The changing face of cerebral venous sinus thrombosis - emerging new causes and treatments.

IF 5.5 2区 医学 Q1 HEMATOLOGY Journal of Thrombosis and Haemostasis Pub Date : 2024-09-09 DOI:10.1016/j.jtha.2024.08.012
Caroline Dix,Beverley J Hunt
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Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon site of venous thromboembolism. CVST more commonly affects younger people and women, in stark contrast to other forms of venous thrombosis where incidence increases with age and overall affects men. Traditional risk factors for the development of CVST include endogenous and exogenous estrogen (combined oral contraceptives and pregnancy and the puerperium), thrombophilias and rare haematologic disorders. New and emerging risk factors include obesity, polycystic ovary syndrome, COVID-19 infection, and vaccine-induced thrombocytopenia and thrombosis (VITT) and VITT-like disorders. Management centres around anticoagulation, managing the underlying cause, and consideration of invasive measures including endovascular thrombolysis and/or thrombectomy and craniectomy for severe cases. This review discusses the emerging risk factors and their identification, evidence for treatment including the use of direct oral anticoagulants, and the role of invasive management options.
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不断变化的脑静脉窦血栓--新出现的病因和治疗方法。
脑静脉窦血栓形成(CVST)是一种不常见的静脉血栓栓塞症。脑静脉窦血栓更常见于年轻人和女性,这与其他形式的静脉血栓形成形成鲜明对比,后者的发病率随着年龄的增长而增加,而且总体上影响男性。发生 CVST 的传统风险因素包括内源性和外源性雌激素(联合口服避孕药、妊娠和产褥期)、血栓性疾病和罕见的血液病。新出现的风险因素包括肥胖、多囊卵巢综合征、COVID-19 感染、疫苗诱发的血小板减少症和血栓形成(VITT)以及 VITT 类疾病。治疗主要围绕抗凝、控制潜在病因以及考虑采取侵入性措施,包括血管内溶栓和/或血栓切除术,严重病例还需进行颅骨切除术。本综述讨论了新出现的风险因素及其识别、治疗证据(包括使用直接口服抗凝剂)以及侵入性治疗方案的作用。
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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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