Management of cerebral venous thrombosis in Spain : MOTIVATE descriptive study Manejo de la trombosis venosa cerebral en España: estudio descriptivo MOTIVATE
Pérez Lázaro, C. (Instituto de Investigación Sanitaria de Aragón)
López-Bravo, A. (Instituto de Investigación Sanitaria de Aragón)
Gómez-Escalonilla Escobar, C. (Hospital Clínico San Carlos (Madrid))
Aguirre, Clara (Hospital Universitario de la Princesa (Madrid))
de Felipe, A. (Hospital Universitario Ramón y Cajal (Madrid))
de la Riva, Pere (Hospital Universitario Donosti)
Calleja, S. (Hospital Universitario Central de Asturias)
Arjona, A. (Hospital Universitario Torrecárdenas)
Serrano Ponz, M. (Hospital Universitario Miguel Servet (Saragossa))
Navarro-Pérez, M.P. (Instituto de Investigación Sanitaria de Aragón)
Delgado Mederos, Raquel (Institut d'Investigació Biomèdica Sant Pau)
Bashir Viturro, S. (Hospital Universitari de Girona Doctor Josep Trueta)
Llul, L. (Hospital Clínic i Provincial de Barcelona)
Egido, José Antonio (Hospital Clínico San Carlos (Madrid))
García Madrona, S. (Hospital Universitario Ramón y Cajal (Madrid))
Díez González, N. (Hospital Universitario Donosti)
Benavente Fernández, L. (Hospital Universitario Central de Asturias)
de la Torre Colmenero, J.D. (Hospital Universitario Torrecárdenas)
Tejada Meza, H. (Hospital Universitario Miguel Servet (Saragossa))
Vesperinas Castro, A. (Institut d'Investigació Biomèdica Sant Pau)
Sánchez Cirera, L. (Hospital Universitari de Girona Doctor Josep Trueta)
Trillo, S. (Hospital Universitario de la Princesa (Madrid))

Data:	2021
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Castellà
Document:	Article ; recerca ; Versió publicada
Matèria:	Headache ; Papilloedema ; Cerebral venous thrombosis ; Thrombophilia ; Anticoagulation ; Endovascular treatment
Publicat a:	Neurología, 2021 , ISSN 1578-1968

DOI: 10.1016/j.nrl.2021.05.016
PMID: 34511275

9 p, 880.5 KB

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