Ulyanovsk Medico-biological Journal

CLINICAL MEDICINE

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DOI: 10.34014/2227-1848-2020-3-8-20

 

MODERN OUTLOOKS ON RISK FACTORS OF CEREBRAL VENOUS THROMBOSIS

 

L.A. Belova, V.V. Mashin, A.I. Sitnikova, D.V. Belov

Ulyanovsk State University, Ulyanovsk, Russia

 

The review presents the main risk factors for cerebral venous thrombosis (CVT). It outlines current understanding of their role in the pathogenesis of venous strokes.

The purpose of the review is to systematize the CVT risk factors according to their effect on a particular component of the Virchow’s triad.

Pubmed and eLIBRARY, as well as publications and papers on the issue were considered to be the main sources. As a rule, CVT is a multifactorial disease, which is more typical for young people, more often women. However, it can also occur in children and elderly patients. Since CVT does not always have a specific onset, knowledge of risk factors can help in the early disease diagnostics. In comparison with arterial thrombosis, CVT prognosis is generally more favorable. However, the consequences of the disease remain in 15–30 % of patients. The article presents the factors influencing CVT prognosis and outcome. It is considered, that such patients require timely detection and early diagnostics, as it will increase treatment efficacy, reduce after-effects and mortality.

Keywords: cerebral venous thrombosis, risk factors, deep vein thrombosis, superficial vein thrombosis, venous stroke.

Conflict of interest. The authors declare no conflict of interest.

 

References

  1. Ferro J.M., Bousser M.G., Canhão P., Coutinho J.M., Crassard I., Dentali F., di Minno M., Maino A., Martinelli I., Masuhr F., de Sousa D.A. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology. European stroke journal. 2017; 2 (3): 195–221.

  2. Belova L.A., Mashin V.V. Venoznye rasstroĭstva pri razlichnykh formakh tserebral'noĭ patologii [Venous disorders in various types of cerebral pathology]. Moscow; 2018. 176 (in Russian).

  3. Coutinho J.M., Zuurbier S.M., Aramideh M., Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012; 43 (12): 3375–3377.

  4. Zuurbier S.M., Hiltunen S., Lindgren E., Silvis S.M., Jood K., Devasagayam S. Cerebral venous thrombosis in older patients. Stroke. 2018; 49 (1): 197–200.

  5. Prasanna Tadi, Babak Behgam, Seth Baruffi. Cerebral Venous Thrombosis. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459315 (accessed: 19.01.2020).

  6. Maksimova M.Yu., Dubovitskaya Yu.I., Bryukhov V.V., Krotenkova M.V. Diagnosis of cerebral veins and venous sinuses thrombosis. RMJ. 2017; 21: 1595–1601.

  7. Einhäupl K., Stam J., Bousser M.G., De Bruijn S.F., Ferro J.M., Martinelli I., Masuhr F. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. European Journal of Neurology. 2010; 17 (10): 1229–1235.

  8. Ferro J.M., Canhão P., Stam J., Bousser M.G., Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004; 35 (3): 664–670.

  9. Lee J.K., Murray K., Renati S. A Case Report of Extensive Cerebral Venous Sinus Thrombosis as a Presenting Sign of Relapsing Nephrotic Syndrome. Neurological Medicine. 2019; 2019: ID 6840240. Available at: https://doi.org/10.1155/2019/6840240 (accessed: 14.01.2020).

  10. Coriu L., Ungureanu R., Talmaci R., Uscatescu V., Cirstoiu M., Coriu D., Copaciu E. Hereditary Thrombophilia and thrombotic events in pregnancy: single-center experience. J. Med. Life. 2014; 7 (4): 567–571.

  11. Belova L.A. Dipiridamol v lechenii i profilaktike tserebral'nogo venoznogo tromboza u zhenshchin, ispol'zuyushchikh gormonal'nye kontratseptivy [Dipyridamole in treatment and prevention of cerebral venous thrombosis in women taking hormonal contraceptives]. Zhurnal nevrologii i psikhiatriiim. S.S. Korsakova. 2017; 12 (117): 116–123.

  12. Duman T., Uluduz D., Midi I., Bektas H., Kablan Y., Goksel B.K., Milanlioglu A., Orken D.N., Aluclu U., Colakoglu S., Tüfekci A. A multicenter study of 1144 patients with cerebral venous thrombosis: the VENOST study. Journal of Stroke and Cerebrovascular Diseases. 2017; 26 (8): 1848–1857.

  13. Saadat P., Mohseni-Ahangar R. Oral contraceptive-related transverse sinus thrombosis as an initial manifestation of antiphospholipid syndrome in the absence of systemic lupus erythematosus. Caspian Journal of Internal Medicine. 2017; 8 (1): 56.

  14. Chandra T., Tilstra J.S. Cerebral venous sinus thrombosis as the initial presentation of systemic lupus erythematosus. Lupus. 2020; 29 (2): 213–215.

