosis and D-dimer for optimizing duration of anticoagulation in idiopathic deep vein thrombosis.

    Science.gov (United States)

    Malato, Alessandra; Saccullo, Giorgia; Iorio, Alfonso; Ageno, Walter; Siragusa, Sergio

    2010-01-01

    Long-term anticoagulant treatment is highly effective in preventing recurrent Venous Thrombo-Embolism (VTE) in patients with idiopathic Deep Vein Thrombosis (DVT) of the lower limbs, though associated with an increased risk for major bleeding that may offset the benefits of anticoagulation. Accordingly to recent guidelines, patients with idiopathic DVT should be treated for at least 3 months and then should be evaluated for the risk-benefit ratio of long-term therapy. However, such 'time for decision' is often unclear and the optimal duration of VKA remains debatable. In recent studies, markers for the assessment of the individual risk for recurrent thrombosis have been proposed, which can be of help to establish the optimal duration of VKA treatment; among them, the D-dimer (D-d) assay and the Residual Vein Thrombosis (RVT) assessment by Compression Ultra-Sonography (CUS) were shown to be the most suitable. Studies' results showed that negative results of these parameters after 3 to 6 months of therapy, identify a group of patients at low-risk for recurrent thrombosis in whom VKA treatment can be withheld. In the present review we will discuss advantages and potential limits of using these individual markers for the management of patients with a first episode of DVT of the lower limbs.

  6. Postural abnormality as a risk marker for leg deep venous thrombosis in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Kazushi Yamane

    Full Text Available BACKGROUND: Pulmonary thromboembolism is a common cause of death in patients with autopsy-confirmed Parkinsonism. This study investigated the incidence of leg deep vein thrombosis in Parkinson's disease and relationships between deep vein thrombosis and clinical/laboratory findings, including postural abnormalities as assessed by photographic measurements. METHODS: This cross-sectional study assessed the presence of deep vein thrombosis using bilateral leg Doppler ultrasonography in 114 asymptomatic outpatients with Parkinson's disease. RESULTS: Deep vein thrombosis was detected in 23 patients (20% with Parkinson's disease. Deep vein thrombosis was located in the distal portion in 18 patients and in the proximal portion in 5 patients. No significant differences in age, sex, body mass index, disease duration, Hoehn-Yahr stage, anti-Parkinson's drugs, or daily levodopa-equivalent dose were seen between deep vein thrombosis-positive and -negative groups. Univariate analysis for developing deep vein thrombosis in patients with Parkinson's disease identified the following markers: long-term wheelchair use, bent knee, bent spine, and D-dimer elevation. Bending angles were significantly greater in the deep vein thrombosis-positive group at the knee and spine than in the deep vein thrombosis-negative group. Half of Parkinson's disease patients with camptocormia had deep vein thrombosis. Among diabetes mellitus cases, long-term wheelchair use, bent knee over 15°, camptocormia, D-dimer elevation, the more risk markers were associated with a higher incidence of DVT. The presence of risk markers contributed to the development of deep vein thrombosis. On multivariate logistic regression analysis, a bent knee posture was strongly associated with an increased risk of deep vein thrombosis. CONCLUSION: Presence of leg deep vein thrombosis correlated with postural abnormalities in Parkinson's disease. We recommend non-invasive ultrasonographic screening for leg

  7. Preventive Effect of Aspirin Eugenol Ester on Thrombosis in κ-Carrageenan-Induced Rat Tail Thrombosis Model.

    Science.gov (United States)

    Ma, Ning; Liu, Xi-Wang; Yang, Ya-Jun; Li, Jian-Yong; Mohamed, Isam; Liu, Guang-Rong; Zhang, Ji-Yu

    2015-01-01

    Based on the prodrug principle, aspirin eugenol ester (AEE) was synthesized, which can reduce the side effects of aspirin and eugenol. As a good candidate for new antithrombotic and anti-inflammatory medicine, it is essential to evaluate its preventive effect on thrombosis. Preventive effect of AEE was investigated in κ-carrageenan-induced rat tail thrombosis model. AEE suspension liquids were prepared in 0.5% sodium carboxymethyl cellulose (CMC-Na). AEE was administrated at the dosage of 18, 36 and 72 mg/kg. Aspirin (20 mg/kg), eugenol (18 mg/kg) and 0.5% CMC-Na (30 mg/kg) were used as control drug. In order to compare the effects between AEE and its precursor, integration of aspirin and eugenol group (molar ratio 1:1) was also designed in the experiment. After drugs were administrated intragastrically for seven days, each rat was injected intraperitoneally with 20 mg/kg BW κ-carrageen dissolved in physiological saline to induce thrombosis. The length of tail-thrombosis was measured at 24 and 48 hours. The blank group just was given physiological saline for seven days without κ-carrageenan administrated. The results indicated that AEE significantly not only reduced the average length of thrombus, PT values and FIB concentration, but also reduced the red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT) and platelet (PLT). The effects of AEE on platelet aggregation and anticoagulant in vitro showed that AEE could inhibit adenosine diphosphate (ADP)-induced platelet aggregation as dose-dependence but no notable effect on blood clotting. From these results, it was concluded that AEE possessed positive effect on thrombosis prevention in vivo through the reduction of FIB, PLT, inhibition of platelet aggregation and the change of TT and PT values.

  8. Delayed cerebral infarction due to stent folding deformation following carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Kwon Duk; Lee, Kyung Yul; Suh, Sang Hyun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Byung Moon [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    We report a case of delayed cerebral infarction due to stent longitudinal folding deformation following carotid artery stenting using a self-expandable stent with an open-cell design. The stented segment of the left common carotid artery was divided into two different lumens by this folding deformation, and the separated lumens became restricted with in-stent thrombosis. Although no established method of managing this rare complication exists, a conservative approach was taken with administration of anticoagulant and dual antiplatelet therapy. No neurological symptoms were observed during several months of clinical follow-up after discharge.

  9. Acute myocardial/cerebral infarction as first/relapse manifestation in one acute promyelocytic leukemia patient.

    Science.gov (United States)

    Li, Ying; Suo, Shanshan; Mao, Liping; Wang, Lei; Yang, Chunmei; Xu, Weilai; Lou, Yinjun; Mai, Wenyuan

    2015-01-01

    In the clinical setting, bleeding is a common manifestation of acute promyelocytic leukemia (APL), whereas thrombosis is relatively rare, especially as an initial symptom. Here, we report an unusual case of APL with acute myocardial infarction as the first manifestation and cerebral infarction as the relapse manifestation in a healthy young woman. This unique case emphasizes that a thrombotic event could be the first manifestation of an underlying hematological disorder such as APL and could also be a sign of relapse. Rapid detection of the underlying disorder and the timely use of anticoagulation therapy and ATRA are crucial for preventing further deterioration of the disease and saving the patient's life.

