Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up
ObjectiveCerebral venous sinus thrombosis (CVST) is increasingly being recognized in the setting of traumatic brain injury (TBI), but its effect on TBI patients and its management remains uncertain. Here, we systematically review the currently available evidence on the complications, effect on morta...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1079579/full |
| _version_ | 1797956835907469312 |
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| author | Dag Ferner Netteland Dag Ferner Netteland Else Charlotte Sandset Else Charlotte Sandset Magnus Mejlænder-Evjensvold Mads Aarhus Elisabeth Jeppesen Diana Aguiar de Sousa Eirik Helseth Eirik Helseth Tor Brommeland |
| author_facet | Dag Ferner Netteland Dag Ferner Netteland Else Charlotte Sandset Else Charlotte Sandset Magnus Mejlænder-Evjensvold Mads Aarhus Elisabeth Jeppesen Diana Aguiar de Sousa Eirik Helseth Eirik Helseth Tor Brommeland |
| author_sort | Dag Ferner Netteland |
| collection | DOAJ |
| description | ObjectiveCerebral venous sinus thrombosis (CVST) is increasingly being recognized in the setting of traumatic brain injury (TBI), but its effect on TBI patients and its management remains uncertain. Here, we systematically review the currently available evidence on the complications, effect on mortality and the diagnostic and therapeutic management and follow-up of CVST in the setting of TBI.MethodsKey clinical questions were posed and used to define the scope of the review within the following topics of complications; effect on mortality; diagnostics; therapeutics; recanalization and follow-up of CVST in TBI. We searched relevant databases using a structured search strategy. We screened identified records according to eligibility criteria and for information regarding the posed key clinical questions within the defined topics of the review.ResultsFrom 679 identified records, 21 studies met the eligibility criteria and were included, all of which were observational in nature. Data was deemed insufficiently homogenous to perform meta-analysis and was narratively synthesized. Reported rates of venous infarctions ranged between 7 and 38%. One large registry study reported increased in-hospital mortality in CVSP and TBI compared to a control group with TBI alone in adjusted analyses. Another two studies found midline CVST to be associated with increased risk of mortality in adjusted analyses. Direct data to inform the optimum diagnostic and therapeutic management of the condition was limited, but some data on the safety, and effect of anticoagulation treatment of CVST in TBI was identified. Systematic data on recanalization rates to guide follow-up was also limited, and reported complete recanalization rates ranged between 41 and 86%. In the context of the identified data, we discuss the diagnostic and therapeutic management and follow-up of the condition.ConclusionCurrently, the available evidence is insufficient for evidence-based treatment of CVST in the setting of TBI. However, there are clear indications in the presently available literature that CVST in TBI is associated with complications and increased mortality, and this indicates that management options for the condition must be considered. Further studies are needed to confirm the effects of CVST on TBI patients and to provide evidence to support management decisions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: PROSPERO [CRD42021247833]. |
| first_indexed | 2024-04-10T23:56:07Z |
| format | Article |
| id | doaj.art-dd82f5e7f4954d66b01ea193a14e78ca |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T23:56:07Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-dd82f5e7f4954d66b01ea193a14e78ca2023-01-10T14:11:41ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-01-011310.3389/fneur.2022.10795791079579Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-upDag Ferner Netteland0Dag Ferner Netteland1Else Charlotte Sandset2Else Charlotte Sandset3Magnus Mejlænder-Evjensvold4Mads Aarhus5Elisabeth Jeppesen6Diana Aguiar de Sousa7Eirik Helseth8Eirik Helseth9Tor Brommeland10Department of Neurosurgery, Oslo University Hospital Ullevål, Oslo, NorwayFaculty of Medicine, University of Oslo, Oslo, NorwayDepartment of Neurology, Oslo University Hospital Ullevål, Oslo, NorwayDepartment of Research, Norwegian Air Ambulance Foundation, Oslo, NorwayDepartment of Radiology and Nuclear Medicine, Oslo University Hospital Ullevål, Oslo, NorwayDepartment of Neurosurgery, Oslo University Hospital Ullevål, Oslo, NorwayFaculty of Health Studies, VID Specialized University, Oslo, NorwayDepartment of Neurosciences (Neurology), Hospital de Santa Maria, University of Lisbon, Lisbon, PortugalDepartment of Neurosurgery, Oslo University Hospital Ullevål, Oslo, NorwayFaculty of Medicine, University of Oslo, Oslo, NorwayDepartment of Neurosurgery, Oslo University Hospital Ullevål, Oslo, NorwayObjectiveCerebral venous sinus thrombosis (CVST) is increasingly being recognized in the setting of traumatic brain injury (TBI), but its effect on TBI patients and its management remains uncertain. Here, we systematically review the currently available evidence on the complications, effect on mortality and the diagnostic and therapeutic management and follow-up of CVST in the setting of TBI.MethodsKey clinical questions were posed and used to define the scope of the review within the following topics of complications; effect on mortality; diagnostics; therapeutics; recanalization and follow-up of CVST in TBI. We searched relevant databases using a structured search strategy. We screened identified records according to eligibility criteria and for information regarding the posed key clinical questions within the defined topics of the review.ResultsFrom 679 identified records, 21 studies met the eligibility criteria and were included, all of which were observational in nature. Data was deemed insufficiently homogenous to perform meta-analysis and was narratively synthesized. Reported rates of venous infarctions ranged between 7 and 38%. One large registry study reported increased in-hospital mortality in CVSP and TBI compared to a control group with TBI alone in adjusted analyses. Another two studies found midline CVST to be associated with increased risk of mortality in adjusted analyses. Direct data to inform the optimum diagnostic and therapeutic management of the condition was limited, but some data on the safety, and effect of anticoagulation treatment of CVST in TBI was identified. Systematic data on recanalization rates to guide follow-up was also limited, and reported complete recanalization rates ranged between 41 and 86%. In the context of the identified data, we discuss the diagnostic and therapeutic management and follow-up of the condition.ConclusionCurrently, the available evidence is insufficient for evidence-based treatment of CVST in the setting of TBI. However, there are clear indications in the presently available literature that CVST in TBI is associated with complications and increased mortality, and this indicates that management options for the condition must be considered. Further studies are needed to confirm the effects of CVST on TBI patients and to provide evidence to support management decisions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: PROSPERO [CRD42021247833].https://www.frontiersin.org/articles/10.3389/fneur.2022.1079579/fullcerebral venous sinus thrombosistraumatic brain injurycomplicationsmortalitydiagnosismanagement |
| spellingShingle | Dag Ferner Netteland Dag Ferner Netteland Else Charlotte Sandset Else Charlotte Sandset Magnus Mejlænder-Evjensvold Mads Aarhus Elisabeth Jeppesen Diana Aguiar de Sousa Eirik Helseth Eirik Helseth Tor Brommeland Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up Frontiers in Neurology cerebral venous sinus thrombosis traumatic brain injury complications mortality diagnosis management |
| title | Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up |
| title_full | Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up |
| title_fullStr | Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up |
| title_full_unstemmed | Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up |
| title_short | Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up |
| title_sort | cerebral venous sinus thrombosis in traumatic brain injury a systematic review of its complications effect on mortality diagnostic and therapeutic management and follow up |
| topic | cerebral venous sinus thrombosis traumatic brain injury complications mortality diagnosis management |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1079579/full |
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