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01-11-2020 | Subdural Hematoma | Original Communication

Features of intracranial hemorrhage in cerebral venous thrombosis

Authors: K. Afifi, G. Bellanger, P. J. Buyck, S. M. Zuurbier, C. G. Esperon, M. A. Barboza, P. Costa, I. Escudero, D. Renard, R. Lemmens, N. Hinteregger, F. Fazekas, J. Jimenez Conde, E. Giralt-Steinhauer, S. Hiltunen, A. Arauz, A. Pezzini, J. Montaner, J. Putaala, C. Weimar, Marc Schlamann, T. Gattringer, T. Tatlisumak, J. M. Coutinho, P. Demaerel, V. Thijs

Published in: Journal of Neurology | Issue 11/2020

Abstract

Background

Cerebral venous thrombosis (CVT) is associated with intracranial hemorrhage.

Aim

To identify clinical and imaging features of CVT-associated intracranial hemorrhage. We hypothesized that higher clot burden would be associated with a higher risk of intracranial hemorrhage.

Methods

We performed a retrospective analysis of an international, multicenter cohort of patients with confirmed cerebral venous thrombosis who underwent computed tomography within 2 weeks of symptom onset. Clinical and imaging features were compared between patients with and without intracranial hemorrhage. Clot burden was assessed by counting the number of thrombosed venous sinuses and veins on confirmatory imaging.

Results

We enrolled 260 patients from 10 institutions in Europe and Mexico. The mean age was 42 years and 74% were female. Intracranial hemorrhage was found in 102 (39%). Among them parenchymal hemorrhage occurred in 64 (63%), in addition, small juxta-cortical hemorrhage was found in 30 (29%), subarachnoid hemorrhage in 24 (24%) and subdural hemorrhage in 11 (11%). Multiple concomitant types of hemorrhage occurred in 23 (23%). Older age and superior sagittal thrombosis involvement were associated with presence of hemorrhage. The number of thrombosed venous sinuses was not associated with intracranial hemorrhage (median number IQRInterquartile ratio] of sinuses/veins involved with hemorrhage 2 (1–3) vs. 2 (1–3) without hemorrhage, p = 0.4).

Conclusion

The high rate of intracranial hemorrhage in cerebral venous thrombosis is not explained by widespread involvement of the venous sinuses. Superior sagittal sinus involvement is associated with higher bleeding risk.

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Title: Features of intracranial hemorrhage in cerebral venous thrombosis
Authors: K. Afifi
G. Bellanger
P. J. Buyck
S. M. Zuurbier
C. G. Esperon
M. A. Barboza
P. Costa
I. Escudero
D. Renard
R. Lemmens
N. Hinteregger
F. Fazekas
J. Jimenez Conde
E. Giralt-Steinhauer
S. Hiltunen
A. Arauz
A. Pezzini
J. Montaner
J. Putaala
C. Weimar
Marc Schlamann
T. Gattringer
T. Tatlisumak
J. M. Coutinho
P. Demaerel
V. Thijs
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Subdural Hematoma
Cerebral Sinus Venous Thrombosis
Subarachnoid Hemorrhage
Venous Thrombosis
Subarachnoid Hemorrhage
Thrombosis
Venous Thrombosis
Published in: Journal of Neurology / Issue 11/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10008-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Features of intracranial hemorrhage in cerebral venous thrombosis

Abstract

Background

Aim

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Aim

Methods

Results

Conclusion

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