  10. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    of the middle cerebral artery (MCAO) was used as an experimental model of ischemic stroke. MCAO produces an acute lesion consisting of an ischemic core or focus with severely reduced blood flow surrounded by a borderzone or ischemic penumbra with less pronounced blood flow reduction. Cells in the ischemic focus...

  11. Common genetic risk factors for venous thrombosis in the Chinese population.

    Science.gov (United States)

    Tang, Liang; Wang, Hua-Fang; Lu, Xuan; Jian, Xiao-Rong; Jin, Bi; Zheng, Hong; Li, Yi-Qing; Wang, Qing-Yun; Wu, Tang-Chun; Guo, Huan; Liu, Hui; Guo, Tao; Yu, Jian-Ming; Yang, Rui; Yang, Yan; Hu, Yu

    2013-02-07

    Venous thrombosis is a major medical disorder caused by both genetic and environmental factors. Little is known about the genetic background of venous thrombosis in the Chinese population. A total of 1,304 individuals diagnosed with a first venous thrombosis and 1,334 age- and sex-matched healthy participants were enrolled in this study. Resequencing of THBD (encoding thrombomodulin) in 60 individuals with venous thrombosis and 60 controls and a functional assay showed that a common variant, c.-151G>T (rs16984852), in the 5' UTR significantly reduced the gene expression and could cause a predisposition to venous thrombosis. Therefore, this variant was genotyped in a case-control study, and results indicated that heterozygotes had a 2.80-fold (95% confidence interval = 1.88-4.29) increased risk of venous thrombosis. The THBD c.-151G>T variant was further investigated in a family analysis involving 176 first-degree relatives from 38 index families. First-degree relatives with this variant had a 3.42-fold increased risk of venous thrombosis, and their probability of remaining thrombosis-free was significantly lower than that of relatives without the variant. In addition, five rare mutations that might be deleterious were also identified in thrombophilic individuals by sequencing. This study is the largest genetic investigation of venous thrombosis in the Chinese population. Further study on genetics of thrombosis should focus on resequencing of THBD and other hemostasis genes in different populations.

  12. Central venous catheter-related thrombosis in senile male patients: New risk factors and predictors.

    Science.gov (United States)

    Liu, Gao; Fu, Zhi-Qing; Zhu, Ping; Li, Shi-Jun

    2015-06-01

    Central venous catheterization (CVC)-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases (6.17%) of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization (Pvenous thrombosis history (Prisk factors or predictors of CVC-related venous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

  13. Recent advances on thrombosis and haemostasis in Asian Pacific region: report of the Fourth Asian Pacific Congress on Thrombosis and Haemostasis

    Institute of Scientific and Technical Information of China (English)

    WANG Zhao-yue

    2006-01-01

    @@ The Fourth Asian Pacific Congress on Thrombosis and Haemostasis (APCTH) was held from September 21 to 23, 2006 in Suzhou, China and organized by the Asian Pacific Society on Thrombosis and Haemostasis and the Chinese Society of Haematology with professor RUAN Chang-geng as the chairperson.

  14. Hypereosinophilic syndrome, Churg-Strauss syndrome and parasitic diseases: possible links between eosinophilia and thrombosis.

    Science.gov (United States)

    Maino, Alberto; Rossio, Raffaella; Cugno, Massimo; Marzano, Angelo V; Tedeschi, Alberto

    2012-09-01

    Throughout the past decade, a possible role of eosinophils in blood coagulation and thrombosis has been suggested. We conducted a Pubmed (MEDLINE) search of case and series referring to any kind of thrombotic events described in three conditions characterised by persistent blood eosinophilia, i.e. the hypereosinophilic syndrome (HES), the Churg Strauss syndrome (CSS), and parasitic infestations from 1966 to date. One hundred and ninety-two articles were found regarding thrombotic events in HES and CSS, and 209 cases of thrombosis were extracted. One hundred and seventy- seven articles dealing with parasitic diseases and thrombosis were found, but only 15 manuscripts reporting thrombosis of unknown origin in 22 patients were selected. In HES, arterial thromboses were more frequent than in CSS (p=0.006), representing almost half of the cases (45%), while venous and mixed artero-venous thrombosis were respectively 28% and 27%. In contrast, in CSS there was a predominance of venous thrombosis (56%, p=0.006), with arterial thrombosis representing 38% of total thrombotic events, and mixed thrombosis being the least frequent (4%). The higher incidence of arterial thrombosis in HES patients can be explained by the common cardiac involvement (64% of patients). In the 22 patients with parasitoses and thrombosis, 15 had arterial thrombosis (68%) and 7 had venous thrombosis (32 %). Literature analysis shows that there are numerous reports of thrombotic events in patients with eosinophil-related disorders supporting a role for eosinophils in thrombosis. This observation raises the problem of prevention and treatment of thromboembolism particularly in HES and CSS patients.

  15. [Semiotics of lesions of the cerebral venous collectors on application of noninvasive techniques of x-ray diagnosis].

    Science.gov (United States)

    Semenov, S; Abalmasov, V

    2001-01-01

    The study included application of a complex of the noninvasive diagnostic techniques such as MR tomography, MR venography, duplex scanning of the internal jugular veins, and transcranial Doppler sonography. The authors provide a detailed description of the semiotics of the MR signs of cerebral venous collector lesion in patients with thrombosis, extravasal compression, aneurysms, and developmental anomalies. Present the quantitative ultrasound parameters of hemodynamics in the efferent vessels of the brain accessible to inspections describe the effect of spontaneous echo-opacification in the internal jugular veins, which is assumed to be a predictor of thrombosis. Intravenous injection of magnevist resulted in an appreciable refinement of visualization of small dural sinuses at MR venography thereby allowing for the diagnosis of their thrombosis. It is suggested that the use of the entire complex of the x-ray modalities under consideration may lead to a more complete and noninvasive evaluation of the nature of cerebral venous insufficiency and of the degree of hemodynamic significance. Moreover, this will make it possible to outline approaches to therapeutic or surgical correction of the disease.

