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Shimizu T, Matsumoto H, Hatano K, Hashida H. Cerebral Venous Thrombosis in a Neuromyelitis Optica Patient. Intern Med 2024; 63:1331-1332. [PMID: 37779060 PMCID: PMC11116004 DOI: 10.2169/internalmedicine.2548-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Affiliation(s)
- Takahiro Shimizu
- Department of Neurology, Japanese Red Cross Medical Center, Japan
| | | | - Keiko Hatano
- Department of Neurology, Japanese Red Cross Medical Center, Japan
| | - Hideji Hashida
- Department of Neurology, Japanese Red Cross Medical Center, Japan
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2
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Doskas T, Dardiotis E, Vavougios GD, Ntoskas KT, Sionidou P, Vadikolias K. Stroke risk in multiple sclerosis: a critical appraisal of the literature. Int J Neurosci 2023; 133:1132-1152. [PMID: 35369835 DOI: 10.1080/00207454.2022.2056459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
Observational studies suggest that the occurrence of stroke on multiple sclerosis (MS) patients is higher compared to the general population. MS is a heterogeneous disease that involves an interplay of genetic, environmental and immune factors. The occurrence of stroke is subject to a wide range of both modifiable and non-modifiable, short- and long-term risk factors. Both MS and stroke share common risk factors. The immune mechanisms that underlie stroke are similar to neurodegenerative diseases and are attributed to neuroinflammation. The inflammation in autoimmune diseases may, therefore, predispose to an increased risk for stroke or potentiate the effect of conventional stroke risk factors. There are, however, additional determinants that contribute to a higher risk and incidence of stroke in MS. Due to the challenges that are associated with their differential diagnosis, the objective is to present an overview of the factors that may contribute to increased susceptibility or occurrence of stroke in MSpatients by performing a review of the available to date literature. As both MS and stroke can individually detrimentally affect the quality of life of afflicted patients, the identification of factors that contribute to an increased risk for stroke in MS is crucial for the prompt implementation of preventative therapeutic measures to limit the additive burden that stroke imposes.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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3
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Abbadessa G, Mainero C, Bonavita S. Hemostasis components as therapeutic targets in autoimmune demyelination. Clin Pharmacol Ther 2022; 111:807-816. [DOI: 10.1002/cpt.2532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 01/04/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Gianmarco Abbadessa
- Division of Neurology Department of Advanced Medical and Surgical Sciences University of Campania Luigi Vanvitelli 80131 Naples Italy
| | - Caterina Mainero
- Athinoula A. Martinos Center for Biomedical Imaging Department of Radiology Massachusetts General Hospital
- Harvard Medical School
| | - Simona Bonavita
- Division of Neurology Department of Advanced Medical and Surgical Sciences University of Campania Luigi Vanvitelli 80131 Naples Italy
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Garg A, Rajendram P, Muccilli A, Noel de Tilly L, Micieli JA. Dural venous sinus thrombosis after lumbar puncture in a patient with idiopathic intracranial hypertension. Eur J Ophthalmol 2020; 32:1120672120970406. [PMID: 33176472 DOI: 10.1177/1120672120970406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Idiopathic intracranial hypertension (IIH) is one of the most common causes of papilloedema seen by ophthalmologists and neurologists. Patients with IIH routinely undergo lumbar puncture (LP) for diagnosis. Dural venous sinus thrombosis (DVST) is a rare complication of cerebrospinal fluid pressure (CSF)-lowering procedures such as lumbar puncture and epidural and may be an intracranial complication of IIH. CASE DESCRIPTION A 29-year-old obese woman was diagnosed with severe idiopathic intracranial hypertension (IIH) after she presented with new-onset headache, pulsatile tinnitus and blurred vision. Magnetic resonance imaging (MRI) and venography (MRV) were normal apart from signs of intracranial hypertension. Lumbar puncture (LP) revealed an opening pressure of 40 cm of water. Due to the severity of the papilloedema and vision loss, she was referred for a ventriculoperitoneal shunt and found to have venous sinus thrombosis involving the superior sagittal sinus on the pre-operative computed tomography (CT) head 5 days after the LP. CT venography (CTV) one day later and MRV 3 days later showed significant worsening as the thrombosis extended into the deep venous system. She was started on therapeutic heparin and her symptoms and vision improved and she did not develop any neurological complications. CONCLUSIONS DVST should be considered in IIH patients who have worsening papilloedema or symptoms of intracranial hypertension. Repeat venous imaging can prevent devastating consequences such as venous infarcts of haemorrhage in these patients.