  15. Borhani-Haghighi A., Kardeh B., Banerjee S., Yadollahikhales G., Safari A., Sahraian M.A., Shapiro L. Neuro-Behcet's disease: An update on diagnosis, differential diagnoses, and treatment. Multiple Sclerosis and Related Disorders. 2020; 39: 101906.

  16. McBane II R.D., Tafur A., Wysokinski W.E. Acquired and congenital risk factors associated with cerebral venous sinus thrombosis. Thrombosis research. 2010; 126 (2): 81–87.

  17. Skoromets A.A., Tadtaeva Z.G., Pak T.E., Skoromets A.P. Geneticheskie priznaki trombofilii u detey i podrostkov pri insul'te [Genetically inherited traits of thrombophilia in children and adolescents with stroke]. Vestnik Sankt-Peterburgskogo universiteta. 2011; 4: 62–68 (in Russian).

  18. Coriu L., Ungureanu R., Talmaci R., Uscatescu V., Cirstoiu M., Coriu D., Copaciu E. Hereditary Thrombophilia and thrombotic events in pregnancy: single-center experience. Journal of medicine and life. 2014; 7 (4): 567.

  19. Wang L., Chen H., Zhang Y., Liu W., Zheng W., Zhang X., Zhang F. Clinical characteristics of cerebral venous sinus thrombosis in patients with systemic lupus erythematosus: a single-centre experience in China. Journal of immunology research. 2015; 2015: 540738–540738.

  20. Kerlin B.A., Ayoob R., Smoyer W.E. Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease. Clinical Journal of the American Society of Nephrology. 2012; 7 (3): 513–520.

  21. Lionaki S., Derebail V.K., Hogan S.L. Venous thromboembolism in patients with membranous nephropathy. Clinical Journal of the American Society of Nephrology. 2012; 7 (1): 43–51.

  22. Kiryushchenkov P.A., Sidel'nikova V.I. Patofiziologicheskie mekhanizmy vliyaniya antifosfolipidnogo sindroma na techenie beremennosti [Pathophysiological mechanisms of antiphospholipid syndrome influence on pregnancy]. Effektivnaya farmakoterapiya. Akusherstvo i ginekologiya. 2010; 4 (in Russian).

  23. Kulagin A.D., Lisukov I.A., Ptushkin V.V., Shilova E.R., Tsvetaeva N.V., Mikhaylova E.A. Natsional'nye klinicheskie rekomendatsii po diagnostike i lecheniyu paroksizmal'noy nochnoy gemoglobinurii [National clinical guidelines for diagnosis and treatment of paroxysmal nocturnal hemoglobinuria]. Onkogematologiya. 2014; 2: 20–28 (in Russian).

  24. Misra U.K., Kalita J., Bansal V., Nair P.P. Paroxysmal nocturnal haemoglobinuria presenting as cerebral venous sinus thrombosis. Transfusion Medicine. 2008; 18 (5): 308–311.

  25. Brodsky A. Paroxysmal nocturnal hemoglobinuria. Blood. 2014; 124 (18): 2804–2811.

  26. Silvis S.M., Hiltunen S., Lindgren E. Cancer and risk of cerebral venous thrombosis: a case-control study. J. Thromb. Haemost. 2018; 16 (1): 90–95.

  27. Fedotkina Yu.A., Panchenko E.P. Trombozy v onkologii [Thrombosis in oncology]. Aterotromboz. 2017; 1: 11–15 (in Russian).

  28. Somonova O., Madzhuga A., Elizarova A. Trombozy i tromboembolii v onkologii. Sovremennyy vzglyad na problemu [Thrombosis and thromboembolism in oncology. Modern view on the problem]. Zlokachestvennye opukholi. 2014; 3 (10): 172–176 (in Russian).

  29. Petralia G.A., Lemoine N.R., Kakkar A.K. Mechanisms of disease: the impact of antithrombotic therapy in cancer patients. Nat. Clin. Pract. Oncol. 2005; 2: 356–363.

  30. Khomand P., Hassanzadeh K. A case-series study of cerebral venous thrombosis in women using short course oral contraceptive. Iran. J. Neurol. 2016; 15 (2): 92–95.

  31. Amoozegar F., Ronksley P., Sauve R., Menon B. Hormonal Contraceptives and Cerebral Venous Thrombosis Risk: A Systematic Review and Meta Analysis. Front. Neurol. 2015; 6: 7.

  32. Mikulenka P., Peisker T., Vasko P., Stetkarova I. Diagnosis of cerebral venous thrombosis: a single centre experience. Neuroendocrinol. Lett. 2019; 39 (6): 473–479.

  33. Kalinin R.E., Suchkov I.A., Rudakova I.N., Nikiforova L.V. Gipergomotsisteinemiya i vozmozhnosti ee korrektsii pri posttromboticheskom sindrome nizhnikh konechnostey [Hyperhomocysteinemia and its correction in post-thrombotic syndrome of the lower extremities]. Vestnik RUDN. Ser. Meditsina. 2016; 1 (in Russian).