  16. Deep venous thrombosis and pulmonary embolism following physical restraint

    DEFF Research Database (Denmark)

    Laursen, S B; Jensen, T N; Bolwig, T

    2005-01-01

    physical restraint may occur in spite of no pre-existing risk factors. Medical guidelines for the prevention of thrombosis following physical restraint are presented. Despite the absence of controlled trials of treatment effectiveness, the catastrophic outcome of DVT and PE warrants early and vigorous......OBJECTIVE: We describe a case of deep venous thrombosis (DVT) and pulmonary embolism (PE) following the use of physical restraint in a patient with a diagnosis of acute delusional psychotic disorder. METHOD: A new case report of DVT and PE associated with prolonged physical restraint is presented....... The literature on physical restraint, DVT, and PE was reviewed using a search of Medline and Psychinfo from 1966 to the present. RESULTS: Four other reported cases of DVT and PE were found in association with physically restrained patients. CONCLUSION: Risk of DVT and PE in association with immobilization during...

  17. Thrombocytopenia and thrombosis in disseminated intravascular coagulation (DIC).

    Science.gov (United States)

    Kitchens, Craig S

    2009-01-01

    Disseminated intravascular coagulation (DIC) is the physiologic result of pathologic overstimulation of the coagulation system. Despite multiple triggers, a myriad of laboratory abnormalities, and a clinical presentation ranging from gross hemostatic failure to life-threatening thrombosis, or even both simultaneously, a simplified clinical approach augmented by a few readily available tests allows prompt identification of the process and elucidation of treatment opportunities. Platelet counts in DIC may be low, especially in acute sepsis-associated DIC, yet increased in malignancy-associated chronic DIC. Thrombotic risk is not a function of the platelet count, and thrombocytopenia does not protect the patient from thrombosis. The stratification of both thrombotic risk and hemorrhagic risk will be addressed.

  18. Pancreatic laceration and portal vein thrombosis in blunt trauma abdomen

    Directory of Open Access Journals (Sweden)

    Rastogi Rajul

    2008-01-01

    Full Text Available Injuries to the pancreas by blunt trauma are uncommon. The association of pancreatic injury with acute portal vein thrombosis secondary to blunt trauma abdomen is furthermore rare. The early diagnosis of the pancreas with injury to the portal vein is challenging and difficult. These injuries are associated with high morbidity and mortality, particularly if the diagnosis is delayed. Accurate and early diagnosis is therefore imperative and computed tomography plays a key role in detection. We present a case of child with a rare combination of pancreatic laceration and acute portal vein thrombosis following a blunt trauma to the abdomen. With extensive literature search we found no such cases has been described previously.

  19. [NHG guideline 'Deep-vein thrombosis and pulmonary embolus'].

    Science.gov (United States)

    de Jong, Jip; Lucassen, Wim A M; Geersing, Geert-Jan; Burgers, Jako S; Wiersma, Tjerk

    2015-01-01

    The revised Dutch College of General Practitioners (Nederlands Huisartsen Genootschap [NHG]) guideline 'Deep-vein thrombosis and pulmonary embolus' includes recommendations for the treatment of patients with deep-vein thrombosis (DVT) and thrombophlebitis, and for the exclusion of pulmonary embolism (PE). The general practitioner (GP) can exclude the presence of DVT or PE in some patients by using a decision rule and a D-dimer test. When using D-dimer test as a point-of-care test, meticulous care is essential during the test procedure and storage of blood. The GP can treat many patients with DVT; the NHG guideline does not advise use of direct oral anticoagulants. In the case of an isolated DVT in the calf, treatment with anticoagulants or ultrasound follow-up can be chosen in consultation with the patient or on the basis of regional agreements. In the case of patients with superficial thrombophlebitis, a wait-and-see approach is usually sufficient.

  20. Thrombosis of celiacomesenteric trunk: Report of a case

    Institute of Scientific and Technical Information of China (English)

    Federico Lovisetto; Gianbattista Finocchiaro De Lorenzi; Piera Stancampiano; Carmen Corradini; Fabio De Cesare; Orazio Geraci; Mario Manzi

    2012-01-01

    Here we present the case of a 79-year-old woman who complained of acute abdominal pain,vomiting and diarrhoea.Laboratory exams demonstrated a severe metabolic imbalance.Abdominal X-rays showed bowel overdistension and pneumatosis of the stomach wall.Abdominal tomography revealed infarction of the stomach,duodenum and small bowel due to thrombosis of the celiacomesenteric trunk.Exploratory laparotomy revealed ischemia of the liver,spleen infarction and necrosis of the gastro-intestinal tube (from the stomach up to the first third of the transverse colon).No further surgical procedures were performed.The patient died the following day.To our knowledge,this is the first reported case about severe gastro-intestinal ischemia due to thrombosis of the celiacomesenteric trunk,a rare anatomic variation of the gastrointestinal vascularisation.

  1. Catheter-Induced Thrombosis of the Superior Vena Cava

    Directory of Open Access Journals (Sweden)

    Elio Venturini

    2012-01-01

    Full Text Available There has been an increase in the use of central venous catheters (CVCs in clinical practice. One of the most dangerous complications associated with their use is symptomatic or asymptomatic thrombosis (T, sometimes associated with superior vena cava (SVC syndrome, resulting from impaired venous drainage. The right heart clots can induce an increased risk of mortality due the potential pulmonary embolism (PE. We report a case of asymptomatic 83-year-old woman in whom the thrombosis was detected after an echocardiogram. Echocardiography demonstrated a cardiac mass, and the T was confirmed by (magnetic resonance imaging MRI. The clinical scenario, a high index of suspicion and routine use of echocardiogram in patients with CVC, can lead to a correct diagnosis, preventing dangerous complications.

  2. Prosthetic valve thrombosis in a patient with mitral valve replacement.

    Science.gov (United States)

    Bilal, Muhammad; Khan, Muhammad Shahzeb; Haseeb, Abdul; Khan, Abdul Bari

    2015-07-01

    Prosthetic valve thrombosis within one year after mitral valve replacement is rarely seen in patients on warfarin therapy and without any risk factor. Here, we describe a case of a 39-year- old female, who presented with dyspnoea and shortness of breath 11 months after mitral valve replacement. The echocardiogram revealed severe valvular stenosis due to presence of clots on the mitral valve and restricted motion of the mitral leaflets. As a result of deterioration of general condition and haemodynamic un-stability, plan was made to re-operate for her valve replacement surgery. This case report highlights the diagnosis, prevention and management of patients with prosthetic valve thrombosis following mitral valve replacement.

  3. Parálisis cerebral Cerebral palsy

    OpenAIRE

    Jorge Malagon Valdez

    2007-01-01

    El término parálisis cerebral (PC) engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia me...

