Department of Neurology, Mustafa Kemal University, School of Medicine, Hatay, Turkey.
Department of Neurology, Aspendos Anatolian Hospital, Antalya, Turkey.
J Stroke Cerebrovasc Dis. 2019 Dec;28(12):104372. doi: 10.1016/j.jstrokecerebrovasdis.2019.104372. Epub 2019 Sep 24.
Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics.
Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded.
In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 ± 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up.
SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.
系统性红斑狼疮(SLE)是脑静脉窦血栓形成(CVST)的不常见危险因素。由于报道的 SLE 合并 CVST 患者较少,因此对于其作为潜在病因的频率、临床特征或长期预后知之甚少。我们在一项多中心脑静脉血栓形成研究——VENOST 研究中评估了一组 SLE 合并 CVST 大病例队列,并研究了他们的临床特征。
在 VENOST 队列的 1144 例 CVST 患者中,研究了诊断为 SLE 的患者。记录了他们的人口统计学和临床特征、病因危险因素、静脉受累情况和结局。
共有 15 例(1.31%)1144 例 CVST 患者患有 SLE。这些患者的平均年龄为 39.9 ± 12.1 岁,其中 13 例(86.7%)为女性。首发症状包括头痛(73.3%)、视野缺损(40.0%)和意识改变(26.7%)。主要受累的窦包括横窦(60.0%)、矢状窦(40.0%)和乙状窦(20.0%)。73.3%的患者未见脑实质受累。在改良 Rankin 量表上,1 个月随访时 92.9%的患者评分为 0-1,1 年随访时 90.9%的患者评分为 0-1。
在 CVST 患者中发现了 1.31%的 SLE,最常见于年轻女性。头痛是最常见的症状,大多数病例的 CVST 起病为慢性。患者结局良好。即使在伴有或不伴有其他神经学表现的孤立性慢性头痛症状的 SLE 患者中,也应怀疑 CVST。