جستجوی مقالات مرتبط با کلیدواژه « cerebral veins » در نشریات گروه « پزشکی »

Anticoagulation therapy following cerebral vein thrombosis (CVT) can improve mortality and morbidity. Vitamin K antagonists are currently the routine oral anticoagulant used for CVT; while by introduction of rivaroxaban, a direct factor Xa inhibitor, the attentions have been deviated toward novel agents, but the evidence is not strong. The current study is aimed to compare the efficacy and safety of rivaroxaban versus warfarin for anticoagulation therapy of CVT. The current randomized clinical trial has been conducted on 50 patients with CVT among which, 25 ones were randomly allocated to rivaroxaban treatment (20 mg per day for three months) and remained 25 ones to warfarin treatment [adjusted based on international normalized ratio (INR) of 2-3]. The Modified Rankin Scale (mRS) and clinical investigations, including the incidence of seizure, papilledema, intra/extra-cranial bleeding, blurred vision, headache, nausea and vomiting, and death were evaluated at discharge time and within 3 and 6 months following CVT incidence; eventually, two groups were compared. Comparison of mRS scores between the groups revealed significant differences in none of the interval assessments, at the time of admission (P = 0.510), within three months (P = 0.630), and within six months (P = 0.990), while both of the approaches led to significant decrease in mRS scores following both of the treatments (P < 0.001). The comparison of drug-related adverse effects showed insignificant difference between warfarin versus rivaroxaban (P > 0.050). Based on this study, rivaroxaban is an efficacious agent for the treatment of CVT without remarkable adverse effects.

Thromboembolic phenomena are the serious consequences of assisted reproductive technology. We present a case of cerebral sinus vein thrombosis (CVST) following ovarian hyper stimulation syndrome (OHSS). Ten days after recovering from OHSS, the patient presented in the emergency department with thunderclap headache. Her Magnetic Resonance Venography (MRV) showed occluded left transverse sinus and left sigmoid sinus. The patient was treated with low molecular weight heparin. She made a good recovery and was independent in activities of daily living in follow up after six months. Disturbances of the coagulation system may occur in moderate OHSS and also persist even after the clinical symptoms of OHSS have resolved.

Cerebral venous-sinus thrombosis (CVST) is a life threatening condition that needs rapid diagnosis and treatment. It appears comparatively more common in Middle East and South Asia. To determine the demographic, clinical patterns, etiologies and prognostic factors of CVST in the North East of Iran. All adult patients admitted with a documented diagnosis of CVST from January 2011 to March 2012 in an academic hospital in the North East of Iran, entered this prospective descriptive study. The patients'' demographic characteristics, clinical presentations, laboratory and brain imaging findings, treatment options were also studied. Follow-up visits were performed at month 1, 6, and then at month 12 using modified Rankin Scale (mRS). Findings were analyzed using descriptive tests and Chi square test in SPSS software version 21. Sixty patients (13.3% men, 86.7% women) with mean age of 38.11±11.30 years were identified. Fifty one cases (85%) had a clinical picture of increased intracranial pressure. Causes included positive antiphospholipid antibodies in 3.3%, protein C, S and anti thrombin III deficiency in 5%, 1.7% and 3.3%, polycythemia in 1.7%, infections in 1.7%, postpartum in 9.6% of women, and using Oral Contraceptive Pills (OCPs) in 65.38%. We found 10% mortality rate on discharge and 11.9% within 30 days and 42.7% rate of death or dependency at month 12. The findings of the study indicate that the use of OCPs was a main factor associated with CVST especially in association with inherited hypercoagulable state.