  4. Human immunodeficiency virus-associated deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Akhilesh Kumar Singh

    2016-01-01

    Full Text Available Deep vein thrombosis (DVT has been reported to occur 2-10 times more common in human immunodeficiency virus-infected individuals than in the general population. We are reporting a case of DVT of right lower limb who was on highly active antiretroviral therapy. The patient did not have any acquired risk factors of DVT. The patient responded well to anticoagulation therapy.

  5. [Acute arterial thrombosis of the extremity in pseudoxanthoma elasticum].

    Science.gov (United States)

    Rodríguez-Camarero, S J; Manchado, P; González, J A; Castro, M A; Rodero, J I; Mateo, A M

    1992-01-01

    We report a case of a patient with an elastic pseudoxanthoma (PXE) who presented an acute ischaemia at the left lower limb. The cause of such ischaemia was a thrombosis into the iliac and femoropopliteal arteries. Patient underwent a surgical procedure. The arteriopathy associated with a PXE rarely cause an arterial major occlusion. We did not found a case of acute arterial thrombotic ischaemia and PXE, treated with direct arterial revascularization in the reviewed literature.

  6. Deep Vein Thrombosis with First Episode Catatonia: A Case Report

    Directory of Open Access Journals (Sweden)

    Sunilkumar

    2015-04-01

    Full Text Available Catatonia is a medical emergency condition with varied causative factors. Subsequent medical complications of catatonia put the patient to high risk of morbidity and mortality. Earlier studies show mortality rates up to 50% without proper and timely intervention. Deep vein thrombosis is one such life threatening complication which can be prevented with proper management and care. A case of acute onset catatonia with a left leg DVT in a 21 yr old young single male is discussed here.

  7. Air pollution and venous thrombosis: a meta-analysis

    OpenAIRE

    Tang, Liang; Wang, Qing-yun; Cheng, Zhi-Peng; Hu, Bei; Liu, Jing-di; Hu, Yu

    2016-01-01

    Exposure to air pollution has been linked to cardiovascular and respiratory disorders. However, the effect of air pollution on venous thrombotic disorders is uncertain. We performed a meta-analysis to assess the association between air pollution and venous thrombosis. PubMed, Embase, EBM Reviews, Healthstar, Global Health, Nursing Database, and Web of Science were searched for citations on air pollutants (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and particulate matters) and v...

  8. Abdominal aortic thrombosis in association with an attempted Heimlich maneuver.

    Science.gov (United States)

    Roehm, E F; Twiest, M W; Williams, R C

    1983-03-04

    We report herein a case of an incorrectly applied Heimlich maneuver--to the best of our knowledge, the first reported fatal complication associated with a Heimlich maneuver, acute thrombosis of an abdominal aortic aneurysm, and the distal aorta. While the Heimlich maneuver is effective for the relief of foreign body-induced upper airway obstruction, increased efforts should be directed toward instructing the public in correctly recognizing and optimally treating airway obstruction.

  9. [Edge effect and late thrombosis -- inevitable complications of vascular brachytherapy?].

    Science.gov (United States)

    Schiele, T M; Staber, L; Kantlehner, R; Pöllinger, B; Dühmke, E; Theisen, K; Klauss, V

    2002-11-01

    Restenosis is the limiting entity after percutaneous coronary angioplasty. Vascular brachytherapy for the treatment of in-stent restenosis has been shown to reduce the repeat restenosis rate and the incidence of major adverse events in several randomized trials. Besides the beneficial effects, brachytherapy yielded some unwanted side effects. The development of new stenoses at the edges of the target lesion treated with radiation is termed edge effect. It occurs after afterloading brachytherapy as well as after implantation of radioactive stents. It is characterized by extensive intimal hyperplasia and negative remodeling. As contributing factors the axial dose fall-off, inherent to all radioactive sources, and the application of vessel wall trauma by angioplasty have been identified. The combination of both factors, by insufficient overlap of the radiation length over the injured vessel segment, has been referred to as geographic miss. It has been shown to be associated with a very high incidence of the edge effect. Avoidance of geographic miss is strongly recommended in vascular brachytherapy procedures. Late thrombosis after vascular brachytherapy is of multifactorial origin. It comprises platelet recruitment, fibrin deposition, disturbed vasomotion, non-healing dissection and stent malapposition predisposing to turbulent blood flow. The strongest predictors for late thrombosis are premature discontinuation of antiplatelet therapy and implantation of new stents during the brachytherapy procedure. With a consequent and prolonged antiplatelet therapy, the incidence of late thrombosis has been reduced to placebo levels. Edge effect and late thrombosis represent unwanted side effects of vascular brachytherapy. By means of a thorough treatment planning and prolonged antiplatelet therapy their incidences can be largely reduced. With regard to the very favorable net effect, they do not constitute relevant limitations of vascular brachytherapy.

  10. Unicompartmental muscle edema: an early sign of deep venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Patrick T. [Mayo Clinic Scottsdale, Department of Diagnostic Radiology, 13400 E. Shea Boulevard, Scottsdale, AZ 85259 (United States); Ilaslan, Hakan [Mayo Clinic Rochester, Department of Diagnostic Radiology, Rochester, Minnesota (United States)

    2003-01-01

    The finding of muscle edema restricted to a single muscle compartment on MRI usually indicates a diagnosis of traumatic injury, myositis, denervation or neoplasm. This case demonstrates that deep venous thrombosis can also be the cause of isolated deep posterior compartment muscle edema in the calf and should be considered in the differential diagnosis even in the absence of diffuse soft tissue or subcutaneous edema. (orig.)

  11. LEFT ATRIUM THROMBOSIS IN PATIENTS WITH RHEUMATIC MITRAL VALVULAR DISEASE

    Directory of Open Access Journals (Sweden)

    N. D. Kaverin

    2012-01-01

    Full Text Available Systemic thromboembolism — fairly common complication of mitral valvular disease, often leading to disability or fatal consequences for the patient. The source of emboli in most cases, are blood clots localized in the left atrium. The survey reflected basic views on the pathogenesis, diagnosis, treatment and prevention of intraatrial thrombosis according to new scientific advances. Articles (reviews, meta-analyzes and original researchs from Pub Med database, as well as domestic literature were used.

  12. LEFT ATRIUM THROMBOSIS IN PATIENTS WITH RHEUMATIC MITRAL VALVULAR DISEASE

    Directory of Open Access Journals (Sweden)

    N. D. Kaverin

    2014-07-01

    Full Text Available Systemic thromboembolism — fairly common complication of mitral valvular disease, often leading to disability or fatal consequences for the patient. The source of emboli in most cases, are blood clots localized in the left atrium. The survey reflected basic views on the pathogenesis, diagnosis, treatment and prevention of intraatrial thrombosis according to new scientific advances. Articles (reviews, meta-analyzes and original researchs from Pub Med database, as well as domestic literature were used.

