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Cerebral sinus-venous thrombosis

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Abstract

Cerebral sinus-venous thrombosis (CSVT) is a rare life-threatening disease with an estimated annual incidence of 3–4 cases per million in adults and 7 cases per million in neonates. Brain tumors, cerebral infections and traumas are local risk factors for CSVT, but the commonest encountered risk factors are oral contraceptive use, pregnancy and puerperium that make the disease predominant in female sex. In 15–20 % of patients, the disease remains unprovoked, i.e., occurring in the absence of predisposing factors. Thrombophilic abnormalities either inherited [deficiency of the natural anticoagulant proteins antithrombin, protein C or protein S, mutations in the factor V gene (factor V Leiden) or prothrombin gene (prothrombin G20210A)] or acquired (antiphospholipid antibodies) are worthy to be investigated in patients with CSVT, as well as hyperhomocysteinemia. In a small proportion of patients, CSVT is the first manifestation of a myeloproliferative neoplasm. The proportion of patients with recurrent CSVT is low, but venous thromboembolism (deep vein thrombosis in the lower limbs or pulmonary embolism) can develop particularly in patients with a first idiopathic CSVT. In the past decade, there has been increasing evidence that early diagnosis and anticoagulant treatment reduce morbidity of CSVT and improve survival. However, the optimal duration of anticoagulant treatment is not well established, because limited information is available on the rate of CSVT recurrence after anticoagulant discontinuation.

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Specialities, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Pace, 9, 20122, Milan, Italy

    Ida Martinelli & Serena Maria Passamonti

  2. Institute of Hematology, Catholic University, Rome, Italy

    Elena Rossi & Valerio De Stefano

Authors
  1. Ida Martinelli
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  2. Serena Maria Passamonti
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  3. Elena Rossi
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  4. Valerio De Stefano
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Correspondence to Ida Martinelli.

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Martinelli, I., Passamonti, S.M., Rossi, E. et al. Cerebral sinus-venous thrombosis. Intern Emerg Med 7 (Suppl 3), 221–225 (2012). https://doi.org/10.1007/s11739-012-0806-9

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  • DOI: https://doi.org/10.1007/s11739-012-0806-9

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