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Affiliation(s)
- Anubhav Garg
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Phavalan Rajendram
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alexandra Muccilli
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lyne Noel de Tilly
- Department of Medical Imaging, Division of Neuroradiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan A Micieli
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Centre, Toronto, Ontario, Canada
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Gasparini S, Russo M, Dattola V, Ferlazzo E, Aguglia U. Cryptogenic cerebral venous thrombosis in a multiple-sclerosis-patient treated with Alemtuzumab. Mult Scler Relat Disord 2020; 44:102246. [DOI: 10.1016/j.msard.2020.102246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022]
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6
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Filippidou N, Krashias G, Pericleous C, Rahman A, Ioannou Y, Giles I, Demetriou C, Anatolitou A, Christodoulou C, Pantzaris M, Lambrianides A. The association between IgG and IgM antibodies against cardiolipin, β2-glycoprotein I and Domain I of β2-glycoprotein I with disease profile in patients with multiple sclerosis. Mol Immunol 2016; 75:161-7. [DOI: 10.1016/j.molimm.2016.05.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/26/2016] [Accepted: 05/28/2016] [Indexed: 11/26/2022]
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7
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Kanaya Y, Takamatsu K, Shimoe Y, Niimi H, Kitajima I, Kuriyama M. Cerebral venous sinus thrombosis in the patient with multiple sclerosis associated with congenital antithrombin deficiency. Rinsho Shinkeigaku 2016; 56:248-54. [PMID: 27010094 DOI: 10.5692/clinicalneurol.cn-000796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report the case of a 25-year-old man with multiple sclerosis (MS) who had severe headache and unconsciousness. He suffered from optic neuritis that had started at age 6. From the age of 12 years, he had suffered from multiple sclerosis (MS) cerebral lesions that relapsed three times over for 5 years. At age 25, he showed a new lesion in the cerebellar cortex, suggesting an exacerbation of the MS. However, magnetic resonance imaging findings the next day showed cerebral venous sinus thrombosis. His laboratory findings showed low antithrombin activity. Genetic analysis revealed a single-base substitution (C>T) at the codon 359 (Arg to STOP) in the 5th exon portion of the antithrombin gene, heterozygote. In the literature review, 17 cases of multiple sclerosis associated with cerebral venous sinus thrombosis, which occurred after the lumbar puncture and the treatment with high-dose methylpredonisolone in 11 of these cases. In our case, antithrombin deficiency, hyperhomocystinemia, infection, and lumbar puncture were suggested as the risk factors.
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Affiliation(s)
- Yuhei Kanaya
- Department of Neurology, and Department of Radiology, Brain Attack Center Ota Memorial Hospital
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8
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Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome. Case Rep Pediatr 2015; 2015:358164. [PMID: 26558127 PMCID: PMC4629016 DOI: 10.1155/2015/358164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 10/05/2015] [Accepted: 10/07/2015] [Indexed: 11/17/2022] Open
Abstract
Background. The causes of cerebral venous thrombosis (CVT) are manifold as is its clinical presentation. Case. We report the case of a CVT following lumbar puncture and intravenous glucocorticosteroid therapy in a female adolescent with a clinically isolated syndrome and risk factors for thrombosis. Conclusion. In adolescent patients with acute inflammatory disease undergoing lumbar puncture followed by intravenous high-dose glucocorticosteroid therapy, one should be aware of the elevated risk for thrombosis. A persistent headache with change in the headache pattern and loss of a postural component might be a sign for CVT, requiring emergency imaging of the brain.