  13. Parálisis cerebral Cerebral palsy

    Directory of Open Access Journals (Sweden)

    Jorge Malagon Valdez

    2007-01-01

    Full Text Available El término parálisis cerebral (PC engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia mental, trastornos del lenguaje, audición, visión, déficit de la atención que mejoran el pronóstico de manera significativa. El pronóstico también depende de la gravedad del padecimiento y de las manifestaciones asociadas.The term cerebral palsy (CP, is used for a great number of clinical neurological syndromes. The syndromes are characterized by having a common cause, motor defects. It is important, because they can cause a brain damage by presenting motor defects and some associated deficiencies, such as mental deficiency, epilepsy, language and visual defects and pseudobulbar paralysis, with the nonevolving fact. Some authors prefer using terms such as "non-evolving encephalopathies". In the treatment the utility of prevention programs of early stimulation and special rehabilitation methods, and treatment of associated deficiencies such as epilepsy, mental deficiency, language, audition and visual problems, and the attention deficit improve the prognosis in an important way. The prognosis depends on the severity of the disease and the associated manifestations.

  14. Dissolution of emboli in rats with experimental cerebral thromboembolism by recombinant human tissue plasminogen activator (TD-2061)

    Energy Technology Data Exchange (ETDEWEB)

    Hara, T.; Iwamoto, M.; Ogawa, H.; Yamamoto, A.; Tomikawa, M. (Research Institute, Daiichi Pharmaceutical Co., Ltd., Tokyo, (Japan))

    1990-08-15

    Tissue plasminogen activator (t-PA) is frequently administered clinically as thrombolytic therapy. We injected recombinant t-PA into rats with cerebral {sup 125}I-labeled blood clot emboli to evaluate the dissolutive effect of recombinant human single-chain t-PA (rt-PA; TD-2061) on such emboli and to examine the possibility of improving neurological damage in patients with cerebral thrombosis. When rt-PA was given intravenously at a dose of 350,000 IU/kg 2 minutes before embolization, radioactivity in the affected cerebral hemisphere decreased to 20% of that in the vehicle control 2 hours after embolization. A significant decrease in radioactivity in the cerebral hemisphere was also found on the administration of 700,000 IU/kg of rt-PA 30 or 60 minutes after embolization, but not when rt-PA was administered 2 minutes after embolization. Marked inhibition of abnormal behavior such as hemiplegia was seen on treatment with rt-PA 2 minutes before embolization, but not at all when rt-PA treatment was given 30 or 60 minutes after embolization. The findings suggest that rt-PA can dissolve blood clot emboli in cerebral vessels and that prompt thrombolytic therapy is important to minimize neurological dysfunction in cases of cerebral thromboembolism.

  15. Venous and arterial thrombosis: Two aspects of the same disease?

    Directory of Open Access Journals (Sweden)

    Paolo Prandoni

    2009-01-01

    Full Text Available Paolo PrandoniDepartment of Cardiothoracic and Vascular Sciences, Thromboembolism Unit, University Hospital of Padua Padua, ItalyAbstract: An increasing body of evidence suggests the likelihood of a link between venous and arterial thrombosis. The two vascular complications share several risk factors, such as age, obesity, diabetes mellitus, blood hypertension, hypertriglyceridemia, and metabolic syndrome. Moreover, there are many examples of conditions accounting for both venous and arterial thrombosis, such as the antiphospholipid antibody syndrome, hyperhomocysteinemia, malignancies, infections, and the use of hormonal treatment. Finally, several recent studies have consistently shown that patients with venous thromboembolism are at a higher risk of arterial thrombotic complications than matched control individuals. We, therefore, speculate the two vascular complications are simultaneously triggered by biological stimuli responsible for activating coagulation and inflammatory pathways in both the arterial and the venous system. Future studies are needed to clarify the nature of this association, to assess its extent, and to evaluate its implications for clinical practice.Keywords: venous thromboembolism, deep vein thrombosis, pulmonary embolism, myocardial infarction, ischemic stroke, atherosclerosis

  16. Lysyl oxidase is associated with increased thrombosis and platelet reactivity.

    Science.gov (United States)

    Matsuura, Shinobu; Mi, Rongjuan; Koupenova, Milka; Eliades, Alexia; Patterson, Shenia; Toselli, Paul; Thon, Jonathan; Italiano, Joseph E; Trackman, Philip C; Papadantonakis, Nikolaos; Ravid, Katya

    2016-03-17

    Lysyl oxidase (LOX) is overexpressed in various pathologies associated with thrombosis, such as arterial stenosis and myeloproliferative neoplasms (MPNs). LOX is elevated in the megakaryocytic lineage of mouse models of MPNs and in patients with MPNs. To gain insight into the role of LOX in thrombosis and platelet function without compounding the influences of other pathologies, transgenic mice expressing LOX in wild-type megakaryocytes and platelets (Pf4-Lox(tg/tg)) were generated. Pf4-Lox(tg/tg) mice had a normal number of platelets; however, time to vessel occlusion after endothelial injury was significantly shorter in Pf4-Lox(tg/tg) mice, indicating a higher propensity for thrombus formation in vivo. Exploring underlying mechanisms, we found that Pf4-Lox(tg/tg) platelets adhere better to collagen and have greater aggregation response to lower doses of collagen compared with controls. Platelet activation in response to the ligand for collagen receptor glycoprotein VI (cross-linked collagen-related peptide) was unaffected. However, the higher affinity of Pf4-Lox(tg/tg) platelets to the collagen sequence GFOGER implies that the collagen receptor integrin α2β1 is affected by LOX. Taken together, our findings demonstrate that LOX enhances platelet activation and thrombosis.

  17. Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: a Rare Association

    Directory of Open Access Journals (Sweden)

    Gökhan Çelik

    2011-11-01

    Full Text Available Sarcoidosis is a multisystem granulomatous disorder of unknown etiology and it may rarely be associated with a second disorder. Celiac disease is an immune-mediated enteropathy characterized with malabsorption caused by gluten intolerance, and several reports indicate an association between celiac disease and sarcoidosis. In addition, although celiac disease is associated with several extraintestinal pathologies, venous thrombosis has been rarely reported. Herein we present a rare case report of a patient with a diagnosis of sarcoidosis, celiac disease and deep venous thrombosis because of the rare association of these disorders. The patient was admitted with abdominal pain, weight loss, chronic diarrhea and a 5-day history of swelling in her right leg. A diagnosis of deep venous thrombosis was achieved by doppler ultrasonographic examination. The diagnosis of celiac disease was made by biopsy of duodenal mucosa and supported with elevated serum level of anti-gliadin IgA and IgG, and a diagnosis of sarcoidosis was achieved by transbronchial needle aspiration from the subcarinal lymph node during flexible bronchoscopy.

