Öz
Amaç: Serebral Venöz Sinüs Trombozunun (SVST) akut fazında hastaların yaklaşık %35-50'sinde epileptik nöbetler görülmektedir. Bu çalışmada, bir yıllık takip süresi boyunca hastaların demografik ve klinik özellikleri, nöbet sıklığı ve prognozunun araştırılması amaçlanmıştır.
Gereç ve Yöntem: Retrospektif olarak yapılan bu çalışmada 1 Ocak 2018 ile 1 Ocak 2022 tarihleri arasında akut iskemik inme tanısı ile takip edilen hastaların dosyaları değerlendirildi. Demografik özellikler, nöbet öyküsü varlığı ve nöbet sıklığı, nörogörüntüleme bulguları, etkilenen serebral venöz sinüsler ve nöbet önleyici ilaç kullanımı kaydedildi.
Bulgular: Akut inme geçiren toplam 701 hastanın tıbbi kayıtları incelenmiştir. 701 hastanın 32'sine (%4,56) SVST tanısı kondu; hastaların %37,5'inde erken başlangıçlı nöbetler görüldü. Nöbet geçiren hastaların %88,8'inde (n:8) monoterapi ile nöbet kontrolü sağlanmıştır. Nöbet geçiren hastalarda tutulan sinüsler; %50 (n=6) superior sagittal sinüs en sık tutulan sinüs olup, inferior sagittal sinüs ve sinüs rektus tutulumu izlenmemiştir. Sinüs tutulumu açısından nöbet geçiren ve geçirmeyen hastalar arasında istatistiksel olarak anlamlı bir fark yoktu. Beyin manyetik rezonans görüntülemede nöbet geçiren hastaların %66,7'sinde (n=8) venöz enfarkt saptanırken, nöbet geçirmeyen hastaların %35'inde saptanmıştır.
Sonuç: Çalışmamız, nöbetlerin tipik olarak hastalığın erken dönemlerinde ortaya çıktığını, uzun vadede olumlu bir prognoza sahip olduğunu ve monoterapi ile yönetilebileceğini ortaya koymuştur.
Anahtar Kelimeler
Epilepsi serebral venöz sinüs trombozu nöbet önleyici ilaçlar prognoz
Destekleyen Kurum
destekleyen kurum yok
Proje Numarası
135-22
Kaynakça
- Mu S, Li J, Lin K, Fang Y, Lin F, Li Z, Xu Y, Wang S. Predictive factors for early-onset seizures in patients with cerebral venous sinus thrombosis. Front Neurol. 2022;29;13:842807.
- Luo Y, Tian X, Wang X. Diagnosis and treatment of cerebral venous thrombosis: a review. Front Aging Neurosci.2018;30:10-2.
- Sassi S B, Touati N, Baccouche H, Drissi C, Romdhane, NB, and Hentati, F Cerebral venous thrombosis: a tunisian monocenter study on 160 patients. Clin Appl Thromb Hemost. 2016; 23:1005–09.
- Masuhr F, Busch M, Amberger N, Ortwein H, Weih M, Neumann K et al. Risk and predictors of early epileptic seizures in acute cerebral venous and sinus thrombosis. Eur J Neurol.2006;13:852–6.
- Habibabadi JM, Saadatnia M, Tabrizi N. Seizure in cerebral venous and sinus thrombosis. Epilepsia Open. 2018;3:316–22.
- Ferro JM, Canhão P, Bousser MG, Stam J, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Venous Sinus Thrombosis (ISCVT). Stroke. 2004;35:664–70.
- Gazioglu S, Yildirim A, Kokturk EG, Seker D, Altunayoglu Cakmak V, Velioglu SK.. Acute seizures in cerebral venous sinus thrombosis risk factors and prognosis. Neurologist. 2020 ;25:126-30.
- Gasparini S, Neri S, Brigo F, Cianci V, Mammì A, Pascarella A et al. Late epileptic seizures following cerebral venous thrombosis: a systematic review and meta‑analysis. Neurol Sci. 2022;43:5229-36.
- Fısher RS, Acevedo C, Arzimanoglou A, Bagacz A, Cross HJ, Elger CE et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia.2014;55:475-82.