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Pelletier J. [Is it always useful to perform lumbar puncture for the diagnosis of multiple sclerosis? No]. Rev Neurol (Paris) 2015; 171:607-10. [PMID: 26343922 DOI: 10.1016/j.neurol.2015.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
Abstract
In the absence of a specific test for the diagnosis of multiple sclerosis (MS), cerebrospinal fluid analysis (CSF) remains discussed. There are robust evidences which demonstrated that an early diagnosis of MS must be done, due to the availability of disease-modifying drugs that could influence the natural history of the disease. However, several arguments can be put forward to assert that CSF analysis is not useful for the diagnosis of MS and thus should not be realized in a systematic way. First, MRI remains the most sensitive and specific marker to validate dissemination in space and in time and CSF analysis is not recommended by the 2010 McDonald criteria. The second argument is related to the low sensitivity and specificity of abnormalities detected in CSF analysis to confirm the diagnosis of MS. Moreover, there is currently no evidence that the presence of oligoclonal bands could represent a surrogate marker on an individual prognostic way. Furthermore, lumbar puncture could be traumatic, may entail some infrequent risks and represents unnecessary expense. Thus, there are strong reasons to not recommend systematic CSF examination to diagnose MS.
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Affiliation(s)
- J Pelletier
- Service de neurologie, pôle de neurosciences cliniques, hôpital de la Timone, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
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Koudriavtseva T, Renna R, Plantone D, Mainero C. Demyelinating and thrombotic diseases of the central nervous system: common pathogenic and triggering factors. Front Neurol 2015; 6:63. [PMID: 25852641 PMCID: PMC4371702 DOI: 10.3389/fneur.2015.00063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/11/2015] [Indexed: 02/02/2023] Open
Affiliation(s)
- Tatiana Koudriavtseva
- Neurology Unit, Multiple Sclerosis Center, Regina Elena National Cancer Institute, IFO , Rome , Italy
| | - Rosaria Renna
- Neurology Unit, Multiple Sclerosis Center, Regina Elena National Cancer Institute, IFO , Rome , Italy
| | - Domenico Plantone
- Neurology Unit, Multiple Sclerosis Center, Regina Elena National Cancer Institute, IFO , Rome , Italy
| | - Caterina Mainero
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital , Boston, MA , USA ; Harvard Medical School , Boston, MA , USA
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Nishida H, Wakida K, Sakurai T. Cerebral venous thrombosis as a complication of neuropsychiatric systemic lupus erythematosus. Intern Med 2015; 54:837-41. [PMID: 25832953 DOI: 10.2169/internalmedicine.54.3079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 51-year-old woman undergoing steroid treatment for systemic lupus erythematosus (SLE) was admitted to our hospital after developing a fever, consciousness disturbance and seizures, leading to a diagnosis of SLE-induced meningoencephalitis. Although steroid therapy improved her symptoms, she complained of post-lumbar puncture thunderclap headaches during follow-up, and cerebral venous thrombosis (CVT) was subsequently diagnosed on magnetic resonance venography and cerebral angiography. This is a rare case of neuropsychiatric SLE complicated by CVT during treatment for aseptic meningoencephalitis. The onset of aseptic meningoencephalitis and administration of the lumbar puncture and steroid therapy may have induced the development of the patient's CVT symptoms.
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Affiliation(s)
- Hiroshi Nishida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
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Koudriavtseva T. Thrombotic processes in multiple sclerosis as manifestation of innate immune activation. Front Neurol 2014; 5:119. [PMID: 25071707 PMCID: PMC4083343 DOI: 10.3389/fneur.2014.00119] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/24/2014] [Indexed: 01/18/2023] Open
Affiliation(s)
- Tatiana Koudriavtseva
- Unit of Neurology, Multiple Sclerosis Center, Regina Elena National Cancer Institute , Rome , Italy
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Sillero Sánchez M, Rodriguez Fernandez N, Sánchez Vera L, Gómez González B, Asencio Marchante J. Cerebral venous thrombosis after lumbar puncture and treatment with high-dose corticosteroids. NEUROLOGÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.nrleng.2012.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cerebral venous thrombosis: an unexpected complication from spinal surgery. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 23 Suppl 2:253-6. [DOI: 10.1007/s00586-013-3147-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 12/15/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
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Al-Hashel JY, Ahmed SF, Alexnader KJ, Ahmed W. Cerebral venous thrombosis in a patient with clinically isolated spinal cord syndrome. Case Rep Neurol Med 2013; 2013:364869. [PMID: 24000313 PMCID: PMC3755436 DOI: 10.1155/2013/364869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/29/2013] [Indexed: 11/17/2022] Open
Abstract
Background. The association between cerebral venous thrombosis (CVT) and multiple sclerosis (MS) has already been reported in patients with clinically definite MS in relation to intravenous methylprednisolone (IVMP) or previously performed lumbar puncture (LP). Case Summery. We report a 29-year-old Indian female who presented with a clinically isolated spinal cord syndrome according to the revised 2010 McDonald Criteria. She developed CVT after a lumbar puncture and two days of finishing the course of IVMP. Conclusion. We conclude that the sequence of doing lumbar puncture followed by high-dose IVMP may increase the risk of CVT. A prophylactic anticoagulation may be indicated in this setting.