  18. Correlation factors and nursing measures for deep venous thrombosis of lower extremity%下肢深静脉血栓形成相关因素及护理要点

    Institute of Scientific and Technical Information of China (English)

    王红月

    2014-01-01

    Objective:To collect relevant clinical data and explore the correlated factors of deep venous thrombosis,and to summarize the nursing measures. Methods:One-hundred and twenty-four patients'data were collected and analyzed,and the influence to deep venous thrombosis was studied. Results:Trauma fracture,cerebral vascular bed,heart failure and major surgery( heart,chest,abdomen)were the significant factors about deep venous thrombosis,the differences were significant(P ﹤ 0. 05). Conclusion:We should figure out the factors about deep venous thrombosis and take effective nurs-ing measures in order to decrease the incidence of deep venous thrombosis and complications.%目的:收集相关病例资料,分析下肢深静脉血栓形成的相关因素,并阐明各时期护理要点。方法对124例下肢深静脉血栓形成的相关因素进行分析,研究其对下肢深静脉血栓形成的影响。结果外伤骨折、脑血管病卧床、心功能衰竭和大手术(心、胸、腹)后与下肢深静脉血栓形成密切相关,具有统计学差异(P ﹤0.05)。结论明确下肢深静脉血栓形成的高危因素,并对其进行有针对性的护理干预,以降低下肢深静脉血栓形成发生率及并发症发生。

  19. Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient

    Directory of Open Access Journals (Sweden)

    Nelson Oliveira

    2011-01-01

    Full Text Available Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging. Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation. Phlegmasia alba dolens installed progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy. Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

  20. Primary iliac venous leiomyosarcoma: a rare cause of deep vein thrombosis in a young patient.

    Science.gov (United States)

    Oliveira, Nelson; Dias, Emanuel; Lima, Ricardo; Oliveira, Fernando; Cássio, Isabel

    2011-01-01

    Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging. Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation. Phlegmasia alba dolens installed progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy. Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

  1. Mesenteric venous thrombosis after prolonged air travel-a case report

    Institute of Scientific and Technical Information of China (English)

    Joaqun Salas-Coronas; Jos L Serrano-Carrillo; Ana B Lozano-Serrano; Jos C Snchez-Snchez; Leticia Miras-Lucas; Rosario Prez-Moyano

    2014-01-01

    We present a case of acute mesenteric venous thrombosis after a long distance flight in a traveller presenting with abdominal pain, diarrhoea and vomiting within 48 h of prolonged immobility situation. Venous thrombosis in the lower limbs and venous thromboembolism has been clearly associated with prolonged air travel (economy class syndrome). Thrombosis was diagnosed by computed tomography of the abdomen, and after starting anticoagulant therapy with acenocumarol, symptoms yielded completely in a few weeks. The study of thrombophilia was negative, although the existence of two first-degree relatives (mother and grandmother) with a history of venous thrombosis with a history of venous thrombosis makes it likely a situation of inherited thrombophilia. Although exceptional, mesenteric venous thrombosis should be considered in travellers with acute abdominal pain after prolonged air travel when there are thrombophilic conditions.

  2. Acquired and Heritable Thrombophilia in Indian Patients With Pediatric Deep Venous Thrombosis (DVT).

    Science.gov (United States)

    Pai, Navin; Ghosh, Kanjaksha; Shetty, Shrimati

    2014-09-01

    Deep venous thrombosis (DVT) in children is more often associated with underlying pathological conditions than with hereditary thrombophilia. The present study is a retrospective analysis of thrombophilia in 285 pediatric patients with venous thrombosis at different sites. Four common thrombophilia markers, that is protein C, protein S, antithrombin III, and factor V Leiden (FVL) mutation, were analyzed. Thrombosis in hepatic and portal veins was more common in pediatric patients (73%) when compared to other sites (27%). Overall, hereditary thrombophilia accounted for 15.5% of the patients with venous thrombosis. The FVL mutation, which was the major causative factor in Budd-Chiari syndrome and portal vein thrombosis cases in the adult group, was not a major contributing factor in pediatric group, that is, 1.8% of the patients. In conclusion, the risk factors for venous thrombosis vary in different age groups.

  3. Mesenteric venous thrombosis after prolonged air travel-a case report

    Directory of Open Access Journals (Sweden)

    Joaquín Salas-Coronas

    2014-07-01

    Full Text Available We present a case of acute mesenteric venous thrombosis after a long distance flight in a traveller presenting with abdominal pain, diarrhoea and vomiting within 48 h of prolonged immobility situation. Venous thrombosis in the lower limbs and venous thromboembolism has been clearly associated with prolonged air travel (economy class syndrome. Thrombosis was diagnosed by computed tomography of the abdomen, and after starting anticoagulant therapy with acenocumarol, symptoms yielded completely in a few weeks. The study of thrombophilia was negative, although the existence of two first-degree relatives (mother and grandmother with a history of venous thrombosis with a history of venous thrombosis makes it likely a situation of inherited thrombophilia. Although exceptional, mesenteric venous thrombosis should be considered in travellers with acute abdominal pain after prolonged air travel when there are thrombophilic conditions.

  4. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  5. Bioprosthetic mitral valve thrombosis complicating antiphospholipid antibody syndrome, successfully treated with thrombolysis.

    Science.gov (United States)

    Chamsi-Pasha, Mohammed A; Alyousef, Tareq; Sayyed, Samer

    2014-10-01

    The incidence of bioprosthetic valve thrombosis and related embolic complications is extremely rare, obviating the need for long-term anticoagulation. As a result, experience in the diagnosis and treatment of bioprosthetic valve thrombosis is fairly limited. We report the first case of antiphospholipid antibody syndrome presenting as bioprosthetic mitral valve thrombosis, 15 months after valve replacement, and successfully treated with thrombolytic therapy.