  34. Silvis S.M., Reinstra E., Hiltunen S., Lindgren E., Heldner M.R., Mansour M., Ghiasian M., Jood K., Zuurbier S.M., Groot A.E., Arnold M., Barboza M.A., Arauz A., Putaala J., Tatlisumak T., Coutinho J.M. Anaemia at admission is associated with poor clinical outcome in cerebral venous thrombosis. Eur. J. Neurol. 2020; 27 (4): 716–722.

  35. Bellwald S., Balasubramaniam R., Nagler M., Burri M.S., Fischer S.D., Hakim A., Dobrocky T., Yu Y., Scalzo F., Heldner M.R., Wiest R. Association of anemia and hemoglobin decrease during acute stroke treatment with infarct growth and clinical outcome. PloS One. 2018; 13 (9): e0203535.

  36. Cardenas A., Hurtado O., Leza J.C., Lizasoain I. Role of nitric oxide after brain ischaemia. Cell Calcium. 2004; 36: 265–275.

  37. Aguiar de Sousa D., Canhão P., Ferro J.M. Safety of pregnancy after cerebral venous thrombosis: a systematic review. Stroke. 2016; 47 (3): 713–718.

  38. Sjøland J.A., Sidelmann J.J., Brabrand M., Pedersen R.S., Pedersen J.H., Esbensen K., Standeven K.F., Ariëns R.A., Gram J. Fibrin clot structure in patients with end-stage renal disease. Thrombosis and haemostasis. 2007; 98 (8): 339–345.

  39. Belova L.A. Effektivnaya terapiya gipertonicheskoy entsefalopatii [Effective therapy for hypertensive encephalopathy]. Sovremennaya meditsina. 2016; 1 (1): 17–20 (in Russian).

  40. Zuurbier S.M., Middeldorp S., Stam J., Coutinho J.M. Sex differences in cerebral venous thrombosis: a systematic analysis of a shift over time. International journal of stroke. 2016; 11 (2): 164–170.

  41. Shatzel J.J., Connelly K.J., DeLoughery T.G. Thrombotic issues in transgender medicine: A review. American journal of hematology. 2017; 92 (2): 204–208.

  42. Amoozegar F., Ronksley P., Sauve R., Menon B. Hormonal Contraceptives and Cerebral Venous Thrombosis Risk: A Systematic Review and Meta-Analysis. Front. Neurol. 2015; 6: 7.

  43. Ignat'eva A.S., Abasova G.B., Kayshibaeva G.S. Tserebral'nyy venoznyy tromboz i beremennost': etiologiya, kliniko-epidemiologicheskaya kharakteristika i metody diagnostiki [Cerebral venous thrombosis and pregnancy: etiology, clinical and epidemiological characteristics and diagnostics]. Neyrokhirurgiya i nevrologiya Kazakhstana. 2016; 3 (44): 15–20 (in Russian).

  44. Lockwood C.J. Heritable coagulopathies in pregnancy. Obstet. Gynecol. Surv. 1999; 54 (12): 754–765.

  45. Khodzhaeva Z.S. Nasledstvennye trombofilii: vliyanie na reproduktivnuyu funktsiyu i kachestvo zhizni zhenshchiny/ Effektivnaya farmakoterapiya [Hereditary thrombophilia: Impact on reproductive function and quality of life in women. Effective pharmacotherape]. Akusherstvo i ginekologiya. 2010; 4 (in Russian).

  46. Kiryushchenkov P.A., Sidel'nikova V.I. Patofiziologicheskie mekhanizmy vliyaniya antifosfolipidnogo sindroma na techenie beremennosti. Effektivnaya farmakoterapiya [Pathophysiological mechanisms of antiphospholipid syndrome on pregnancy]. Akusherstvo i ginekologiya. 2010; 4 (in Russian).

  47. Benjamin C.G., Sen R.D., Golfinos J.G., Sen C., Roland J.T., McMenomey S., Pacione D. Postoperative cerebral venous sinus thrombosis in the setting of surgery adjacent to the major dural venous sinuses. Journal of Neurosurgery. 2018; 131 (4): 1317–1323.

  48. Puchkov V.L. Vnutricherepnoy venoznyy tromboz i tromboflebit tserebral'nykh ven pri cherepno-mozgovoy travme. Klinicheskoe rukovodstvo po cherepno-mozgovoy travme [Intracranial venous thrombosis and cerebral veins thrombophlebitis in traumatic brain injury. Clinical guidelines for traumatic brain injury]. Vol. 3. Moscow: Antidor; 2002: 372–375 (in Russian).

  49. Mashin V.V., Belova L.A., Proshin A.N. Arterio-venoznye rasstroĭstva pri nevrologicheskoĭ i somaticheskoĭ patologii [Arterial and venous disorders in neurological and somatic pathology]. Vserossiĭskaya konferentsiya s mezhdunarodnym uchastiem Nexus Medicus Venous Forum – 2016: sbornik tezisov [All-Russian conference with international participation Nexus Medicus Venous Forum – 2016: Proceedings]. Kazan', May 16–17, 2016. Ulyanovsk: UlGU; 2016 (in Russian).

