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Title: Ten years of cerebral venous thrombosis: male gender and myeloproliferative neoplasm is associated with thrombotic recurrence in unprovoked events.
Austin Authors: Lim, Hui Yin;Ng, C;Donnan, Geoffrey A ;Nandurkar, H;Ho, Prahlad W
Affiliation: Australian Centre for Blood Diseases, Prahran, Victoria, Australia
Monash University, Clayton, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
Florey Institute of Neurosciences and Mental Health, Parkville, Victoria, Australia
University of Melbourne, Parkville, Victoria, Australia
Department of Haematology, Northern Health, 185 Cooper Street, Epping, Melbourne, Victoria, Australia
Issue Date: Oct-2016
Publication information: Journal of thrombosis and thrombolysis 2016; 42(3): 423-31
Abstract: Cerebral venous thrombosis (CVT) is a rare venous thrombotic event. We review our local experience in the management of CVT in comparison to other venous thromboembolism (VTE) with specific focus on risk factors for thrombotic recurrence. Retrospective evaluation of consecutive CVT presentations from January 2005 to June 2015, at two major tertiary hospitals in Northeast Melbourne, Australia. This population was compared to a separate audit of 1003 consecutive patients with DVT and PE. Fifty-two patients (30 female, 22 male) with a median age of 40 (18-83) years, presented with 53 episodes of CVT. Twenty-nine episodes (55 %) were associated with an underlying risk factor, with hormonal risk factors in females being most common. The median duration of anticoagulation was 6 months with 11 receiving life-long anticoagulation. Eighty-one percent had residual thrombosis on repeat imaging, which was not associated with recurrence at the same or distant site. Nine (17 %) had CVT-related haemorrhagic transformation with two resultant CVT-related deaths (RR 22.5; p = 0.04). All three VTE recurrences occured in males with unprovoked events (RR 18.2; p = 0.05) who were subsequently diagnosed with myeloproliferative neoplasm (MPN). Compared to the non-cancer VTE population, non-cancer CVT patients were younger, had similar rate of provoked events and VTE recurrence, although with significantly higher rate of MPN diagnosis (RR 9.30 (2.29-37.76); p = 0.002) CVT is a rare thrombotic disorder. All recurrences in this audit occurred in male patients with unprovoked events and subsequent diagnosis of MPN, suggesting further evaluation for MPN may be warranted in patients with unprovoked CVT.
DOI: 10.1007/s11239-016-1362-3
ORCID: 0000-0003-1875-3927
PubMed URL: 27085541
Type: Journal Article
Subjects: Cerebral venous thrombosis
Myeloproliferative neoplasm
Venous thrombosis
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