open access

Vol 54, No 1 (2020)
Research paper
Published online: 2020-01-22
Submitted: 2019-09-17
Accepted: 2019-11-16
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Cerebral venous and sinus thrombosis diagnosis: preliminary study of clinical picture and D-dimer concentration correlation

Izabela Domitrz, Artur Sadowski, Wojciech Domitrz, Jan Kochanowski
DOI: 10.5603/PJNNS.a2020.0006
·
Pubmed: 31965561
·
Neurol Neurochir Pol 2020;54(1):66-72.

open access

Vol 54, No 1 (2020)
Research paper
Published online: 2020-01-22
Submitted: 2019-09-17
Accepted: 2019-11-16

Abstract

Aim of the study. We investigated whether D-dimer (DD) concentration is elevated in cerebral venous and sinus thrombosis (CVST), as has been reported in the literature. Clinical rationale for the study. CVST is a disease with variable clinical presentations and a challenging diagnosis. We looked into whether D-dimer concentration might be an indicator of CVST, and the need for neuroimaging tests correlated with clinical factors. Materials and methods. We included all consecutive patients (mean age 41.6 years) with CVST treated in our neurology department from 2014 to 2018 whose DD levels had been measured. DD concentrations were categorised as normal (≤ 0.5 μg/ml) or elevated ( > 0.5 μg/ml). Appropriate imaging confirmed the diagnosis of CVST. The results were compared to those of a control group consisting of 22 age- and sex-matched patients (mean age 40 years) with a diagnosis of primary headache (tension type or migraine) hospitalised to exclude secondary causes. Results. In 20 patients in the CVST study group, median level of DD was 1.0 + 0.57 μg/ml (range 0.19–2.45 μg/ml), compared to the control group’s mean DD level of 0.50 + 0.45 μg/ml (range 0.15–1.73 μg/ml), with p < 0.005. Higher DD levels were associated with complications of the disease and fatal course (p < 0.005). One female and one male patient died because of CVST with DD levels of (respectively) 2.45 and 1.80 μg/ml — the two highest concentrations in our study group. Conclusions and clinical implications. DD concentration, especially in headache patients, may be a factor to predict CVST and an indicator for further diagnostic procedures with venography. But in clinical practice, low levels of DD cannot be taken to exclude CVST.

Abstract

Aim of the study. We investigated whether D-dimer (DD) concentration is elevated in cerebral venous and sinus thrombosis (CVST), as has been reported in the literature. Clinical rationale for the study. CVST is a disease with variable clinical presentations and a challenging diagnosis. We looked into whether D-dimer concentration might be an indicator of CVST, and the need for neuroimaging tests correlated with clinical factors. Materials and methods. We included all consecutive patients (mean age 41.6 years) with CVST treated in our neurology department from 2014 to 2018 whose DD levels had been measured. DD concentrations were categorised as normal (≤ 0.5 μg/ml) or elevated ( > 0.5 μg/ml). Appropriate imaging confirmed the diagnosis of CVST. The results were compared to those of a control group consisting of 22 age- and sex-matched patients (mean age 40 years) with a diagnosis of primary headache (tension type or migraine) hospitalised to exclude secondary causes. Results. In 20 patients in the CVST study group, median level of DD was 1.0 + 0.57 μg/ml (range 0.19–2.45 μg/ml), compared to the control group’s mean DD level of 0.50 + 0.45 μg/ml (range 0.15–1.73 μg/ml), with p < 0.005. Higher DD levels were associated with complications of the disease and fatal course (p < 0.005). One female and one male patient died because of CVST with DD levels of (respectively) 2.45 and 1.80 μg/ml — the two highest concentrations in our study group. Conclusions and clinical implications. DD concentration, especially in headache patients, may be a factor to predict CVST and an indicator for further diagnostic procedures with venography. But in clinical practice, low levels of DD cannot be taken to exclude CVST.

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Keywords

d-dimer, cerebral venous and sinus thrombosis, number of venous sinuses involvement, symptoms duration

About this article
Title

Cerebral venous and sinus thrombosis diagnosis: preliminary study of clinical picture and D-dimer concentration correlation

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 54, No 1 (2020)

Pages

66-72

Published online

2020-01-22

DOI

10.5603/PJNNS.a2020.0006

Pubmed

31965561

Bibliographic record

Neurol Neurochir Pol 2020;54(1):66-72.

Keywords

d-dimer
cerebral venous and sinus thrombosis
number of venous sinuses involvement
symptoms duration

Authors

Izabela Domitrz
Artur Sadowski
Wojciech Domitrz
Jan Kochanowski

References (19)
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