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- Canhao, P C, et al.
(författare)
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Causes and predictors of death in cerebral venous thrombosis
- 2005
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 36:8, s. 1720-1725
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose - The causes of death of patients with cerebral venous thrombosis (CVT) have not been systematically addressed in previous studies. We aimed to analyze the causes and predictors of death during the acute phase of CVT in the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) to identify preventable or treatable causes. Methods - ISCVT is a multinational, prospective, observational study including 624 patients with CVT occurring between May 1998 and May 2001, in which 27 patients (4.3%) died during the acute phase, 21 (3.4%) within 30 days from symptom onset. Inclusion forms and a questionnaire assessing the causes of death were analyzed. A logistic regression analysis was performed to identify the predictors of death within 30 days from symptom onset of CVT. Results - Median time between onset of symptoms and death was 13 days and between diagnosis and death, 5 days. Causes of death were mainly transtentorial herniation due to a unilateral focal mass effect (10 patients) or to diffuse edema and multiple parenchymal lesions (10 patients). Independent predictors of death were coma (odds ratio [OR], 8.8; 95% confidence interval [CI], 2.8 to 27.7), mental disturbance (OR, 2.5; 95% CI 0.9 to 7.3), deep CVT thrombosis (OR, 8.5; 95% CI, 2.6 to 27.8), right intracerebral hemorrhage (OR, 3.4; 95% CI, 1.1 to 10.6), and posterior fossa lesion (OR, 6.5; 95% CI, 1.3 to 31.7). Worsening of previous focal or de novo focal deficits increased the risk of death. Conclusions - The main causes of acute death were neurologic, the most frequent mechanism being transtentorial herniation.
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| 2. |
- Lindgren, Arne, et al.
(författare)
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Long-term prognosis of cerebral vein and sinus thrombosis
- 2008
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Ingår i: Frontiers of neurology and neuroscience (Frontiers of neurology and neuroscience). - 1660-4431. - 9783805583787 ; 23, s. 172-178
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In recent reports, cerebral vein and sinus thrombosis has had a better long-term prognosis than previously thought. However, there may be long-term problems that have not attracted enough attention. The aim of this chapter is to examine the literature for studies reporting long-term prognosis and outcome after cerebral vein and sinus thrombosis. The long-term prognosis after cerebral vein and sinus thrombosis mainly depends on underlying diseases, e.g. cancer. If no serious underlying disease is present, the long-term prognosis is generally good. However, death, impaired functional outcome, headache, epileptic seizures, cognitive impairment and recurrent thrombosis occur in some patients. Although the general long-term prognosis after cerebral vein and sinus thrombosis is good, the practicing clinician handling these patients should be aware of certain complications that are not uncommon. Follow-up of these patients is important, even if they initially seem to have recovered completely.
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| 3. |
- Malm, J., et al.
(författare)
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The Swedish Malignant Middle cerebral artery Infarction Study : long-term results from a prospective study of hemicraniectomy combined with standardized neurointensive care
- 2006
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Ingår i: Acta Neurologica Scandinavica. - Copenhagen : Munksgaard. - 0001-6314 .- 1600-0404. ; 113:1, s. 25-30
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Hemicraniectomy in patients with malignant middle cerebral artery (mMCA) infarct may be life-saving. The long-term prognosis is unknown.Methods: Patients with mMCA infarct treated with hemicraniectomy between 1998 and 2002 at three hospitals were included. The criterion for surgical intervention was if the patients deteriorated from awake to being responding to painful stimuli only. All patients were followed for at least 1 year. Outcome was defined as alive/dead, walkers/non-walkers or modified Rankin Scale (mRS) score ≤2.Results: Thirty patients were included (median age at stroke onset 49 years, range 17–67 years). Fourteen patients had mMCA infarct on the left side and 16 patients on the right side. Fourteen patients had pupil dilatation before surgery. Hemicraniectomy was performed at a median of 52 h (range 13–235 h) after stroke onset. Nine patients died within 1 month after surgery because of cerebral herniation (n = 6), myocardial infarction (n = 1) or intensive care complications (n = 2). No further deaths occurred during follow-up, which was at median 3.4 years after surgery. Status for the 21 survivors at the last follow-up was: mRS 2 or less (n = 6) and mRS 3–5 (n = 15). The oldest patient with mRS 2 or less was 53 years at stroke onset. Thirteen patients (43%) could walk without substantial aid.Conclusion: The long-term survival after mMCA infarction treated with hemicraniectomy seems to be favourable if the patient survives the acute phase. The outcome as measured with mRS may be better among younger patients.
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