  50. Belova L.A., Mashin V.V., Nikitin Yu.M., Belov V.G. Gipertonicheskaya entsefalopatiya: kliniko-patogeneticheskie podtipy, klassifikatsiya, diagnostika: monografiya [Hypertensive encephalopathy: Clinical and pathogenetic subtypes, classification, and diagnosis: Monograph]. Ulyanovsk: UlGU; 2010. 204 (in Russian).

  51. Abbakumova L.N., Arsent'ev V.G. Nasledstvennye i mnogofaktornye narusheniya soedinitel'noy tkani u detey. Algoritmy diagnostiki. Taktika vedeniya. Rossiyskie rekomendatsii [Hereditary and multifactorial connective tissue disorders in children. Diagnostics. Management. Russian recommendations]. Pediatr. 2016; 2 (in Russian).

  52. Kadurina T.I., Gnusaev S.F., Abbakumova L.N. Nasledstvennye i mnogofaktornye narusheniya soedinitel'noy tkani u detey algoritmy diagnostiki. Taktika vedeniya [Hereditary and multifactorial connective tissue disorders in children, diagnostic algorithms. Management]. Meditsinskiy vestnik Severnogo Kavkaza. 2015; 10 (1): 5–35 (in Russian).

  53. Nechaeva G.I., Yakovlev V.M., Konev V.P. Displaziya soedinitel'noy tkani: osnovnye klinicheskie sindromy, formulirovka diagnoza, lechenie [Connective tissue dysplasia: Main clinical syndromes, diagnosis, and treatment]. Lechashchiy vrach. 2008; 2: 22–28 (in Russian).

  54. Shilova M.A., Konev V.P., Tsaregorodtsev A.G. Patologiya sosudov u lits s displaziey soedinitel'noy tkani v aspekte vnezapnoy smerti [Vascular pathology in persons with connective tissue dysplasia in case of sudden death]. Kazanskiy meditsinskiy zhurnal. 2007; 88 (5): 33–36 (in Russian).

  55. Robertson W.C., Given C.A. Spontaneous intracranial arterial dissection in the young: diagnosis by CT angiography. BMC Neurol. 2006; 6.

  56. Dolgikh G.B. Tserebral'nye arterial'nye i venoznye distonii u detey (mekhanizmy, klinichnskie proyavleniya i lechenie) [Cerebral arterial and venous dystonia in children (mechanisms, clinical manifestations and treatment)]: avtoref. dis. … d-ra med. nauk. Kazan', 2009 (in Russian).

  57. Elykomov V.A., Kopylov A.N., Fedyanin S.A. Sklonnost' k tromboobrazovaniyu u bol'nykh s mezenkhimal'noy displaziey i sosudistymi mal'formatsiyami na fone gotovnosti k krovotochivosti [Liability to thrombogenesis in patients with mesenchymal dysplasia and vascular malformations related to readiness for bleeding]. Meditsinskiy al'manakh. 2017; 3: 172–175 (in Russian).

  58. Riedl J., Posch F., Königsbrügge O., Lötsch F., Reitter E.M., Eigenbauer E., Marosi C., Schwarzinger I., Zielinski C., Pabinger I., Ay C. Red cell distribution width and other red blood cell parameters in patients with cancer: association with risk of venous thromboembolism and mortality. PloS One. 2014; 9 (10): e111440.

  59. Rezende S.M., Lijfering W.M., Rosendaal F.R., Cannegieter S.C. Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk. Haematologica. 2014; 99 (1): 194–200.

  60. Sukhanova G.A., Barkagan Z.S., Kotovshchikova E.F. Tromboticheskie mezenkhimal'nye displazii i ikh svyaz' s drugimi trombofiliyami [Thrombotic mesenchymal dysplasias and their relations to thrombophilia]. Gematologiya i transfuziologiya. 2003; 6: 13–14 (in Russian).

  61. Nikitin Yu.M., Belova L.A., Mashin V.V., Belov V.G. Venoznaya gemodinamika golovnogo mozga u bol'nykh s gipertonicheskoy entsefalopatiey (kliniko-ul'trazvukovoe issledovanie) [Venous brain hemodynamics in patients with hypertensive encephalopathy (clinical and ultrasound examination)]. Klinicheskaya fiziologiya krovoobrashcheniya. 2011; 4: 49–54 (in Russian).

  62. Kolotik-Kameneva O.Yu. Sostoyanie tserebral'noy venoznoy gemodinamiki u bol'nykh gipertonicheskoy entsefalopatiey s konstitutsional'noy venoznoy nedostatochnost'yu v protsesse neyroprotektivnoy terapii [Cerebral venous hemodynamics in patients with hypertensive encephalopathy with constitutional venous insufficiency during neuroprotective therapy]. Klinicheskaya fiziologiya krovoobrashcheniya. 2013; 3: 28–36 (in Russian).

