Volume 140, Issue 6 p. 435-442
ORIGINAL ARTICLE

Early, delayed, and expanded intracranial hemorrhage in cerebral venous thrombosis

Banafsheh Shakibajahromi

Banafsheh Shakibajahromi

Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

MPH Department, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran

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Afshin Borhani-Haghighi

Corresponding Author

Afshin Borhani-Haghighi

Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Correspondence

Afshin Borhani-Haghighi, Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Email: [email protected]

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Mehrnaz Ghaedian

Mehrnaz Ghaedian

Department of Radiology, Namazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

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Farnia Feiz

Farnia Feiz

Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

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Hossein Molavi Vardanjani

Hossein Molavi Vardanjani

MPH Department, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran

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Anahid Safari

Anahid Safari

Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

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Alireza Salehi

Alireza Salehi

Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

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Ashkan Mowla

Ashkan Mowla

Division of Interventional Neuroradiology, Department of Radiology, University of California Los Angeles (UCLA) Medical Center, Los Angeles, CA, USA

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First published: 10 September 2019
Citations: 12

Abstract

Objectives

One of the most important prognostic factors of cerebral venous sinus thrombosis (CVST) is intracranial hemorrhage (ICH). We studied the risk factors, clinical, and radiologic characteristics of early, delayed, and expanded ICH in Iranian patients with CVST.

Materials and Methods

In a retrospective study, from August 2012 to September 2016, all adult patients with a confirmed diagnosis of CVST were recruited. Demographic, clinical, and radiologic characteristics of the patients were recorded. The predictors of early, delayed, and expanded ICH were assessed through logistic regression analysis.

Results

Among 174 eligible patients, 35.1% of the patients had early ICH. Delayed and expanded hemorrhage occurred in 5% and 7.4% of the patients, respectively. Higher age was a risk factor (odds ratio [OR] = 1.038, 95% confidence interval [CI] = 1.008-1.069), and involvement of multiple sinuses/veins was associated with lower risk of early ICH (OR = 0.432, CI = 0.226-0.827). The risk of delayed ICH was higher in the patients with early hemorrhage (OR = 4.44, CI: 0.990-19.94), men (OR = 4.18, CI: 0.919-19.05), and those with a focal neurologic deficit on admission (OR = 16.05, CI: 1.82-141.39). Acute onset was the predictor of the expansion of early ICH (OR = 8.92, CI: 1.81-43.77), whereas female gender-related conditions were associated with a lower risk of hemorrhage expansion (OR = 0.138, CI: 0.025-0.770). Administration of anticoagulants was associated with neither delayed (P value = .140) nor expanded hemorrhage (P-value = .623).

Conclusions

Male gender, early hemorrhages, acute onset, and presence of focal neurologic deficit are the risk factors for delayed and/or expanded hemorrhages in the patients with CVST.

CONFLICT OF INTEREST

The authors declare that they have no conflict of interest.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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