Triquenot Bagan Aude, Crassard Isabelle, Drouet Ludovic, Barbieux-Guillot Marianne, Marlu Raphaël, Robinet-Borgomino Emmanuelle, Morange Pierre-Emmanuel, Wolff Valérie, Grunebaum Lelia, Klapczynski Frédéric, André-Kerneis Elisabeth, Pico Fernando, Martin-Bastenaire Brigitte, Ellie Emmanuel, Menard Fanny, Rouanet François, Freyburger Geneviève, Godenèche Gaëlle, Allano Hong-An, Moulin Thierry, Mourey Guillaume, Derex Laurent, Berruyer Micheline, Runavot Gwénaëlle, Trichet Catherine, Viader Fausto, Le Querrec Agnès, Husein Thomas Tarek, Cluet-Dennetiere Sophie, Macian-Montoro Francisco, Donnard Magali, Guillon Benoît, Ternisien Catherine, Zuber Mathieu, Laplanche Sophie, Tassan Philippe, Peeltier Jean-Yves, Canaple Sandrine, Roussel Bertrand, Gaillard Nicolas, Scavazza Emilie, Le Cam Duchez Véronique
Department of Neurology, CHU Rouen, Rouen, France.
Department of Neurology, Lariboisière University Hospital, Paris, France.
Front Neurol. 2021 Nov 8;12:753110. doi: 10.3389/fneur.2021.753110. eCollection 2021.
Cerebral venous thrombosis (CVT) is a rare disease with highly variable clinical presentation and outcome. Etiological assessment may be negative. The clinical and radiological presentation and evolution can be highly variable. The mechanisms involved in this variability remain unknown. The aim of this multicenter French study registered on ClinicalTrials.gov (NCT02013635) was therefore to prospectively recruit a cohort of patients with cerebral venous thrombosis (FPCCVT) in order to study thrombin generation and clot degradation, and to evaluate their influence on clinical radiological characteristics. The first part of the study was to compare our cohort with a reference cohort. This prospective, multicenter, French study was conducted from July 2011 to September 2016. Consecutive patients (aged >15 years) referred to the stroke units of 21 French centers and who had a diagnosis of symptomatic CVT were included. All patients gave their written informed consent. The diagnosis of CVT had to be confirmed by imaging. Clinical, radiological, biological, and etiological characteristics were recorded at baseline, at acute phase, at 3 months and at last follow-up visit. Thrombophilia screening and the choice of treatment were performed by the attending physician. All data were compared with data from the International Study on CVT published by Ferro et al. Two hundred thirty-one patients were included: 117 (50.6%) had isolated intracranial hypertension, 96 (41.5%) had focal syndrome. During hospitalization, 229 (99.1%) patients received anticoagulant treatment. Median length of hospital stay was 10 days. Five patients died during hospitalization (2.2%). At 3 months, 216 patients (97.0%) had follow-up with neurological data based on an outpatient visit. The mean duration of antithrombotic treatment was 9 months, and the mean time to last follow-up was 10.5 months. At the end of follow-up, eight patients had died, and 26 patients were lost to follow-up. At least one risk factor was identified in 200 patients. We demonstrated that the FPCCVT cohort had radiological, biological, and etiological characteristics similar to the historical ISCVT cohort. Nevertheless, the initial clinical presentation was less severe in our study probably due to an improvement in diagnostic methods between the two studies.
脑静脉血栓形成（CVT）是一种罕见疾病，临床表现和预后差异很大。病因评估可能为阴性。临床和影像学表现及演变情况差异可能很大。这种差异所涉及的机制尚不清楚。因此，这项在ClinicalTrials.gov（NCT02013635）上注册的法国多中心研究的目的是前瞻性招募一组脑静脉血栓形成患者（FPCCVT），以研究凝血酶生成和血凝块降解情况，并评估它们对临床影像学特征的影响。该研究的第一部分是将我们的队列与一个对照队列进行比较。这项前瞻性、多中心的法国研究于2011年7月至2016年9月进行。纳入了被转诊至法国21个中心的卒中单元且被诊断为有症状CVT的连续患者（年龄>15岁）。所有患者均签署了书面知情同意书。CVT的诊断必须通过影像学确认。在基线、急性期、3个月时以及最后一次随访时记录临床、影像学、生物学和病因学特征。由主治医生进行血栓形成倾向筛查和治疗选择。所有数据均与费罗等人发表的国际脑静脉血栓形成研究的数据进行比较。共纳入231例患者：117例（50.6%）有孤立性颅内高压，96例（41.5%）有局灶性综合征。住院期间，229例（99.1%）患者接受了抗凝治疗。中位住院时间为10天。5例患者在住院期间死亡（2.2%）。3个月时，216例患者（97.0%）通过门诊就诊进行了神经学数据随访。抗血栓治疗的平均持续时间为9个月，最后一次随访的平均时间为10.5个月。随访结束时，8例患者死亡，26例患者失访。200例患者中至少发现了一个危险因素。我们证明，FPCCVT队列在影像学、生物学和病因学特征方面与历史上的国际脑静脉血栓形成队列相似。然而，我们研究中的初始临床表现较轻，这可能是由于两项研究之间诊断方法的改进。