  63. Belova L.A., Mashin V.V. Venoznaya distsirkulyatsiya pri khronicheskikh formakh tserebrovaskulyarnoy patologii: monografiya [Venous discirculation in chronic cerebrovascular pathology: Monograph]. Ulyanovsk: UlGU; 2015. 132 (in Russian).

  64. Stulin I.D. Osobennosti izucheniya venoznoy tserebral'noy tsirkulyatsii v norme i patologii [Research of venous cerebral circulation in health and disease]. Sovremennye minimal'no-invazivnye tekhnologii: Materialy VI mezhdunarodnogo simpoziuma [Modern minimally invasive technologies: Proceedings of the 6th International Symposium]. St. Petersburg, 2001: 78–80 (in Rusian).

  65. Bousser M.G., Ferro J.M. Cerebral venous thrombosis: an update. The Lancet Neurology. 2007; 6 (2): 162–170.

  66. Bogdanov E.I., Zabbarova A.T. Tserebral'nye venoznye trombozy [Cerebral venous thrombosis]. Nevrologicheskiy vestnik. 2003; XXXV (1–2): 52–57 (in Russian).

  67. Tadi P., Behgam B., Baruffi S. Cerebral Venous Thrombosis. StatPearls Publishing. 2020. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459315/#article-19194.s2 (accessed: 12.03.2020).

  68. Lodigiani C., Iapichino G., Carenzo L. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb. Res. 2020; 191: 9–14.

  69. Cavalcanti D.D., Shapiro M., Dehkharghani S., Yaghi S., Lillemoe K., Nossek E., Torres J., Jain R., Riina H., Radmanesh A., Nelson P.K. Cerebral venous thrombosis associated with COVID-19. Am. J. Neuroradiol. 2020; 41 (8): 1370–1376.

  70. Hess D.C., Eldahshan W., Rutkowski E. COVID-19-related stroke. Transl. Stroke Res. 2020; 11: 322–325.

  71. Hughes C., Nichols T., Pike M., Subbe C., Elghenzai S. Cerebral Venous Sinus Thrombosis as a Presentation of COVID-19. European Journal of Case Reports in Internal Medicine. 2020; 7 (5).

  72. Mehta P., McAuley D.F., Brown M. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020; 395: 1033–1034.

  73. Connors J.M., Levy J.H. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020; 135. Available at: http://www.ncbi.nlm.nih.gov/pubmed/32339221 (accessed: 12.03.2020).

  74. Bolaji P. Extensive cerebral venous sinus thrombosis: a potential complication in a patient with COVID-19 disease. BMJ Case Rep. 2020; 13 (8): e236820.

Received 30 July 2020; accepted 20 August 2020.

 

Information about the authors

Belova Lyudmila Anatol'evna, Doctor of Sciences (Medicine), Professor, Dean of the Medical Department, Institute of Medicine, Ecology and Physical Culture named after T.Z. Biktimirov, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy Street, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-9585-5604

Mashin Viktor Vladimirovich, Doctor of Sciences (Medicine), Professor, Head of the Chair of Neurology, Neurosurgery, Physiotherapy and Physical Therapy, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy Street, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-0085-3727

Sitnikova Anastasiya Ivanovna, Post-graduate Student, Department of Neurology, Neurosurgery, Physiotherapy and Physical Therapy, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy Street, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-4392-4225

Belov Dmitriy Vyacheslavovich, 4th-year Student, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy Street, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-1766-0032

 

For citation

Belova L.A., Mashin V.V., Sitnikova A.I., Belov D.V. Sovremennye predstavleniya o faktorakh riska tserebral'nykh venoznykh trombozov [Modern outlooks on risk factors of cerebral venous thrombosis]. Ul'yanovskiy mediko-biologicheskiy zhurnal. 2020; 3: 8–20. DOI: 10.34014/2227-1848-2020-3-8-20 (in Russian).

 

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УДК 616.8-005

DOI 10.34014/2227-1848-2020-3-8-20

 

СОВРЕМЕННЫЕ ПРЕДСТАВЛЕНИЯ О ФАКТОРАХ РИСКА ЦЕРЕБРАЛЬНЫХ ВЕНОЗНЫХ ТРОМБОЗОВ

 

Л.А. Белова, В.В. Машин, А.И. Ситникова, Д.В. Белов

ФГБОУ ВО «Ульяновский государственный университет», г. Ульяновск, Россия

 

В обзоре представлены основные факторы риска развития церебральных венозных тромбозов (ЦВТ). Обсуждаются современные представления о роли этих факторов в патогенезе венозных инсультов.

Целью данного обзора является систематизация факторов риска ЦВТ в зависимости от влияния на тот или иной компонент триады Вирхова.

В качестве источников информации использовались данные электронных библиотек Pubmed, eLIBRARY , а также публикации и статьи по данной проблеме.

