RESUMO
BACKGROUND: Cerebral venous thrombosis (CVT) is associated with intracranial hemorrhage. AIM: To identify clinical and imaging features of CVT-associated intracranial hemorrhage. We hypothesized that higher clot burden would be associated with a higher risk of intracranial hemorrhage. METHODS: We performed a retrospective analysis of an international, multicenter cohort of patients with confirmed cerebral venous thrombosis who underwent computed tomography within 2 weeks of symptom onset. Clinical and imaging features were compared between patients with and without intracranial hemorrhage. Clot burden was assessed by counting the number of thrombosed venous sinuses and veins on confirmatory imaging. RESULTS: We enrolled 260 patients from 10 institutions in Europe and Mexico. The mean age was 42 years and 74% were female. Intracranial hemorrhage was found in 102 (39%). Among them parenchymal hemorrhage occurred in 64 (63%), in addition, small juxta-cortical hemorrhage was found in 30 (29%), subarachnoid hemorrhage in 24 (24%) and subdural hemorrhage in 11 (11%). Multiple concomitant types of hemorrhage occurred in 23 (23%). Older age and superior sagittal thrombosis involvement were associated with presence of hemorrhage. The number of thrombosed venous sinuses was not associated with intracranial hemorrhage (median number IQRInterquartile ratio] of sinuses/veins involved with hemorrhage 2 (1-3) vs. 2 (1-3) without hemorrhage, p = 0.4). CONCLUSION: The high rate of intracranial hemorrhage in cerebral venous thrombosis is not explained by widespread involvement of the venous sinuses. Superior sagittal sinus involvement is associated with higher bleeding risk.
Assuntos
Veias Cerebrais , Trombose Intracraniana , Trombose Venosa , Adulto , Idoso , Europa (Continente) , Feminino , Humanos , Hemorragias Intracranianas/complicações , Hemorragias Intracranianas/diagnóstico por imagem , Hemorragias Intracranianas/epidemiologia , Trombose Intracraniana/complicações , Trombose Intracraniana/diagnóstico por imagem , Trombose Intracraniana/epidemiologia , Masculino , México , Estudos Retrospectivos , Trombose Venosa/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/epidemiologiaRESUMO
It could be shown that MRI has capability of demostrating parenchymal damage due to cerebrovascular disease even in asymptomatic individuals. In ischemic stroke MRI is superior to CT because of the earlier detection of the lesion, a More precise delineation of lacunes, of brainstem infarcts, and of hemorrhagic components. Evidence of confluent white matter damage is helpful in differentiating vascualr dementia from degenerative forms. Is hemorrhagic stroke CT remains the preferred imaging technique during the acute phase but MRI will detect remnants of a cerebral hemorrhage for lifetime
Assuntos
Embolia e Trombose Intracraniana/diagnóstico , Hemorragia Cerebral/diagnóstico , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios X , Demência Vascular/diagnóstico , Demência Vascular , Embolia e Trombose Intracraniana , Hemorragia Cerebral , Infarto Cerebral/diagnóstico , Infarto Cerebral , Isquemia Encefálica/diagnóstico , Isquemia Encefálica , Estudo de AvaliaçãoRESUMO
It could be shown that MRI has capability of demostrating parenchymal damage due to cerebrovascular disease even in asymptomatic individuals. In ischemic stroke MRI is superior to CT because of the earlier detection of the lesion, a More precise delineation of lacunes, of brainstem infarcts, and of hemorrhagic components. Evidence of confluent white matter damage is helpful in differentiating vascualr dementia from degenerative forms. Is hemorrhagic stroke CT remains the preferred imaging technique during the acute phase but MRI will detect remnants of a cerebral hemorrhage for lifetime
Assuntos
Hemorragia Cerebral/diagnóstico , Embolia e Trombose Intracraniana/diagnóstico , Espectroscopia de Ressonância Magnética/diagnóstico , Tomografia Computadorizada por Raios X , Hemorragia Cerebral/diagnóstico por imagem , Embolia e Trombose Intracraniana/diagnóstico por imagem , Infarto Cerebral/diagnóstico , Infarto Cerebral/diagnóstico por imagem , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/diagnóstico por imagem , Demência Vascular/diagnóstico , Demência Vascular/diagnóstico por imagem , Estudo de AvaliaçãoRESUMO
Dentro de los pacientes con enfermedad de Parkinson existen algunos que tienen especial frecuencia de factores de riesgo hemodinámico (hipertensión, diabetes, hipertrigliceridemia, agregación plaquetaria aumentada, disminución del flujo sanguíneo cerebral y anormalidades tomográficas). Estos pacientes tienen iguales síntomas que los demás, salvo en que los síntomas progresan más rápidamente. Es posible que una mejoría terapéutica de su estado vascular les sea útil (AU)
Assuntos
Humanos , Masculino , Feminino , Doença de Parkinson/complicações , Doenças Vasculares/complicações , Hipertensão/fisiopatologia , Diabetes Mellitus/fisiopatologia , Levodopa/uso terapêutico , Fluxo Sanguíneo Regional , Cérebro/irrigação sanguínea , RiscoRESUMO
Dentro de los pacientes con enfermedad de Parkinson existen algunos que tienen especial frecuencia de factores de riesgo hemodinámico (hipertensión, diabetes, hipertrigliceridemia, agregación plaquetaria aumentada, disminución del flujo sanguíneo cerebral y anormalidades tomográficas). Estos pacientes tienen iguales síntomas que los demás, salvo en que los síntomas progresan más rápidamente. Es posible que una mejoría terapéutica de su estado vascular les sea útil