Department of Emergency, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, 210008, China.
J Thromb Thrombolysis. 2018 Jan;45(1):186-191. doi: 10.1007/s11239-017-1570-5.
Cerebral venous sinus thrombosis (CVST) is a rare ischemic cerebrovascular disease. The aim of this retrospective observational study was to investigate the risk factors for complication of cerebral venous sinus thrombosis by seizures and to explore the impact of such seizures on clinical outcomes. Patients with cerebral venous sinus thrombosis with or without epileptic seizures were retrospectively analyzed and compared in terms of clinical variables, causative factors, clinical presentation, and imaging data. In all, 69 patients with cerebral venous sinus thrombosis were enrolled in this study, 32 (46.38%) of whom had experienced secondary seizures. Compared with those with no seizures, significantly more patients with secondary seizures had hemiplegia (37.50 vs. 15.63%; P = 0.020), bleeding (29.40 vs. 10.81%; P = 0.047), lesions involving the frontal (31.25 vs. 10.81%; P = 0.023) and temporal lobe (43.75 vs. 8.11%; P = 0.005), and thrombosis in the superior sagittal sinus (65.63 vs. 40.54%; P = 0.036). Multivariate logistic regression analysis showed focal neurological deficits (P = 0.004, odds ratio = 5.16, 95% CI 1.99-15.76) and thrombosis of the superior sagittal sinus (P = 0.039, odds ratio = 0.13, 95% CI 0.04-0.37) were independent risk factors for secondary seizures in patients with cerebral venous sinus thrombosis. In addition, mortality rate (9.38 vs. 5.41%; P = 0.469) and 90-day excellent prognosis rate (81.25 vs. 86.47%; P = 0.793) did not differ significantly between patients with and without epileptic seizures. The presence of focal neurological deficits and thrombosis of the superior sagittal sinus are independent risk factors for secondary seizures in patients with cerebral venous sinus thrombosis, whereas mortality and 90-day prognosis have no correlation with secondary seizures.
脑静脉窦血栓形成(CVST)是一种罕见的缺血性脑血管病。本回顾性观察研究旨在探讨脑静脉窦血栓形成并发癫痫的危险因素,并探讨此类癫痫发作对临床结局的影响。对伴有或不伴有癫痫发作的脑静脉窦血栓形成患者进行回顾性分析和比较,比较其临床变量、病因、临床表现和影像学资料。本研究共纳入 69 例脑静脉窦血栓形成患者,其中 32 例(46.38%)发生继发性癫痫。与无癫痫发作的患者相比,有继发性癫痫发作的患者更易出现偏瘫(37.50%比 15.63%;P=0.020)、出血(29.40%比 10.81%;P=0.047)、额叶(31.25%比 10.81%;P=0.023)和颞叶病变(43.75%比 8.11%;P=0.005),以及上矢状窦血栓形成(65.63%比 40.54%;P=0.036)。多因素 logistic 回归分析显示,局灶性神经功能缺损(P=0.004,比值比=5.16,95%CI 1.99-15.76)和上矢状窦血栓形成(P=0.039,比值比=0.13,95%CI 0.04-0.37)是脑静脉窦血栓形成患者继发性癫痫的独立危险因素。此外,癫痫发作患者的死亡率(9.38%比 5.41%;P=0.469)和 90 天预后良好率(81.25%比 86.47%;P=0.793)与无癫痫发作患者无显著差异。局灶性神经功能缺损和上矢状窦血栓形成是脑静脉窦血栓形成患者继发性癫痫的独立危险因素,而死亡率和 90 天预后与继发性癫痫无相关性。