- Uluduz D, Midi I, Duman T, Yayla V, Karahan AY, Afsar N et al. Epileptic seizures in cerebral venous sinus thrombosis: subgroup analysis of VENOST study. Seizure. 2020;78:113-7.
- Daghriri HM, Alrajhi AA, Aburasain KS, Ateya EA, Hakami MA, Gosadi IM. An assessment of cerebral venous thrombosis risk factors and associated clinical outcomes in Jazan region, Saudi Arabia. Neurosciences (Riyadh).2021;26:15-20.
- Roeder HJ, Lopez JR, Miller EC. Ischemic stroke and cerebral venous sinus thrombosis in Pregnancy. Handb Clin Neurol.2020;172:3–31.
- Alimohammadi A, Kim DJ, Field TS. Updates in cerebral venous thrombosis. Curr Cardiol Rep. 2022;24:43-50.
- Moraes Junior AAA, Conforto AB. Cerebral venous thrombosis. Arq Neuropsiquiatr. 2022;80:53-9.
- Kalita J, Chandra S, Misra UK. Significance of seizure in cerebral venous sinus thrombosis. Seizure.2012;21:639-42.
- Ferro JM, Correia M, Rosas MJ, Pinto AN, Neves G. Cerebral venous thrombosis portuguese collaborative study group [venoport]. seizures in cerebral vein and dural sinus thrombosis. Cerebrovasc Dis. 2003;15:78–83.
- Lindgren E, Silvis SM, Hiltunen S, Heldner MR, Serrano F, de Scisco M et al. Acute symptomatic seizures in cerebral venous thrombosis. Neurology. 2020;95:1706-15.
- Ferro JM, Bousser MG, Canhao P, Coutinho JM, Crassard I, Dentali F et al. European stroke organisation guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology. Eur J Neurol.2017;24:1203-13.
- Saposnik G, Barinagarrementeria F, Brown RD, Bushnell CD, Cucchiara B, Cushman M et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:1158-92.
- Beghi E, D’Alessandro R, Beretta S, Consoli D, Crespi V, Delaj L et al. Incidence and predictors of acute symptomatic seizures after stroke. Neurology. 2011;77:1785-93.
- Sha D, Qian J, Gu S, Wang L, Wang F, Xu Y. Cerebral venous sinus thrombosis complicated by seizures: a retrospective analysis of 69 cases. J Thromb Thrombolysis. 2018;45:186-91.
Öz
Purpose: In the acute phase of Cerebral Venous Sinus Thrombosis (CVST), approximately 35-50 % of patients diagnosed epileptic seizures. This study aimed to investigate the demographic and clinical characteristics, frequency of seizures, prognosis of patients during a one-year follow-up period.
Materials and Methods: The files of patients who were followed up with the diagnosis of acute ischemic stroke between January 1, 2018 and January 1, 2022 were evaluated in this retrospective study. Demographic features, presence of seizure history and seizure frequency, neuroimaging findings, affected cerebral venous sinuses, and anti-seizure medication use were recorded.
Results: A total of 701 patients with acute stroke had their medical records reviewed. Thirty-two of 701 patients (4.56 %) were diagnosed with CVST; 37.5 % of patients experienced early-onset seizures. Seizure control was achieved with monotherapy in 88.8 % (n:8) of patients with seizures. Involved sinuses in patients with seizures; 50 % (n=6) superior sagittal sinus was the most commonly involved sinus and inferior sagittal sinus and sinus rectus were not involved. In terms of sinus involvement, there was no statistically significant difference between patients with and without seizures. On cerebral magnetic resonance imaging, venous infarcts were detected in 66.7 % (n=8) of patients with seizures, compared to 35 % of patients without seizures.
Conclusion: This retrospective study revealed that seizures typically occur early in the disease, have a favorable prognosis over the long term, and can be managed with monotherapy.
Anahtar Kelimeler
Epilepsy Cerebral venous sinus thrombosis Anti-seizure medication prognosis
Proje Numarası
135-22
Kaynakça
- Mu S, Li J, Lin K, Fang Y, Lin F, Li Z, Xu Y, Wang S. Predictive factors for early-onset seizures in patients with cerebral venous sinus thrombosis. Front Neurol. 2022;29;13:842807.
- Luo Y, Tian X, Wang X. Diagnosis and treatment of cerebral venous thrombosis: a review. Front Aging Neurosci.2018;30:10-2.
