Risk factors for the development of secondary intracranial hypertension in acute cerebral venous thrombosis.

Purpose: Intracranial hypertension (IH) can complicate cerebral venous thrombosis (CVT), potentially causing permanent visual loss. Current knowledge on risk factors for the development of IH following CVT is scarce. We applied a compound classifier (CSF opening pressure > 25 cmH2O, papilledema, or...

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Publicado en:Neuroradiology Vol. 65; no. 3; pp. 463 - 478
Autores principales: Schuchardt, Florian, Demerath, T., Lützen, N., Elsheikh, S., Lagrèze, W., Reich, M., Küchlin, S., Urbach, H., Meckel, S., Harloff, A.
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Mar2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-022-03091-9
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        atl: Risk factors for the development of secondary intracranial hypertension in acute cerebral venous thrombosis.
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        au:
          Schuchardt, Florian
          Demerath, T.
          Lützen, N.
          Elsheikh, S.
          Lagrèze, W.
          Reich, M.
          Küchlin, S.
          Urbach, H.
          Meckel, S.
          Harloff, A.
        affil: Department of Neurology and Neurophysiology, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany
      sug:
        subj:
          Intracranial Hypertension Risk Factors
          Venous Thrombosis Complications
          Intracranial Thrombosis Complications
          Risk Assessment
          Magnetic Resonance Imaging
          Human
          Prospective Studies
          Cerebrospinal Fluid Analysis
          Papilledema Complications
          Phlebography Methods
          Predictive Value of Tests
      ab: Purpose: Intracranial hypertension (IH) can complicate cerebral venous thrombosis (CVT), potentially causing permanent visual loss. Current knowledge on risk factors for the development of IH following CVT is scarce. We applied a compound classifier (CSF opening pressure > 25 cmH2O, papilledema, or optic disc protrusion on MRI) as a surrogate for IH and studied the predictive value of thrombus location, the number of thrombosed segments, and thrombus volume. Methods: We prospectively included 26 patients with acute CVT and complete MRI data. IH was defined by CSF opening pressure > 25 cmH2O, papilledema, or optic disc protrusion on MRI. Using high-resolution contrast-enhanced venography, we determined the thrombus location, number of thrombosed segments, and thrombus volume. We analyzed their association with IH by logistic regression, their predictive power by the area under the receiver operating characteristic curve, and their association with CSF opening pressure by linear regression. Results: IH occurred in 46% of CVT patients and was associated with higher thrombus volume (AUC 0.759, p = 0.025) and superior sagittal sinus thrombosis both alone (OR 2.086, p = 0.049) and combined with transverse sinus thrombosis (OR 2.014, p = 0.028). Effects in patients presenting CSF opening pressure > 25 cm H2O and the compound classifier were consistent. Thrombus volume > 4 ml was the single most important predictor of higher CSF opening pressure (ß = 0.566, p = 0.035), increasing IH risk. Conclusion: Larger thrombus volume, dominant transverse sinus occlusion, and extensive superior sagittal combined with transverse sinus thrombosis were associated with IH. Thrombus volumetry might identify patients at risk for IH and direct further clinical evaluation.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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