Cerebral Venous Thrombosis in a Mexican Multicenter Registry of Acute Cerebrovascular Disease: The RENAMEVASC Study

被引:62
作者
Ruiz-Sandoval, Jose L. [1 ,2 ]
Chiquete, Erwin [1 ]
Jacqueline Banuelos-Becerra, L. [3 ]
Torres-Anguiano, Carolina [3 ]
Gonzalez-Padilla, Christian [3 ]
Arauz, Antonio [4 ]
Leon-Jimenez, Carolina [5 ]
Murillo-Bonilla, Luis M. [6 ,7 ]
Villarreal-Careaga, Jorge [8 ]
Barinagarrementeria, Fernando [9 ]
Cantu-Brito, Carlos [10 ]
机构
[1] Hosp Civil Guadalajara Fray Antonio Alcalde, Dept Neurol, Guadalajara, Jalisco, Mexico
[2] Univ Guadalajara, Ctr Univ Ciencias Salud, Dept Neurosci, Guadalajara 44430, Jalisco, Mexico
[3] Hosp Civil Guadalajara Fray Antonio Alcalde, Dept Internal Med, Guadalajara, Jalisco, Mexico
[4] Inst Nacl Neurol & Neurocirug, Stroke Clin, Mexico City, DF, Mexico
[5] Hosp Valentin Gomez Farias, Dept Neurol, Zapopan, Mexico
[6] Inst Panvasc Occidente, Guadalajara, Jalisco, Mexico
[7] Univ Autonoma Guadalajara, Guadalajara, Jalisco, Mexico
[8] Hosp Gen Culiacan, Dept Neurol, Culiacan, Mexico
[9] Hosp Angeles Queretaro, Queretaro, Mexico
[10] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico
关键词
Cerebral veins; cerebral venous thrombosis; cerebrovascular disease; cranial sinuses; outcome; stroke; DURAL SINUS THROMBOSIS; VEIN-THROMBOSIS; PROGNOSIS; STROKE; COMMUNITY; DIAGNOSIS; ISFAHAN; ADULTS; LONG; IRAN;
D O I
10.1016/j.jstrokecerebrovasdis.2011.01.001
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Cerebral venous thrombosis (CVT) is a rare form of cerebrovascular disease that is usually not mentioned in multicenter registries on all-type acute stroke. We aimed to describe the experience on hospitalized patients with CVT in a Mexican multicenter registry on acute cerebrovascular disease. Methods: CVT patients were selected from the RENAMEVASC registry, which was conducted between 2002 and 2004 in 25 Mexican hospitals. Risk factors, neuroimaging, and 30-day outcome as assessed by the modified Rankin scale (mRS) were analyzed. Results: Among 2000 all-type acute stroke patients, 59 (3%; 95% CI, 2.3-3.8%) had CVT (50 women; female: male ratio, 5: 1; median age, 31 years). Puerperium (42%), contraceptive use (18%), and pregnancy (12%) were the main risk factors in women. In 67% of men, CVT was registered as idiopathic, but thrombophilia assessment was suboptimal. Longitudinal superior sinus was the most frequent thrombosis location (78%). Extensive (>5 cm) venous infarction occurred in 36% of patients. Only 81% of patients received anticoagulation since the acute phase, and 3% needed decompressive craniectomy. Mechanical ventilation (13.6%), pneumonia (10.2%) and systemic thromboembolism (8.5%) were the main in-hospital complications. The 30-day case fatality rate was 3% (2 patients; 95% CI, 0.23-12.2%). In a Cox proportional hazards model, only age <40 years was associated with a mRS score of 0 to 2 (functional independence; rate ratio, 3.46; 95% CI, 1.34-8.92). Conclusions: The relative frequency of CVT and the associated in-hospital complications were higher than in other registries. Thrombophilia assessment and acute treatment was suboptimal. Young age is the main determinant of a good short-term outcome.
引用
收藏
页码:395 / 400
页数:6
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