- Sassi S B, Touati N, Baccouche H, Drissi C, Romdhane, NB, and Hentati, F Cerebral venous thrombosis: a tunisian monocenter study on 160 patients. Clin Appl Thromb Hemost. 2016; 23:1005–09.
- Masuhr F, Busch M, Amberger N, Ortwein H, Weih M, Neumann K et al. Risk and predictors of early epileptic seizures in acute cerebral venous and sinus thrombosis. Eur J Neurol.2006;13:852–6.
- Habibabadi JM, Saadatnia M, Tabrizi N. Seizure in cerebral venous and sinus thrombosis. Epilepsia Open. 2018;3:316–22.
- Ferro JM, Canhão P, Bousser MG, Stam J, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Venous Sinus Thrombosis (ISCVT). Stroke. 2004;35:664–70.
- Gazioglu S, Yildirim A, Kokturk EG, Seker D, Altunayoglu Cakmak V, Velioglu SK.. Acute seizures in cerebral venous sinus thrombosis risk factors and prognosis. Neurologist. 2020 ;25:126-30.
- Gasparini S, Neri S, Brigo F, Cianci V, Mammì A, Pascarella A et al. Late epileptic seizures following cerebral venous thrombosis: a systematic review and meta‑analysis. Neurol Sci. 2022;43:5229-36.
- Fısher RS, Acevedo C, Arzimanoglou A, Bagacz A, Cross HJ, Elger CE et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia.2014;55:475-82.
- Uluduz D, Midi I, Duman T, Yayla V, Karahan AY, Afsar N et al. Epileptic seizures in cerebral venous sinus thrombosis: subgroup analysis of VENOST study. Seizure. 2020;78:113-7.
- Daghriri HM, Alrajhi AA, Aburasain KS, Ateya EA, Hakami MA, Gosadi IM. An assessment of cerebral venous thrombosis risk factors and associated clinical outcomes in Jazan region, Saudi Arabia. Neurosciences (Riyadh).2021;26:15-20.
- Roeder HJ, Lopez JR, Miller EC. Ischemic stroke and cerebral venous sinus thrombosis in Pregnancy. Handb Clin Neurol.2020;172:3–31.
- Alimohammadi A, Kim DJ, Field TS. Updates in cerebral venous thrombosis. Curr Cardiol Rep. 2022;24:43-50.
- Moraes Junior AAA, Conforto AB. Cerebral venous thrombosis. Arq Neuropsiquiatr. 2022;80:53-9.
- Kalita J, Chandra S, Misra UK. Significance of seizure in cerebral venous sinus thrombosis. Seizure.2012;21:639-42.
- Ferro JM, Correia M, Rosas MJ, Pinto AN, Neves G. Cerebral venous thrombosis portuguese collaborative study group [venoport]. seizures in cerebral vein and dural sinus thrombosis. Cerebrovasc Dis. 2003;15:78–83.
- Lindgren E, Silvis SM, Hiltunen S, Heldner MR, Serrano F, de Scisco M et al. Acute symptomatic seizures in cerebral venous thrombosis. Neurology. 2020;95:1706-15.
- Ferro JM, Bousser MG, Canhao P, Coutinho JM, Crassard I, Dentali F et al. European stroke organisation guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology. Eur J Neurol.2017;24:1203-13.
- Saposnik G, Barinagarrementeria F, Brown RD, Bushnell CD, Cucchiara B, Cushman M et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:1158-92.
- Beghi E, D’Alessandro R, Beretta S, Consoli D, Crespi V, Delaj L et al. Incidence and predictors of acute symptomatic seizures after stroke. Neurology. 2011;77:1785-93.
- Sha D, Qian J, Gu S, Wang L, Wang F, Xu Y. Cerebral venous sinus thrombosis complicated by seizures: a retrospective analysis of 69 cases. J Thromb Thrombolysis. 2018;45:186-91.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Nöroloji ve Nöromüsküler Hastalıklar |
| Bölüm | Araştırma |
| Yazarlar | |
| Proje Numarası | 135-22 |
| Erken Görünüm Tarihi | 25 Eylül 2023 |
| Yayımlanma Tarihi | 30 Eylül 2023 |
| Kabul Tarihi | 4 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 48 Sayı: 3 |