ЦВТ представляет собой, как правило, мультифакторное заболевание, более характерное для лиц молодого возраста, чаще женского пола, но также встречающееся у детей и пожилых пациентов. Поскольку ЦВТ не всегда имеет специфическое начало, знание факторов риска может помочь в ранней диагностике этого заболевания. Прогноз при ЦВТ, по сравнению с артериальным тромбозом, в целом более благоприятный. Однако у 15–30 % пациентов остаются последствия данного заболевания. В статье представлены факторы, влияющие на прогноз и исход ЦВТ. Постулируется, что указанная категория пациентов требует своевременного распознавания и ранней диагностики заболевания, что будет способствовать повышению эффективности лечения, уменьшению последствий патологии и снижению летальности.

Ключевые слова: церебральный венозный тромбоз, факторы риска, тромбоз глубоких вен, тромбоз поверхностных вен, венозный инсульт.

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

 

Литература

  1. Ferro J.M., Bousser M.G., Canhão P., Coutinho J.M., Crassard I., Dentali F., di Minno M., Maino A., Martinelli I., Masuhr F., de Sousa D.A. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology. European stroke journal. 2017; 2 (3): 195–221.

  2. Белова Л.А., Машин В.В. Венозные расстройства при различных формах церебральной патологии. М.; 2018. 176.

  3. Coutinho J.M., Zuurbier S.M., Aramideh M., Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012; 43 (12): 3375–3377.

  4. Zuurbier S.M., Hiltunen S., Lindgren E., Silvis S.M., Jood K., Devasagayam S. Cerebral venous thrombosis in older patients. Stroke. 2018; 49 (1): 197–200.

  5. Prasanna Tadi, Babak Behgam, Seth Baruffi. Cerebral Venous Thrombosis. URL: https://www.ncbi.nlm.nih.gov/books/NBK459315 (дата обращения: 19.01.2020).

  6. Maksimova M.Yu., Dubovitskaya Yu.I., Bryukhov V.V., Krotenkova M.V. Diagnosis of cerebral veins and venous sinuses thrombosis. RMJ. 2017; 21: 1595–1601.

  7. Einhäupl K., Stam J., Bousser M.G., De Bruijn S.F., Ferro J.M., Martinelli I., Masuhr F. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. European Journal of Neurology. 2010; 17 (10): 1229–1235.

  8. Ferro J.M., Canhão P., Stam J., Bousser M.G., Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004; 35 (3): 664–670.

  9. Lee J.K., Murray K., Renati S. A Case Report of Extensive Cerebral Venous Sinus Thrombosis as a Presenting Sign of Relapsing Nephrotic Syndrome. Neurological Medicine. 2019; 2019: ID 6840240. URL: https://doi.org/10.1155/2019/6840240 (дата обращения: 14.01.2020).

  10. Coriu L., Ungureanu R., Talmaci R., Uscatescu V., Cirstoiu M., Coriu D., Copaciu E. Hereditary Thrombophilia and thrombotic events in pregnancy: single-center experience. J. Med. Life. 2014; 7 (4): 567–571.

  11. Белова Л.А. Дипиридамол в лечении и профилактике церебрального венозного тромбоза у женщин, использующих гормональные контрацептивы. Журнал неврологии и психиатрии им. С.С. Корсакова. 2017; 12 (117): 116–123.

  12. Duman T., Uluduz D., Midi I., Bektas H., Kablan Y., Goksel B.K., Milanlioglu A., Orken D.N., Aluclu U., Colakoglu S., Tüfekci A. A multicenter study of 1144 patients with cerebral venous thrombosis: the VENOST study. Journal of Stroke and Cerebrovascular Diseases. 2017; 26 (8): 1848–1857.

  13. Saadat P., Mohseni-Ahangar R. Oral contraceptive-related transverse sinus thrombosis as an initial manifestation of antiphospholipid syndrome in the absence of systemic lupus erythematosus. Caspian Journal of Internal Medicine. 2017; 8 (1): 56.

  14. Chandra T., Tilstra J.S. Cerebral venous sinus thrombosis as the initial presentation of systemic lupus erythematosus. Lupus. 2020; 29 (2): 213–215.

  15. Borhani-Haghighi A., Kardeh B., Banerjee S., Yadollahikhales G., Safari A., Sahraian M.A., Shapiro L. Neuro-Behcet's disease: An update on diagnosis, differential diagnoses, and treatment. Multiple Sclerosis and Related Disorders. 2020; 39: 101906.

  16. McBane II R.D., Tafur A., Wysokinski W.E. Acquired and congenital risk factors associated with cerebral venous sinus thrombosis. Thrombosis research. 2010; 126 (2): 81–87.

  17. Скоромец А.А., Тадтаева З.Г., Пак Т.Е., Скоромец А.П. Генетические признаки тромбофилии у детей и подростков при инсульте. Вестник Санкт-Петербургского университета. 2011; 4: 62–68.

  18. Coriu L., Ungureanu R., Talmaci R., Uscatescu V., Cirstoiu M., Coriu D., Copaciu E. Hereditary Thrombophilia and thrombotic events in pregnancy: single-center experience. Journal of medicine and life. 2014; 7 (4): 567.

