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Assessment of Patients with Intracerebral Hemorrhage or Hemorrhagic Transformation in the VENOST Study
European Neurology ( IF 2.1 ) Pub Date : 2020-01-01 , DOI: 10.1159/000510627
Taşkın Duman , Vildan Yayla , Derya Uludüz , Eylem Özaydın Göksu , Vedat Ali Yürekli , Hamit Genç , Uygar Utku , Nilgün Çınar , Hakan Tekeli , Mehmet Ali Sungur , Firdevs Ezgi Tokuç , Nevzat Uzuner , Mehmet Güney Şenol , Arda Yılmaz , Mustafa Gökçe , Seden Demirci , Özge Yılmaz Küsbeci , Gülnur Tekgöl Uzuner , Şevki Şahin , Hale Zeynep Batur Çağlayan , Mustafa Açıkgöz , Fatih Özdağ , Sevim Baybaş , Hakan Ekmekçi , Murat Çabalar , Mehmet Yaman , Hesna Bektaş , Yüksel Kaplan , Başak Karakurum Göksel , Aysel Milanlıoğlu , Dilek Necioğlu Örken , Mehmet Ufuk Aluçlu , Sena Çolakoğlu , Ahmet Tüfekçi , Mustafa Bakar , Bijrn Nazlıel , Nida Taşçılar , Baki Göksan , Hasan Hüseyin Kozak , Handan Mısırlı , Hayriye Küçükoğlu , İpek Midi , Necdet Mengüllüoğlu , Emrah Aytaç , Nilüfer Yeşilot , Birsen İnce , Osman Özgür Yalın , Taşkın Güneş , Serdar Oruç , Füsun Mayda Domaç , Şerefnur Öztürk , Ali Karahan , Hacı Ali Erdoğan , Nazire Afşar

INTRODUCTION Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group. MATERIALS AND METHODS In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded. RESULTS CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was ≥3 in 23.1% of the patients in the CH group. DISCUSSION AND CONCLUSION CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.

中文翻译:

VENOST 研究中脑出血或出血转化患者的评估

引言 脑静脉窦血栓形成 (CVST) 可能导致脑水肿和颅内压升高;此外,可能会出现缺血性或出血性病变。大约三分之一的 CVST 患者会发生脑出血。我们评估并比较了脑出血 (CH) 组和 CVST 组的结果。材料与方法 在 VENOST 研究中,从 35 个国家卒中中心获得了 1,193 名年龄超过 18 岁的 CVST 患者的医疗记录。报告了人口统计学特征、临床症状、入院时体征、放射学发现、病因、急性和维持治疗以及结果结果。记录受累窦或静脉的数量、血栓的定位以及 CT 和 MRI 扫描的病变。结果 在 241 (21. 1%) 患者,出血性梗塞 198 例,脑出血 43 例。在 CVST 组中,妇科原因占病因和危险因素的最大百分比 (41.7%)。在 CH 组中,与其他神经系统症状相关的头痛更为频繁。这些神经系统症状包括癫痫发作 (46.9%)、恶心和/或呕吐 (36.5%)、意识改变 (36.5%) 和局灶性神经功能缺损 (33.6%)。CH 组 23.1% 的患者 mRS ≥ 3。讨论与结论 CVST 是年轻人中风的一个重要原因,如果患者有头痛、多发性鼻窦受累和 CH 等其他症状,应密切监测。年龄较大和脑实质病变,无论是出血性梗塞还是脑内出血,都意味着预后不良。出血性梗塞 198 例,脑出血 43 例。在 CVST 组中,妇科原因占病因和危险因素的最大百分比 (41.7%)。在 CH 组中,与其他神经系统症状相关的头痛更为频繁。这些神经系统症状包括癫痫发作 (46.9%)、恶心和/或呕吐 (36.5%)、意识改变 (36.5%) 和局灶性神经功能缺损 (33.6%)。CH 组 23.1% 的患者 mRS ≥ 3。讨论与结论 CVST 是年轻人中风的一个重要原因,如果患者有头痛、多发性鼻窦受累和 CH 等其他症状,应密切监测。年龄较大和脑实质病变,无论是出血性梗塞还是脑内出血,都意味着预后不良。出血性梗塞 198 例,脑出血 43 例。在 CVST 组中,妇科原因占病因和危险因素的最大百分比 (41.7%)。在 CH 组中,与其他神经系统症状相关的头痛更为频繁。这些神经系统症状包括癫痫发作 (46.9%)、恶心和/或呕吐 (36.5%)、意识改变 (36.5%) 和局灶性神经功能缺损 (33.6%)。CH 组 23.1% 的患者 mRS ≥ 3。讨论与结论 CVST 是年轻人中风的一个重要原因,如果患者有头痛、多发性鼻窦受累和 CH 等其他症状,应密切监测。年龄较大和脑实质病变,无论是出血性梗塞还是脑内出血,都意味着预后不良。
更新日期:2020-01-01
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