Original Article

Cerebral Vein Thrombosis: Screening of Acquired and Hereditary Thrombophilic Risk Factors

Abstract

Cerebral vein thrombosis (CVT) is an infrequent condition with a large variety of causes that can lead to serious disabilities. However, in 20% to 35% of cases, no cause is found. In this study we evaluated the hereditary (P & C Proteins, antithrombin, mutation of prothrombin G20210A and factor V Leiden), other risk factors (hyperhomocycteinemia, factor VIII, ACL-ab, APL-ab, and OCP) and clinical manifestations among a population of Iranian patients with CVT. 18 women and 10 men aged 16 to 50 years with CVT were screened for inherited and acquired coagulation risk factors. No one had an abnormal ACL-ab, APL-ab or antithrombin III deficiency. One had prothrombin G20210A mutation (heterozygot) (3.6%). Hyperhomocycteinemia was observed in 5 patients (17.9%). APC-R was decreased in 3 (10.7%). 2 had positive factor V Leiden mutation (heterozygot) (7.1%). 17 had an increased of factor VIII (60.7). PS and PC deficiencies were each detected in two cases (7.1%). Conclusion: Our study suggests that screening for inherited thrombophilia may be an integral part in the diagnostic workup and duration of treatment in patients with CVT.

Martinelli I, Battaglioli T, Pedotti P, Cattaneo M, Mannucci PM. Hyperhomocysteinemia in cerebral vein thrombosis. Blood 2003; 102(4): 1363-6.

Dulli DA, Luzzio CC, Williams EC, Schutta HS. Cerebral venous thrombosis and activated protein C resistance. Stroke 1996; 27(10): 1731-3.

Deschiens MA, Conard J, Horellou MH, Ameri A, Preter M, Chedru F, et al. Coagulation studies, factor V Leiden, and anticardiolipin antibodies in 40 cases of cerebral venousthrombosis. Stroke 1996; 27(10): 1724-30.

Cakmak S, Derex L, Berruyer M, Nighoghossian N, Philippeau F, Adeleine P, et al. Cerebral venous thrombosis: clinical outcome and systematic screening of prothrombotic factors. Neurology 2003; 60(7): 1175-8.

Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005; 352(17): 1791-8.

Biousse V, Tong F, Newman NJ. Cerebral Venous Thrombosis. Curr Treat Options Cardiovasc Med 2003; 5(3): 181-192.

Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Neurology in Clinical Practice. 4th ed. Philadelphia: Butterworth,Heinemann; 2004.

Terazzi E, Mittino D, Rudà R, Cerrato P, Monaco F, Sciolla R, et al. Cerebral venous thrombosis: a retrospective multicentre study of 48 patients. Neurol Sci 2005; 25(6): 311-5.

de Bruijn SF, Stam J, Vandenbroucke JP. Increased risk of cerebral venous sinus thrombosis with third-generation oral contraceptives. Cerebral Venous Sinus Thrombosis Study Group. Lancet 1998; 351(9113): 1404.

Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F; ISCVT Investigators. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004; 35(3): 664-70.

deVeber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, et al. Cerebral sinovenous thrombosis in children. N Engl J Med 2001; 345(6): 417-23.

de Bruijn SF, Stam J, Koopman MM, Vandenbroucke JP. Case-control study of risk of cerebral sinus thrombosis in oral contraceptive users and in [correction of who are] carriers of hereditary prothrombotic conditions. The Cerebral Venous Sinus Thrombosis Study Group. BMJ 1998; 316(7131): 589-92.

Martinelli I, Sacchi E, Landi G, Taioli E, Duca F, Mannucci PM. High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. N Engl J Med 1998; 338(25): 1793-7.

Dulli DA, Luzzio CC, Williams EC, Schutta HS. Cerebral venous thrombosis and activated protein C resistance. Stroke 1996; 27(10): 1731-3.

Stolz E, Kemkes-Matthes B, Pötzsch B, Hahn M, Kraus J, Wirbartz A, et al. Screening for thrombophilic risk factorsamong 25 German patients with cerebral venous thrombosis. Acta Neurol Scand 2000; 102(1): 31-6.

Kuwahara S, Abe T, Uga S, Mori K. Superior sagittal sinus and cerebral cortical venous thrombosis caused by congenital protein C deficiency: case report. Neurol Med Chir (Tokyo) 2000; 40(12): 645-9.

Zuber M, Toulon P, Marnet L, Mas JL. Factor V Leiden mutation in cerebral venous thrombosis. Stroke 1996;27(10): 1721-3.

Deschiens MA, Conard J, Horellou MH, Ameri A, Preter M, Chedru F, et al. Coagulation studies, factor V Leiden, and anticardiolipin antibodies in 40 cases of cerebral venous thrombosis. Stroke 1996; 27(10): 1724-30.

Kellett MW, Martin PJ, Enevoldson TP, Brammer C, Toh CM. Cerebral venous sinus thrombosis associated with 20210A mutation of the prothrombin gene. J Neurol Neurosurg Psychiatry 1998; 65(4): 611-2.

Lane DA, Mannucci PM, Bauer KA, Bertina RM, Bochkov NP, Boulyjenkov V, et al. Inherited thrombophilia: Part 1. Thromb Haemost 1996; 76(5): 651-62.

Karl H. Prothrombin gene G20210A transition is a risk factor for cerebral venous Thrombosis. Stroke 1998; 29: 1765-69.

Ameri A, Bousser MG. Cerebral venous thrombosis. Neurol Clin 1992; 10(1): 87-111.

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IssueVol 47, No 3 (2009) QRcode
SectionOriginal Article(s)
Keywords
Cerebral vein thrombosis thrombophilia risk factors
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How to Cite
1.
Sarraf P, Ghaffarpoor M, Poormahmoodian H, Harrirchian H, Hashemi H. Cerebral Vein Thrombosis: Screening of Acquired and Hereditary Thrombophilic Risk Factors. Acta Med Iran. 1;47(3):197-202.