Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy
Introduction: Despite the highly favorable prognosis, mortality occurs in nearly 2% of patients with cerebral venous thrombosis (CVT), in which decompressive craniectomy (DC) may be the only way to save the patient's life. The aim of this report is to describe the risk factors, neuroimaging fea...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2023-11-01
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| Series: | Neurología (English Edition) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2173580822001663 |
| _version_ | 1797506310752698368 |
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| author | A. Arauz M.A. Barboza L.C. Quintero C. Cantu E. Chiquete F. Serrano |
| author_facet | A. Arauz M.A. Barboza L.C. Quintero C. Cantu E. Chiquete F. Serrano |
| author_sort | A. Arauz |
| collection | DOAJ |
| description | Introduction: Despite the highly favorable prognosis, mortality occurs in nearly 2% of patients with cerebral venous thrombosis (CVT), in which decompressive craniectomy (DC) may be the only way to save the patient's life. The aim of this report is to describe the risk factors, neuroimaging features, in-hospital complications and functional outcome of severe CVT in patients treated with DC. Materials and methods: Consecutive malignant CVT cases treated with DC from a retrospective third-level hospital database were analyzed. Demographic, clinical, and functional outcomes were analyzed. Results: Twenty-six patients were included (20 female, age 35.4 ± 12.1 years); 53.8% of the patients had acute CVT, with neurological focalization as the most common symptom in 92.3% of the patients. Superior sagittal sinus thromboses were found in 84.6% of cases. Bilateral lesions were present in 10 patients (38.5%). Imaging on admission showed a parenchymal lesion (venous infarction ± hemorrhagic lesion) > 6 cm measured along the longest diameter in 25 patients (96.2%). Mean duration of clinical neurological deterioration was 3.5 days; eleven patients (42.3%) died during hospitalization. Conclusion: In patients with severe forms of CVT, we found higher mortality than previously reported. DC is an effective life-saving treatment with acceptable functional prognosis for survivors. Resumen: Introducción: A pesar del pronóstico favorable en pacientes con trombosis venosa cerebral (TVC), cerca de un 2% de estos pacientes fallecen, para los cuales la craniectomía descompresiva (CD) puede ser una opción terapéutica. El objetivo de este artículo es describir los factores de riesgo, las características de las neuroimágenes, complicaciones hospitalarias y evolución funcional, de pacientes con TVC severa tratados con CD. Materiales y métodos: Se analizaron características demográficas, clínicas y funcionales de casos consecutivos de TVC severa tratados con CD, a partir de una base de datos retrospectiva de un hospital de tercer nivel. Resultados: Veintiséis pacientes fueron incluidos (20 mujeres, media de edad 35,4 ±12,1 años); un 53,8% de los pacientes presentaron una TVC aguda, con manifestaciones neurológicas focales como el síntoma más frecuente en el 92,3% de los casos. La trombosis del seno sagital superior estuvo presente en el 84,6% y se presentaron lesiones bilaterales parenquimatosas en 10 pacientes (38,5%). La imagen al ingreso demostró lesiones parenquimatosas (infarto venoso ± lesión hemorrágica) > 6 cm (medida en el mayor diámetro de la misma), en 25 pacientes (96,2%). La duración media del deterioro neurológico fue de 3,5 días; 11 pacientes (42,3%) murieron durante la hospitalización. Conclusión: En pacientes con formas severas de TVC encontramos una mayor mortalidad que la publicada previamente; la CD podría ser una opción terapéutica en ese grupo de pacientes. |
| first_indexed | 2024-03-10T04:30:48Z |
| format | Article |
| id | doaj.art-6983fe3f488647fd8605f12bfc22033e |
| institution | Directory Open Access Journal |
| issn | 2173-5808 |
| language | English |
| last_indexed | 2024-03-10T04:30:48Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Neurología (English Edition) |
