Management of cerebral venous thrombosis in Spain: MOTIVATE descriptive study
Por:
Pérez Lázaro, C., López-Bravo, A., Gómez-Escalonilla Escobar, C., Aguirre, C., de Felipe, A., de la Riva, P., Calleja, S., Arjona, A., Serrano Ponz, M., Navarro-Pérez, M.P., Delgado-Mederos, R., Bashir Viturro, S., Llul, L., Egido, J., García Madrona, S., Díez González, N., Benavente Fernández, L., de la Torre Colmenero, J.D., Tejada Meza, H., Vesperinas Castro, A., Sánchez Cirera, L., Trillo, S.
Publicada:
1 ene 2021
Ahead of Print:
1 mar 2024
Resumen:
Introduction: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications. Objective: The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain. Methods: We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 11 Spanish centres. Results: We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3-6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score = 2), with papilloedema (P =.03), focal deficits (P =.001), and encephalopathy (P <.001) showing a statistically significant association with poor prognosis (mRS > 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%. Conclusion: The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity. © 2021 Sociedad Española de Neurología
Filiaciones:
Pérez Lázaro, C.:
Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain
López-Bravo, A.:
Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain
Gómez-Escalonilla Escobar, C.:
Hospital Clínico San Carlos, Madrid, Spain
Aguirre, C.:
Hospital La Princesa, Madrid, Spain
de Felipe, A.:
Hospital Ramón y Cajal, Madrid, Spain
de la Riva, P.:
Hospital Universitario Donosti, San Sebastián, Spain
Calleja, S.:
Hospital Universitario Central de Asturias, Oviedo, Spain
Arjona, A.:
Hospital Universitario Torrecárdenas, Almería, Spain
Serrano Ponz, M.:
Hospital Universitario Miguel Servet, Zaragoza, Spain
Navarro-Pérez, M.P.:
Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain
Delgado-Mederos, R.:
Hospital Sant Creu y Sant Pau, Barcelona, Spain
Bashir Viturro, S.:
Hospital Josep Trueta, Girona, Spain
Llul, L.:
Hospital Clínic, Barcelona, Spain
Egido, J.:
Hospital Clínico San Carlos, Madrid, Spain
García Madrona, S.:
Hospital Ramón y Cajal, Madrid, Spain
Díez González, N.:
Hospital Universitario Donosti, San Sebastián, Spain
Benavente Fernández, L.:
Hospital Universitario Central de Asturias, Oviedo, Spain
de la Torre Colmenero, J.D.:
Hospital Universitario Torrecárdenas, Almería, Spain
Tejada Meza, H.:
Hospital Universitario Miguel Servet, Zaragoza, Spain
Vesperinas Castro, A.:
Hospital Sant Creu y Sant Pau, Barcelona, Spain
Sánchez Cirera, L.:
Hospital Josep Trueta, Girona, Spain
Trillo, S.:
Hospital La Princesa, Madrid, Spain
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