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Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis

Background  Cerebral venous sinus thrombosis (CVST) is not as well understood as an ischemic stroke of arterial origin. Although the prognosis of CVST is usually good, parenchymal lesions may occur in some patients, and the development of intracranial herniation may result in death. For this reason,...

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Autores principales: Dinç, Yasemin, Ozpar, Rıfat, Hakyemez, Bahattin, Bakar, Mustafa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda. 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232022/
https://www.ncbi.nlm.nih.gov/pubmed/37257462
http://dx.doi.org/10.1055/s-0043-1767822
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author Dinç, Yasemin
Ozpar, Rıfat
Hakyemez, Bahattin
Bakar, Mustafa
author_facet Dinç, Yasemin
Ozpar, Rıfat
Hakyemez, Bahattin
Bakar, Mustafa
author_sort Dinç, Yasemin
collection PubMed
description Background  Cerebral venous sinus thrombosis (CVST) is not as well understood as an ischemic stroke of arterial origin. Although the prognosis of CVST is usually good, parenchymal lesions may occur in some patients, and the development of intracranial herniation may result in death. For this reason, recognizing the risk factors for intracranial herniation and accurately determining those patients who should undergo decompressive craniectomy is important. Objective  This study aims to determine the risk factors for intracranial herniation in patients with CVST. Methods  A total of 177 patients diagnosed with CVST between 2015 and 2021 in our tertiary center were retrospectively included in this study. Results  Of the 177 patients, 124 were female and 53 were male with mean ages of 40.65 ± 13.23 and 44.13 ± 17.09, respectively. Among those, 18 patients had developed intracranial herniation. A significant statistical relationship was observed between superior sagittal sinus thrombosis, sinus rectus thrombosis, venous collateral score, nonhemorrhagic venous infarct, presence of malignancy, small juxtacortical hemorrhage, and cortical vein thrombosis. The binary logistic regression analysis results showed that the most significant variables were the venous collateral score of 0, malignancy, and small juxtacortical hemorrhages. Conclusion  This study identified small juxtacortical hemorrhages, the presence of malignancy, and a venous collateral score of 0 to be independent risk factors for intracranial herniation in CVST patients. Drawing on these results, we recommend close clinical observation of CVST patients, as they may be candidates for decompressive craniectomy.
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spelling pubmed-102320222023-06-01 Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis Dinç, Yasemin Ozpar, Rıfat Hakyemez, Bahattin Bakar, Mustafa Arq Neuropsiquiatr Background  Cerebral venous sinus thrombosis (CVST) is not as well understood as an ischemic stroke of arterial origin. Although the prognosis of CVST is usually good, parenchymal lesions may occur in some patients, and the development of intracranial herniation may result in death. For this reason, recognizing the risk factors for intracranial herniation and accurately determining those patients who should undergo decompressive craniectomy is important. Objective  This study aims to determine the risk factors for intracranial herniation in patients with CVST. Methods  A total of 177 patients diagnosed with CVST between 2015 and 2021 in our tertiary center were retrospectively included in this study. Results  Of the 177 patients, 124 were female and 53 were male with mean ages of 40.65 ± 13.23 and 44.13 ± 17.09, respectively. Among those, 18 patients had developed intracranial herniation. A significant statistical relationship was observed between superior sagittal sinus thrombosis, sinus rectus thrombosis, venous collateral score, nonhemorrhagic venous infarct, presence of malignancy, small juxtacortical hemorrhage, and cortical vein thrombosis. The binary logistic regression analysis results showed that the most significant variables were the venous collateral score of 0, malignancy, and small juxtacortical hemorrhages. Conclusion  This study identified small juxtacortical hemorrhages, the presence of malignancy, and a venous collateral score of 0 to be independent risk factors for intracranial herniation in CVST patients. Drawing on these results, we recommend close clinical observation of CVST patients, as they may be candidates for decompressive craniectomy. Thieme Revinter Publicações Ltda. 2023-05-31 /pmc/articles/PMC10232022/ /pubmed/37257462 http://dx.doi.org/10.1055/s-0043-1767822 Text en Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ( https://creativecommons.org/licenses/by/4.0/ ) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Dinç, Yasemin
Ozpar, Rıfat
Hakyemez, Bahattin
Bakar, Mustafa
Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis
title Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis
title_full Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis
title_fullStr Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis
title_full_unstemmed Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis
title_short Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis
title_sort identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232022/
https://www.ncbi.nlm.nih.gov/pubmed/37257462
http://dx.doi.org/10.1055/s-0043-1767822
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