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Affiliation(s)
- Jasem Yousef Al-Hashel
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
- Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait
| | - Samar Farouk Ahmed
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
- Minia University, P.O. Box 61519, Minia City, Minia 61111, Egypt
| | - K. J. Alexnader
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
| | - Walaa Ahmed
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
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Presicci A, Garofoli V, Simone M, Campa MG, Lamanna AL, Margari L. Cerebral venous thrombosis after lumbar puncture and intravenous high dose corticosteroids: a case report of a childhood multiple sclerosis. Brain Dev 2013; 35:602-5. [PMID: 23044052 DOI: 10.1016/j.braindev.2012.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 09/05/2012] [Accepted: 09/06/2012] [Indexed: 11/28/2022]
Abstract
The association between cerebral venous thrombosis (CVT) and multiple sclerosis (MS) has already been reported in several adult patients with clinically definite MS, in a suspected relation to i.v. corticosteroids or previously performed lumbar puncture (LP). We are reporting a case, which is, to our knowledge, the first one concerning a child patient with a MS, who developed multiple CVT after LP and during high-dose i.v. corticosteroid. Our conclusions are that the sequence LP followed by high dose corticosteroids may be a contributory factor for the development of CVT when associated with other risk factors.
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Affiliation(s)
- Anna Presicci
- Child Neuropsychiatry Unit, Department of Neurological Science and Sense Organs, University Aldo Moro of Bari, Italy
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17
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Cerebral venous thrombosis after lumbar puncture and treatment with high-dose corticosteroids. Neurologia 2013; 29:315-6. [PMID: 23318159 DOI: 10.1016/j.nrl.2012.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Revised: 10/22/2012] [Accepted: 11/02/2012] [Indexed: 11/23/2022] Open
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Venous thrombosis in multiple sclerosis patients after high-dose intravenous methylprednisolone: the preventive effect of enoxaparin. THROMBOSIS 2011; 2011:785459. [PMID: 22242201 PMCID: PMC3253479 DOI: 10.1155/2011/785459] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 11/15/2011] [Accepted: 11/16/2011] [Indexed: 11/20/2022]
Abstract
Aim. This study was designed to examine the possible role of high-dose intravenous methylprednisolone (IVMP) in the development of venous thrombosis (VT). The cerebral one anecdotally had been reported in patients with relapsing remitting multiple sclerosis (RRMS) in acute attacks and the possible preventive role of enoxaparin. Material and Methods. From a pool of 520 patients, 388 patients with definite RRMS who fulfilled entry characteristics were selected and randomly received either a 5-day course of daily 1 gr IVMP or the aforementioned plus 5 days of daily subcutaneous 40 units of enoxaparin according to a predefined protocol. Results. Mean age, gender ratio, mean relapse rate, and EDSS were similar in both groups of patients (P > 0.05). Finally, 366 patients remained in the study. Of 188 patients treated with IVMP with 855 relapses, 5 developed VT (0.37% per patient per year and 0.58% per each course of IVMP) within 3 to 15 days of starting therapy. None of the 178 patients who experienced 809 relapses who received IVMP plus enoxaparin developed such complications. Conclusion. The study implies that high-dose IVMP in MS exacerbation may increase the risk of VT and prophylactic anticoagulant treatment in this setting is warranted.
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Miglis MG, Levine DN. Intracranial Venous Thrombosis After Placement of a Lumbar Drain. Neurocrit Care 2009; 12:83-7. [DOI: 10.1007/s12028-009-9278-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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