  19. Wang L., Chen H., Zhang Y., Liu W., Zheng W., Zhang X., Zhang F. Clinical characteristics of cerebral venous sinus thrombosis in patients with systemic lupus erythematosus: a single-centre experience in China. Journal of immunology research. 2015; 2015: 540738–540738.

  20. Kerlin B.A., Ayoob R., Smoyer W.E. Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease. Clinical Journal of the American Society of Nephrology. 2012; 7 (3): 513–520.

  21. Lionaki S., Derebail V.K., Hogan S.L. Venous thromboembolism in patients with membranous nephropathy. Clinical Journal of the American Society of Nephrology. 2012; 7 (1): 43–51.

  22. Кирющенков П.А., Сидельникова В.И. Патофизиологические механизмы влияния антифосфолипидного синдрома на течение беременности. Эффективная фармакотерапия. Акушерство и гинекология. 2010; 4.

  23. Кулагин А.Д., Лисуков И.А., Птушкин В.В., Шилова Е.Р., Цветаева Н.В., Михайлова Е.А. Национальные клинические рекомендации по диагностике и лечению пароксизмальной ночной гемоглобинурии. Онкогематология. 2014; 2: 20–28.

  24. Misra U.K., Kalita J., Bansal V., Nair P.P. Paroxysmal nocturnal haemoglobinuria presenting as cerebral venous sinus thrombosis. Transfusion Medicine. 2008; 18 (5): 308–311.

  25. Brodsky A. Paroxysmal nocturnal hemoglobinuria. Blood. 2014; 124 (18): 2804–2811.

  26. Silvis S.M., Hiltunen S., Lindgren E. Cancer and risk of cerebral venous thrombosis: a case-control study. J. Thromb. Haemost. 2018; 16 (1): 90–95.

  27. Федоткина Ю.А., Панченко Е.П. Тромбозы в онкологии. Атеротромбоз. 2017; 1: 11–15.

  28. Сомонова О., Маджуга А., Елизарова А. Тромбозы и тромбоэмболии в онкологии. Современный взгляд на проблему. Злокачественные опухоли. 2014; 3 (10): 172–176.

  29. Petralia G.A., Lemoine N.R., Kakkar A.K. Mechanisms of disease: the impact of antithrombotic therapy in cancer patients. Nat. Clin. Pract. Oncol. 2005; 2: 356–363.

  30. Khomand P., Hassanzadeh K. A case-series study of cerebral venous thrombosis in women using short course oral contraceptive. Iran. J. Neurol. 2016; 15 (2): 92–95.

  31. Amoozegar F., Ronksley P., Sauve R., Menon B. Hormonal Contraceptives and Cerebral Venous Thrombosis Risk: A Systematic Review and Meta Analysis. Front. Neurol. 2015; 6: 7.

  32. Mikulenka P., Peisker T., Vasko P., Stetkarova I. Diagnosis of cerebral venous thrombosis: a single centre experience. Neuroendocrinol. Lett. 2019; 39 (6): 473–479.

  33. Калинин Р.Е., Сучков И.А., Рудакова И.Н., Никифорова Л.В. Гипергомоцистеинемия и возможности ее коррекции при посттромботическом синдроме нижних конечностей. Вестник РУДН. Сер. Медицина. 2016; 1.

  34. Silvis S.M., Reinstra E., Hiltunen S., Lindgren E., Heldner M.R., Mansour M., Ghiasian M., Jood K., Zuurbier S.M., Groot A.E., Arnold M., Barboza M.A., Arauz A., Putaala J., Tatlisumak T., Coutinho J.M. Anaemia at admission is associated with poor clinical outcome in cerebral venous thrombosis. Eur. J. Neurol. 2020; 27 (4): 716–722.

  35. Bellwald S., Balasubramaniam R., Nagler M., Burri M.S., Fischer S.D., Hakim A., Dobrocky T., Yu Y., Scalzo F., Heldner M.R., Wiest R. Association of anemia and hemoglobin decrease during acute stroke treatment with infarct growth and clinical outcome. PloS One. 2018; 13 (9): e0203535.

  36. Cardenas A., Hurtado O., Leza J.C., Lizasoain I. Role of nitric oxide after brain ischaemia. Cell Calcium. 2004; 36: 265–275.

  37. Aguiar de Sousa D., Canhão P., Ferro J.M. Safety of pregnancy after cerebral venous thrombosis: a systematic review. Stroke. 2016; 47 (3): 713–718.

  38. Sjøland J.A., Sidelmann J.J., Brabrand M., Pedersen R.S., Pedersen J.H., Esbensen K., Standeven K.F., Ariëns R.A., Gram J. Fibrin clot structure in patients with end-stage renal disease. Thrombosis and haemostasis. 2007; 98 (8): 339–345.

  39. Белова Л.А. Эффективная терапия гипертонической энцефалопатии. Современная медицина. 2016; 1 (1): 17–20.