  6. Postural Abnormality as a Risk Marker for Leg Deep Venous Thrombosis in Parkinson’s Disease

    OpenAIRE

    Kazushi Yamane; Fumiharu Kimura; Kiichi Unoda; Takafumi Hosokawa; Takahiko Hirose; Hiroki Tani; Yoshimitsu Doi; Simon Ishida; Hideto Nakajima; Toshiaki Hanafusa

    2013-01-01

    BACKGROUND: Pulmonary thromboembolism is a common cause of death in patients with autopsy-confirmed Parkinsonism. This study investigated the incidence of leg deep vein thrombosis in Parkinson's disease and relationships between deep vein thrombosis and clinical/laboratory findings, including postural abnormalities as assessed by photographic measurements. METHODS: This cross-sectional study assessed the presence of deep vein thrombosis using bilateral leg Doppler ultrasonography in 114 asymp...

  7. Improving deep vein thrombosis prophylaxis with mechanical modalities in surgical intensive care unit.

    Science.gov (United States)

    Restrepo, Paula; Jameson, Deborah L; Carroll, Diane L

    2015-01-01

    Deep vein thrombosis remains a source of adverse outcomes in surgical patients. Deep vein thrombosis is preventable with prophylactic intervention. The success of noninvasive mechanical modalities for prophylaxis relies on compliance with correct application. The goals of this project were to create a guideline that reflected current evidence and expert thinking about mechanical modalities use, assess compliance with mechanical modalities, and develop strategies to disseminate an evidence-based guideline for deep vein thrombosis prophylaxis.

  8. Phenylpropanolamine and cerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    McDowell, J.R.; LeBlanc, H.J.

    1985-05-01

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

  9. Cerebral salt wasting syndrome

    Directory of Open Access Journals (Sweden)

    Harshal Dholke

    2016-01-01

    Full Text Available Traumatic brain injury (TBI is on the rise, especially in today′s fast-paced world. TBI requires not only neurosurgical expertise but also neurointensivist involvement for a better outcome. Disturbances of sodium balance are common in patients with brain injury, as the central nervous system plays a major role in sodium regulation. Hyponatraemia, defined as serum sodium <135 meq/L is commonly seen and is especially deleterious as it can contribute to cerebral oedema in these patients. Syndrome of inappropriate antidiuretic hormone secretion (SIADH, is the most well-known cause of hyponatraemia in this subset of patients. Cerebral Salt Wasting Syndrome (CSWS, leading to renal sodium loss is an important cause of hyponatraemia in patients with TBI. Although incompletely studied, decreased renal sympathetic responses and cerebral natriuretic factors play a role in the pathogenesis of CSWS. Maintaining a positive sodium balance and adequate hydration can help in the treatment. It is important to differentiate between SIADH and CSWS when trying to ascertain a case for patients with acute brain injury, as the treatment of the two are diametrically opposite.

  10. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain

    2014-03-01

    Full Text Available Hyperthermia is associated with marked reductions in cerebral blood flow (CBF. Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g. posture and degree of hyperthermia. The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2 causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g. hemorrhage or orthostatic challenges, an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e. 1.0°C to 2.0°C increase in body core temperature levels of hyperthermia. Future research directions are provided.

  11. Infections and inflammatory diseases as risk factors for venous thrombosis. A systematic review.

    Science.gov (United States)

    Tichelaar, Y I G Vladimir; Kluin-Nelemans, Hanneke J C; Meijer, Karina

    2012-05-01

    Inflammation and venous thrombosis are intertwined. Only in the recent 15 years clinical epidemiological studies have focussed on inflammatory or infectious diseases as risk factors for venous thrombosis. Although a few reviews and many case reports or studies on these topic has been written, a review reporting relative or absolute risks for venous thrombosis has not been published yet. We performed a systematic review using Medline, Pubmed and Embase and found 31 eligible articles. Inflammatory bowel disease, ANCA-associated vasculitis, infections in general and more specifically, human immunodeficiency virus, pneumonia and urinary tract infections are associated with an increased risk of venous thrombosis.

  12. Cerebral malformations without antenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine J. [Diagnostic Neuroradiology, Hopital Timone, Marseille (France)

    2010-06-15

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  13. Cerebral Autoregulation in Normal Pregnancy and Preeclampsia

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; Griffioen, Annemiek C.; Zeeman, Gerda; Belfort, Michael A.

    2013-01-01

    OBJECTIVE: To test the hypothesis that preeclampsia is associated with impaired dynamic cerebral autoregulation. METHODS: In a prospective cohort analysis, cerebral blood flow velocity of the middle cerebral artery (determined by transcranial Doppler), blood pressure (determined by noninvasive arter

  14. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

    Stokum, Jesse A; Gerzanich, Volodymyr; Simard, J Marc

    2016-03-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema.

  15. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Byrd, Sharon E.; Elias, Dean [Rush Medical College and Rush University Medical Center, Department of Diagnostic Radiology and Nuclear Medicine Section of Neuroradiology, Chicago, IL (United States); Abramowicz, Jacques S. [Rush Medical College and Rush University Medical Center, Department of Obstetrics and Gynecology, Rush Fetal and Neonatal Medicine Center, Chicago, IL (United States); Kent, Paul [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Hematology and Oncology, Chicago, IL (United States); Kimura, Robert E. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Neonatology, Chicago, IL (United States); Heydeman, Peter T. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Pediatric Neurology, Chicago, IL (United States)

    2012-05-15

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature

  16. A novel mechanism of thrombosis in antiphospholipid antibody syndrome.

    Science.gov (United States)

    Vlachoyiannopoulos, Panayiotis G; Routsias, John G

    2010-11-01

    Antiphospholipid antibody syndrome (APS) is an autoimmune thrombophilia mediated by autoantibodies directed against phospholipid-binding plasma proteins, mainly β2 Glycoprotein I (β2GPI)-a plasma apolipoprotein and prothrombin (PT). A subgroup of these antibodies termed "Lupus Anticoagulant" (LA) elongate in vitro the clotting times, this elongation not corrected by adding normal plasma in the detection system. The exact mechanism by which these autoantibodies induce thrombosis is not well understood. Resistance to natural anticoagulants such as protein C, impaired fibrinolysis, activation of endothelial cells to a pro-coagulant phenotype and activation of platelets, are among the mechanisms partially supported by experimental evidence. Artificially dimerized β2GPI binds tightly to platelet membrane activating them. We search for mechanisms of natural dimerization of β2GPI by proteins of the platelet membranes and found that platelet factor 4 (PF4) assembled in homotetramers binds two molecules of β2GPI and this complex is recognized by anti-β2GPI antibodies, the whole complexes being thrombogenic in terms of activating platelets as confirmed by p38MAP kinase phosphorylation and thromboxane B2 production. Of note PF4/heparin complexes are also immunogenic triggering the production of anti-PF4/heparin antibodies which activate also platelets (the so-called "heparin-induced thrombocytopenia and thrombosis syndrome", HITT). The anti-β2GPI antibodies activate platelets by their F(ab)2, while the anti-PF4/heparin by their Fc fragments. Thus PF4 is a common denominator in the pathogenesis of APS and HITT which share also clinical characteristics such as thrombocytopenia and thrombosis.