| spelling | doaj.art-6983fe3f488647fd8605f12bfc22033e2023-11-23T04:28:13ZengElsevier EspañaNeurología (English Edition)2173-58082023-11-01389617624Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomyA. Arauz0M.A. Barboza1L.C. Quintero2C. Cantu3E. Chiquete4F. Serrano5Stroke Clinic, Instituto Nacional de Neurología and Neurocirugía Manuel Velasco Suárez, Mexico City, MexicoStroke Clinic, Instituto Nacional de Neurología and Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico; Neurosciences Department, Hospital Dr. Rafael A. Calderón Guardia, CCSS, San José, Costa Rica; Corresponding author.Stroke Clinic, Instituto Nacional de Neurología and Neurocirugía Manuel Velasco Suárez, Mexico City, MexicoStroke Clinic, Instituto Nacional de Ciencias Medicas y de la Nutricion Salvador Zubiran, Mexico City, MexicoStroke Clinic, Instituto Nacional de Ciencias Medicas y de la Nutricion Salvador Zubiran, Mexico City, MexicoStroke Clinic, Instituto Nacional de Neurología and Neurocirugía Manuel Velasco Suárez, Mexico City, MexicoIntroduction: Despite the highly favorable prognosis, mortality occurs in nearly 2% of patients with cerebral venous thrombosis (CVT), in which decompressive craniectomy (DC) may be the only way to save the patient's life. The aim of this report is to describe the risk factors, neuroimaging features, in-hospital complications and functional outcome of severe CVT in patients treated with DC. Materials and methods: Consecutive malignant CVT cases treated with DC from a retrospective third-level hospital database were analyzed. Demographic, clinical, and functional outcomes were analyzed. Results: Twenty-six patients were included (20 female, age 35.4 ± 12.1 years); 53.8% of the patients had acute CVT, with neurological focalization as the most common symptom in 92.3% of the patients. Superior sagittal sinus thromboses were found in 84.6% of cases. Bilateral lesions were present in 10 patients (38.5%). Imaging on admission showed a parenchymal lesion (venous infarction ± hemorrhagic lesion) > 6 cm measured along the longest diameter in 25 patients (96.2%). Mean duration of clinical neurological deterioration was 3.5 days; eleven patients (42.3%) died during hospitalization. Conclusion: In patients with severe forms of CVT, we found higher mortality than previously reported. DC is an effective life-saving treatment with acceptable functional prognosis for survivors. Resumen: Introducción: A pesar del pronóstico favorable en pacientes con trombosis venosa cerebral (TVC), cerca de un 2% de estos pacientes fallecen, para los cuales la craniectomía descompresiva (CD) puede ser una opción terapéutica. El objetivo de este artículo es describir los factores de riesgo, las características de las neuroimágenes, complicaciones hospitalarias y evolución funcional, de pacientes con TVC severa tratados con CD. Materiales y métodos: Se analizaron características demográficas, clínicas y funcionales de casos consecutivos de TVC severa tratados con CD, a partir de una base de datos retrospectiva de un hospital de tercer nivel. Resultados: Veintiséis pacientes fueron incluidos (20 mujeres, media de edad 35,4 ±12,1 años); un 53,8% de los pacientes presentaron una TVC aguda, con manifestaciones neurológicas focales como el síntoma más frecuente en el 92,3% de los casos. La trombosis del seno sagital superior estuvo presente en el 84,6% y se presentaron lesiones bilaterales parenquimatosas en 10 pacientes (38,5%). La imagen al ingreso demostró lesiones parenquimatosas (infarto venoso ± lesión hemorrágica) > 6 cm (medida en el mayor diámetro de la misma), en 25 pacientes (96,2%). La duración media del deterioro neurológico fue de 3,5 días; 11 pacientes (42,3%) murieron durante la hospitalización. Conclusión: En pacientes con formas severas de TVC encontramos una mayor mortalidad que la publicada previamente; la CD podría ser una opción terapéutica en ese grupo de pacientes.http://www.sciencedirect.com/science/article/pii/S2173580822001663Trombosis venosa cerebralCraniectomía descompresivaMortalidadResultado |
| spellingShingle | A. Arauz M.A. Barboza L.C. Quintero C. Cantu E. Chiquete F. Serrano Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy Neurología (English Edition) Trombosis venosa cerebral Craniectomía descompresiva Mortalidad Resultado |
| title | Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy |
| title_full | Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy |
| title_fullStr | Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy |
| title_full_unstemmed | Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy |
| title_short | Prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy |
| title_sort | prognosis of patients with severe cerebral venous thrombosis treated with decompressive craniectomy |
| topic | Trombosis venosa cerebral Craniectomía descompresiva Mortalidad Resultado |
| url | http://www.sciencedirect.com/science/article/pii/S2173580822001663 |
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