Clinical and prognostic characteristics of cerebral venous thrombosis at high altitude: a single-center retrospective study of Tibet.
Cerebral vascular thrombosis
High altitude
Prognosis
Risk factors
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
08
01
2023
accepted:
29
01
2023
revised:
26
01
2023
medline:
27
4
2023
pubmed:
9
2
2023
entrez:
8
2
2023
Statut:
ppublish
Résumé
Data regarding diagnosis, management, and prognosis of patients with cerebral venous thrombosis (CVT) from high altitude are limited. The aim of the present study is to identify the clinical features, risk factors, and outcomes of cerebral venous thrombosis (CVT) in Tibet. We retrospectively included patients with a diagnosis of CVT consecutively admitted to Tibet Autonomous Region People's Hospital between July 2015, and September 2022. The risk factors, clinical and radiological presentations, treatment and outcomes were analyzed. A total of 38 patients with CVT were included in this study. The median age was 31 years, and females accounted for 63.2%. Patients of Tibetan nationality accounted for 71.1% (n = 27) and the median altitude of residence in Tibet was 3800 m (3657, 4054). Headache was the most common symptom (92.1%). The most common risk factors of CVT were infection in the past 4 weeks (34.2%) and pregnancy or puerperium (23.7%). Lateral sinus (transverse and/or sigmoid sinus) (68.4%) and superior sagittal sinus (55.3%) were the most commonly involved. The D-dimer increased in 31 patients (81.6%). All three patients who died in hospital and during follow-up had risk factor of recent infection. Favorable outcome at follow-up with a median length of 454 days (189, 1059) was observed in 85.3% of patients. CVT at high altitude is more common in young patients and women, with various clinical manifestations and risk factors. Recent infection is the most common risk factor and may increase the mortality of CVT at high altitude. The long-term prognosis of CVT at high altitude is favorable.
Identifiants
pubmed: 36754900
doi: 10.1007/s00415-023-11597-2
pii: 10.1007/s00415-023-11597-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2688-2692Subventions
Organisme : STI2030-Major Project
ID : #2021ZD0201105
Organisme : National High Level Hospital Clinical Research Funding
ID : 2022-PUMCH-D-007
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
Références
Ropper AH, Klein JP (2021) Cerebral venous thrombosis. N Engl J Med 385:59–64. https://doi.org/10.1056/NEJMra2106545
doi: 10.1056/NEJMra2106545
pubmed: 34192432
Tatlisumak T, Jood K, Putaala J (2016) Cerebral venous thrombosis: epidemiology in change. Stroke 47:2169–2170. https://doi.org/10.1161/strokeaha.116.014336
doi: 10.1161/strokeaha.116.014336
pubmed: 27435404
Fang J, Zhuo-Ga C, Zhao Y, Kong F, Si Y, Liu M et al (2011) Characteristics of stroke in tibet autonomous region in China: a hospital-based study of acute stroke. Eur Neurol 66:151–158. https://doi.org/10.1159/000330558
doi: 10.1159/000330558
pubmed: 21894017
Lu Y, Zhuoga C, Jin H, Zhu F, Zhao Y, Ding Z et al (2020) Characteristics of acute ischemic stroke in hospitalized patients in Tibet: a retrospective comparative study. BMC Neurol 20:380. https://doi.org/10.1186/s12883-020-01957-0
doi: 10.1186/s12883-020-01957-0
pubmed: 33087079
pmcid: 7576739
Hassan WU, Syed MJ, Alamgir W, Awan S, Bell SM, Majid A et al (2019) Cerebral venous thrombosis at high altitude: analysis of 28 cases. Cerebrovasc Dis 48:184–192. https://doi.org/10.1159/000504504
doi: 10.1159/000504504
pubmed: 31775151
Li M, Tang X, Liao Z, Shen C, Cheng R, Fang M et al (2022) Hypoxia and low temperature up-regulate transferrin to induce hypercoagulability at high altitude. Blood. https://doi.org/10.1182/blood.2022016410
doi: 10.1182/blood.2022016410
pubmed: 36399071
pmcid: 10023726
Prabhakar A, Chatterjee T, Bajaj N, Tyagi T, Sahu A, Gupta N et al (2019) Venous thrombosis at altitude presents with distinct biochemical profiles: a comparative study from the Himalayas to the plains. Blood Adv 3:3713–3723. https://doi.org/10.1182/bloodadvances.2018024554
doi: 10.1182/bloodadvances.2018024554
pubmed: 31765479
pmcid: 6880906
Wu J, Han X, Ke H, Wang L, Wang K, Zhang J et al (2022) Pulmonary embolism at extreme high altitude: a study of seven cases. High Alt Med Biol 23:209–214. https://doi.org/10.1089/ham.2021.0109
doi: 10.1089/ham.2021.0109
pubmed: 35605091
Saposnik G, Barinagarrementeria F, Brown RD Jr, Bushnell CD, Cucchiara B, Cushman M et al (2011) Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42:1158–1192. https://doi.org/10.1161/STR.0b013e31820a8364
doi: 10.1161/STR.0b013e31820a8364
pubmed: 21293023
Khattar NK, Sumardi F, Zemmar A, Liang Q, Li H, Xing Y et al (2019) Cerebral venous thrombosis at high altitude: a retrospective cohort of twenty-one consecutive patients. Cureus 11:e4940. https://doi.org/10.7759/cureus.4940
doi: 10.7759/cureus.4940
pubmed: 31431845
pmcid: 6697453
Wasay M, Kaul S, Menon B, Dai AI, Saadatnia M, Malik A et al (2019) Asian study of cerebral venous thrombosis. J Stroke Cerebrovasc Dis 28:104247. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.06.005
doi: 10.1016/j.jstrokecerebrovasdis.2019.06.005
pubmed: 31350167
Ding J, Song B, Xie X, Li X, Chen Z, Wang Z et al (2022) Inflammation in cerebral venous thrombosis. Front Immunol 13:833490. https://doi.org/10.3389/fimmu.2022.833490
doi: 10.3389/fimmu.2022.833490
pubmed: 35444662
pmcid: 9013750
Jain RS, Sripadma PV, Tejwani S (2022) Clinical characteristics, etiology, recanalization rates and neurological outcomes in CVT: a prospective cohort study. Ann Indian Acad Neurol 25:229–234. https://doi.org/10.4103/aian.aian_718_21
doi: 10.4103/aian.aian_718_21
pubmed: 35693659
pmcid: 9175402