  17. Implantable port thrombosis in cancer patients: a monocentric experience

    Science.gov (United States)

    Dridi, Manel; Mejri, Nesrine; Labidi, Soumaya; Afrit, Mehdi; Benna, Houda El; Miled, Khaoula Ben; Boussen, Hamouda

    2016-01-01

    Objective: Implantable port thrombosis (IPT) in cancer patients is a relatively rare but severe complication. Several factors are reportedly associated with the occurrence of thrombosis. We aimed to describe the prevalence and the anatomoclinical features of IPT observed in cancer patients who were treated in a medical oncology department in Tunisia. Methods: A total of 600 cancer patients who had port implantation from January 2013 to December 2015 were retrospectively identified. Cases with symptomatic/incidental IPT (radiologically confirmed) were further identified. Epidemiological and anatomoclinical features were collected from patient records and the department database. Results: We observed that 33 of the 600 patients had IPT; thus, the prevalence was 5.5%. The median age was 57 years, and the gender ratio was 0.43. Overweight or obesity was observed in 73% of the patients. IPT occurred mainly in patients with breast (36.4%) and colorectal (33.3%) cancers, which were mostly nonmetastatic (79%). At least one identified classical thromboembolic risk factor was found in 13 patients (smoking in 9, tamoxifen in 2). IPT was symptomatic in 93% of the cases, occurring within an average time of 56 days. Implantable ports were removed because of infection in 2 cases and nonfunctionality in 3 cases. IPT treatment was based on low-molecular-weight heparins (94%) and antivitamin K (6%) for an average of 130 days. Four patients had post-therapy complications: one thrombosis recurrence and three infections. Conclusions: IPT cases in the 600 patients were observed to occur in obese nonmetastatic cancer patients within the first 3 months after IP implantation.

  18. Thrombosis and its significance after experimental pulmonary thromboembolism

    Institute of Scientific and Technical Information of China (English)

    季颖群; 张中和; 张平

    2003-01-01

    Objective To study thrombosis and its significance after acute experimental pulmonary thromboembolism. Methods The acute pulmonary thromboembolism (PTE) model of rabbits was established by intravenous injection of autologous blood clots (0.04 g/kg) which were stabilized in temperature-controlled (70℃) distilled water for 10 min. The process of thrombosis was observed grossly and microscopically. The Quick's method was used to examine the coagulability of blood and radioimmunoassay was employed to measure the level of plasma thromboxane A2 and endothelin. Results Thrombotic propensity was observed at 1 h, fresh thrombus started to form and the blood coagulation system was activated at 24 h following clots infusion. Emboli were completely or partly dissolved at 5 d and appeared to organize at both 10 d and 14 d after clots were infused. Venous plasma thromboxane A2 concentration began to increase at 5 min (2489.59±714.68 ng/L) and reached its maximum at 15 min (2545.46±590.58 ng/L) then declined at 60 min after clot infusion (P<0.001, respectively, vs 626.59±510.02 ng/L of pre-clot). The level of endothelin in both arterial and venous blood increased at 5 d post-clot infusion (840.74±154.19 ng/L, 230.35±52.39 ng/L, respectively) compared to the one before infusion (602.66±453.26 ng/L, 148.01±53.28 ng/L, respectively, P<0.05).Conclusions Thrombosis occurs after autologous-blood-clot-induced PTE. The interactions between thrombus formation, fibrinolysis and organization determines the consequences of emboli. Abnormalities of endothelin metabolism and the increment of thromboxane A2 may play an important role in PTE.

  19. Implantable port thrombosis in cancer patients:a monocentric experience

    Institute of Scientific and Technical Information of China (English)

    Manel Dridi; Nesrine Mejri; Soumaya Labidi; Mehdi Afrit; Houda El Benna; Khaoula Ben Miled; Hamouda Boussen

    2016-01-01

    Objective:Implantable port thrombosis (IPT) in cancer patients is a relatively rare but severe complication. Several factors are reportedly associated with the occurrence of thrombosis. We aimed to describe the prevalence and the anatomoclinical features of IPT observed in cancer patients who were treated in a medical oncology department in Tunisia. Methods:A total of 600 cancer patients who had port implantation from January 2013 to December 2015 were retrospectively identified. Cases with symptomatic/incidental IPT (radiologically confirmed) were further identified. Epidemiological and anatomoclinical features were collected from patient records and the department database. Results: We observed that 33 of the 600 patients had IPT; thus, the prevalence was 5.5%. The median age was 57 years, and the gender ratio was 0.43. Overweight or obesity was observed in 73% of the patients. IPT occurred mainly in patients with breast (36.4%) and colorectal (33.3%) cancers, which were mostly nonmetastatic (79%). At least one identified classical thromboembolic risk factor was found in 13 patients (smoking in 9, tamoxifen in 2). IPT was symptomatic in 93% of the cases, occurring within an average time of 56 days. Implantable ports were removed because of infection in 2 cases and nonfunctionality in 3 cases. IPT treatment was based on low-molecular-weight heparins (94%) and antivitamin K (6%) for an average of 130 days. Four patients had post-therapy complications: one thrombosis recurrence and three infections. Conclusions:IPT cases in the 600 patients were observed to occur in obese nonmetastatic cancer patients within the first 3 months after IP implantation.

  20. Management of Deep Vein Thrombosis (DVT) Prophylaxis in Trauma Patients.

    Science.gov (United States)

    Paydar, Shahram; Sabetian, Golnar; Khalili, Hosseinali; Fallahi, Javad; Tahami, Mohammad; Ziaian, Bizhan; Abbasi, Hamid Reza; Bolandparvaz, Shahram; Ghaffarpasand, Fariborz; Ghahramani, Zahra

    2016-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause swelling or leg pain, but sometimes may occur with no symptoms. Awareness of DVT is the best way to prevent the VTE. Patients with trauma are at increased risk of DVT and subsequent PE because of coagulopathy in patients with multiple trauma, DVT prophylaxis is essential but the VTE prophylaxis strategy is controversial for the trauma patients. The risk factors for VTE includes pelvic and lower extremity fractures, and head injury.