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Titolo:
Cerebral venous sinus thrombosis: a diagnostic challenge
Autore:
Fink, JN; McAuley, DL;
Indirizzi:
Beth Israel Deaconess Med Ctr, Stroke Div, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Boston MA USA 02215 v, Boston, MA 02215 USA Auckland Hosp, Dept Neurol, Auckland, New Zealand Auckland Hosp AucklandNew Zealand , Dept Neurol, Auckland, New Zealand
Titolo Testata:
INTERNAL MEDICINE JOURNAL
fascicolo: 7, volume: 31, anno: 2001,
pagine: 384 - 390
SICI:
1444-0903(200109/10)31:7<384:CVSTAD>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
ENDOVASCULAR THROMBOLYTIC THERAPY; HEPARIN TREATMENT; FOLLOW-UP; UROKINASE; PROGNOSIS; INFUSION; ADULTS; MRI;
Keywords:
cerebral thrombosis; diagnosis; headache; heparin; intracranial; sinus thrombosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Fink, JN Beth Israel Deaconess Med Ctr, Stroke Div, Dana 710,330 BrooklineAve, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Dana 710,330 Brookline Ave Boston MA USA 02215
Citazione:
J.N. Fink e D.L. McAuley, "Cerebral venous sinus thrombosis: a diagnostic challenge", INTERN M J, 31(7), 2001, pp. 384-390

Abstract

Background: Cerebral venous sinus thrombosis (CVT) is a potentially serious but treatable disorder that has been underdiagnosed in the past. Delay indiagnosis and treatment of this disorder has resulted in the death of one of our patients. Aim: To review the local experience with CVT in order to identify factors that may allow diagnosis and appropriate treatment decisions to be made more readily in the future. Methods: A retrospective review of all cases of CVT diagnosed or treated at Auckland Hospital between 1990 and 1999. Results: Twenty-five cases of CVT were identified. The number of cases diagnosed increased from less than one per year in 1990-94 to eight in 1999. Clinical signs at presentation included headache (96%), focal neurological deficits (60%), seizures (40%) and papilloedema (43%). Delayed diagnosis after admission to hospital occurred in two young women presenting with neurological symptoms during pregnancy or puerperium, in two cases in whom focal symptoms were not explained by negative computed tomography and in five cases presenting with intracerebral haemorrhage. Twenty patients received anticoagulant therapy and their condition remained stable or improved after treatment. Conclusions: The diagnosis of CVT should be considered in women with any neurological symptoms during pregnancy or puerperium and in all cases of unexplained intracerebral haemorrhage. CVT should also be considered in cases of recent onset and progressive headache, particularly when associated withfocal neurological symptoms or signs, seizures or papilloedema. Magnetic resonance imaging with magnetic resonance venography is the investigation ofchoice. Anticoagulation with heparin remains the mainstay of treatment, even in the presence of intracerebral haemorrhage.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 10:43:36