Cerebral venous thrombosis in elderly patients.
cerebral venous thrombosis
cohort
elderly
etiology
incidence
prognosis
risk factors
thrombophlebitis
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
04 Oct 2024
04 Oct 2024
Historique:
revised:
09
09
2024
received:
30
05
2024
accepted:
17
09
2024
medline:
5
10
2024
pubmed:
5
10
2024
entrez:
5
10
2024
Statut:
aheadofprint
Résumé
We aimed to report the characteristics of cerebral venous thrombosis (CVT) in elderly people (aged ≥65 years). This multicenter retrospective cohort included elderly patients hospitalized for a first CVT in nine Paris-Ile-de-France hospitals between 2011 and 2021. The estimated incidence was compared to CVT recorded by the French health insurance data system. Lariboisière Hospital's CVT registry allowed comparisons of our elderly cohort with individuals younger than 65 years. One hundred fourteen patients were included in this study (mean age = 74.2 years, range = 65-93, 61% female). The CVT annual incidence in Ile-de-France was 5.9-7.1 per million elderly individuals versus 8.5 per million nationwide. Headaches and focal deficits were the most common initial clinical features (50% and 51%, respectively), followed by seizures and confusion (40% and 27%). Treatment included anticoagulation (93%) and, rarely, endovascular procedure (2%) or craniectomy (1%). Compared with adult patients aged <65 years (younger adults), elderly patients presented fewer headaches (50% vs. 96%, p < 0.01) and intracranial hypertension (7% vs. 22%, p < 0.01) but more seizures and focal deficits (40% vs. 27% and 51% vs. 38%, respectively, p < 0.01). Underlying cancer, hemopathy, and locoregional infections were more frequent in elderly patients than among younger adults (p < 0.01). The prognosis of patients from our elderly cohort was poorer than that of younger adults; 8% died in the acute phase, and 73% had a favorable outcome at 1 year (vs. 1.7% and 87%, respectively, p < 0.01). CVT in elderly patients has a specific clinical presentation, epidemiology, and risk factors such as cancer or hemopathy, justifying specialized management.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
We aimed to report the characteristics of cerebral venous thrombosis (CVT) in elderly people (aged ≥65 years).
METHODS
METHODS
This multicenter retrospective cohort included elderly patients hospitalized for a first CVT in nine Paris-Ile-de-France hospitals between 2011 and 2021. The estimated incidence was compared to CVT recorded by the French health insurance data system. Lariboisière Hospital's CVT registry allowed comparisons of our elderly cohort with individuals younger than 65 years.
RESULTS
RESULTS
One hundred fourteen patients were included in this study (mean age = 74.2 years, range = 65-93, 61% female). The CVT annual incidence in Ile-de-France was 5.9-7.1 per million elderly individuals versus 8.5 per million nationwide. Headaches and focal deficits were the most common initial clinical features (50% and 51%, respectively), followed by seizures and confusion (40% and 27%). Treatment included anticoagulation (93%) and, rarely, endovascular procedure (2%) or craniectomy (1%). Compared with adult patients aged <65 years (younger adults), elderly patients presented fewer headaches (50% vs. 96%, p < 0.01) and intracranial hypertension (7% vs. 22%, p < 0.01) but more seizures and focal deficits (40% vs. 27% and 51% vs. 38%, respectively, p < 0.01). Underlying cancer, hemopathy, and locoregional infections were more frequent in elderly patients than among younger adults (p < 0.01). The prognosis of patients from our elderly cohort was poorer than that of younger adults; 8% died in the acute phase, and 73% had a favorable outcome at 1 year (vs. 1.7% and 87%, respectively, p < 0.01).
CONCLUSIONS
CONCLUSIONS
CVT in elderly patients has a specific clinical presentation, epidemiology, and risk factors such as cancer or hemopathy, justifying specialized management.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e16504Informations de copyright
© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
Références
Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of Geriatryerebral vein and Dural sinus thrombosis: results of the international study on cerebral vein and Dural sinus thrombosis (ISCVT). Stroke. 2004;35(3):664‐670.
Devianne J, Legris N, Crassard I, et al. Epidemiology, clinical features, and outcome in a cohort of adolescents with cerebral venous thrombosis. Neurology. 2021;97(19):e1920‐e1932.
Otite FO, Patel S, Sharma R, et al. Trends in incidence and epidemiologic characteristics of cerebral venous thrombosis in the United States. Neurology. 2020;95(16):e2200‐e2213.
Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross‐sectional study. Stroke. 2012;43(12):3375‐3377.
Coutinho JM, Zuurbier SM, Stam J. Declining mortality in cerebral venous thrombosis: a systematic review. Stroke. 2014;45(5):1338‐1341.
Ferro JM, Canhão P, Bousser MG, Stam J, Barinagarrementeria F. Cerebral vein and Dural sinus thrombosis in elderly patients. Stroke. 2005;36(9):1927‐1932.
Zuurbier SM, Hiltunen S, Lindgren E, et al. Cerebral venous thrombosis in older patients. Stroke. 2018;49(1):197‐200.
Tuppin P, Rudant J, Constantinou P, et al. Value of a national administrative database to guide public decisions: From the système national d'information interrégimes de l'Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France. Rev Epidemiol Sante Publique. 2017;65(Suppl 4):S149‐S167.
Kuiper L, Sánchez Van Kammen M, Coert BA, et al. Association between Dural AVFs and cerebral venous thrombosis. Am J Neuroradiol. 2022;43(12):1722‐1729.
Ferro JM, Bousser MG, Canhão P, et al. European stroke organization guideline for the diagnosis and treatment of cerebral venous thrombosis ‐ endorsed by the European academy of neurology. Eur J Neurol. 2017;24(10):1203‐1213.
Simaan N, Molad J, Honig A, et al. Characteristics of patients with cerebral sinus venous thrombosis and JAK2 V617F mutation. Acta Neurol Belg. 2023;123(5):1855‐1859.
Lamy M, Palazzo P, Agius P, et al. Should we screen for Janus kinase 2 V617F mutation in cerebral venous thrombosis? Cerebrovasc Dis. 2017;44(3–4):97‐104.