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Cerebral venous thrombosis

associated with extracranial tumours: a clinical series

S. IURLARO, A. SILVANI*, M. MAURI**, G. TRUCI***, S. BERETTA****, A. ZILIOLI,

M. GUIDOTTI**, A. SALMAGGI**, C. FERRARESE****, G. COMI***, M. RIVA

Department of Neurology, Azienda Ospedaliera, Lodi, Italy

* Department of Neuro-oncology, “C. Besta” Neurological Institute, Milan, Italy

** Department of Neurology, “Valduce” Hospital, Como, Italy

*** Department of Neurology, “S. Raffaele” Hospital, University “Vita Salute”, Milan, Italy

**** Department of Neurology, “S. Gerardo” Hospital, University of Milan-Bicocca, Monza, Italy

 

 

 

 

Summary

 

 

 

 

 

 

Progress in Neuroscience 2013; 1 (1-4): 83-90.

doi: 10.14588/PiN.2013.Riva.91

 

 

 

 

 

 

AIM. Cerebral Venous Thrombosis (CVT) may occur at the clinical onset of malignancies or complicate their course, even in a quiescent phase, and the literature contains several case reports linking the two diseases. However, thus far only one article has been written with the specific objective of reporting the characteristics of CVT in cancer patients. We therefore set out to analyse the clinical characteristics of CVT associated with extracranial tumours.

MATERIALS AND METHOD. We identified 9 cases of CVT in adults (> 15 years) affected by extracranial tumours seen in 6 hospitals from January 2004 to December 2009.

RESULTS. The median age of patients was 40 years (range 24-75 years). Eight out of the 9 patients were female. Associated tumours were: lymphoma (4 patients); breast (2 patients), rhinopharyngeal (1 patient) and gastric (1 patient) carcinomas. One patient presented concurrent kidney tumour and melanoma. In the majority of patients (7/9), CVT onset was metachronous, while it was synchronous in the remainder. In all cases, diagnosis of CVT was based on cerebral angiography, CT venography or brain MRI/MR venography. Multiple sinuses were affected in 7 out of the 9 patients, and parenchymal lesions were also detected in 7 patients. In the acute phase, all patients were anticoagulated with unfractionated heparin (2 cases) or subcutaneous low-molecularweight heparin (7 patients) at therapeutic doses. None went on to develop further haemorrhagic complications. At discharge, the patients presented a complete recovery in 4 of the 9 cases, mild sequelae in 4/9, and moderate sequelae in 1/9. At 6-month follow-up, 2 patients had died due to tumour progression, one patient presented arterial stroke, and one patient partial seizures.

CONCLUSIONS. In our cases, all female, the active phase of tumour and malignant haemolymphoproliferative diseases were associated with CVT. The anticoagulant therapy administered did not lead to an increased risk of haemorrhagic complications, and the patients’long-term prognoses were conditioned by the tumours themselves.

KEY WORDS: Cerebral venous thrombosis, Extracranial tumour, Outcome, Therapy.

 

 

 

 

 

 

 

 

 


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 Progress in Neuroscience - ISSN 2240-5135 - Copyright  © 2011-2015 SNO & new MAGAZINE s.r.l. - Italy