  40. Zuurbier S.M., Middeldorp S., Stam J., Coutinho J.M. Sex differences in cerebral venous thrombosis: a systematic analysis of a shift over time. International journal of stroke. 2016; 11 (2): 164–170.

  41. Shatzel J.J., Connelly K.J., DeLoughery T.G. Thrombotic issues in transgender medicine: A review. American journal of hematology. 2017; 92 (2): 204–208.

  42. Amoozegar F., Ronksley P., Sauve R., Menon B. Hormonal Contraceptives and Cerebral Venous Thrombosis Risk: A Systematic Review and Meta-Analysis. Front Neurol. 2015; 6: 7.

  43. Игнатьева А.С., Абасова Г.Б., Кайшибаева Г.С. Церебральный венозный тромбоз и беременность: этиология, клинико-эпидемиологическая характеристика и методы диагностики. Нейрохирургия и неврология Казахстана. 2016; 3 (44): 15–20.

  44. Lockwood C.J. Heritable coagulopathies in pregnancy. Obstet. Gynecol. Surv. 1999; 54 (12): 754–765.

  45. Ходжаева З.С. Наследственные тромбофилии: влияние на репродуктивную функцию и качество жизни женщины. Эффективная фармакотерапия. Акушерство и гинекология. 2010; 4.

  46. Кирющенков П.А., Сидельникова В.И. Патофизиологические механизмы влияния антифосфолипидного синдрома на течение беременности. Эффективная фармакотерапия. Акушерство и гинекология. 2010; 4.

  47. Benjamin C.G., Sen R.D., Golfinos J.G., Sen C., Roland J.T., McMenomey S., Pacione D. Postoperative cerebral venous sinus thrombosis in the setting of surgery adjacent to the major dural venous sinuses. Journal of Neurosurgery. 2018; 131 (4): 1317–1323.

  48. Пучков В.Л. Внутричерепной венозный тромбоз и тромбофлебит церебральных вен при черепно-мозговой травме. Клиническое руководство по черепно-мозговой травме. Т. III. М.: Антидор; 2002: 372–375.

  49. Машин В.В., Белова Л.А., Прошин А.Н. Артерио-венозные расстройства при неврологической и соматической патологии. Всероссийская конференция с международным участием Nexus Medicus Venous Forum – 2016: сборник тезисов. Казань, 16–17 мая 2016. Ульяновск: УлГУ; 2016.

  50. Белова Л.А., Машин В.В., Никитин Ю.М., Белов В.Г. Гипертоническая энцефалопатия: клинико-патогенетические подтипы, классификация, диагностика: монография. Ульяновск: УлГУ; 2010. 204.

  51. Аббакумова Л.Н., Арсентьев В.Г. Наследственные и многофакторные нарушения соединительной ткани у детей. Алгоритмы диагностики. Тактика ведения. Российские рекомендации. Педиатр. 2016; 2.

  52. Кадурина Т.И., Гнусаев С.Ф., Аббакумова Л.Н. Наследственные и многофакторные нарушения соединительной ткани у детей. Алгоритмы диагностики. Тактика ведения. Медицинский вестник Северного Кавказа. 2015; 10 (1): 5–35.

  53. Нечаева Г.И., Яковлев В.М., Конев В.П. Дисплазия соединительной ткани: основные клинические синдромы, формулировка диагноза, лечение. Лечащий врач. 2008; 2: 22–28.

  54. Шилова М.А., Конев В.П., Царегородцев А.Г. Патология сосудов у лиц с дисплазией соединительной ткани в аспекте внезапной смерти. Казанский медицинский журнал. 2007; 88 (5): 33–36.

  55. Robertson W.C., Given C.A. Spontaneous intracranial arterial dissection in the young: diagnosis by CT angiography. BMC Neurol. 2006; 6.

  56. Долгих Г.Б. Церебральные артериальные и венозные дистонии у детей (механизмы, клинические проявления и лечение): автореф. дис. … д-ра мед. наук. Казань, 2009.

  57. Елыкомов В.А., Копылов А.Н., Федянин С.А. Склонность к тромбообразованию у больных с мезенхимальной дисплазией и сосудистыми мальформациями на фоне готовности к кровоточивости. Медицинский альманах. 2017; 3: 172–175.

  58. Riedl J., Posch F., Königsbrügge O., Lötsch F., Reitter E.M., Eigenbauer E., Marosi C., Schwarzinger I., Zielinski C., Pabinger I., Ay C. Red cell distribution width and other red blood cell parameters in patients with cancer: association with risk of venous thromboembolism and mortality. PloS One. 2014; 9 (10): e111440.

  59. Rezende S.M., Lijfering W.M., Rosendaal F.R., Cannegieter S.C. Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk. Haematologica. 2014; 99 (1): 194–200.

  60. Суханова Г.А., Баркаган З.С., Котовщикова Е.Ф. Тромботические мезенхимальные дисплазии и их связь с другими тромбофилиями. Гематология и трансфузиология. 2003; 6: 13–14.

  61. Никитин Ю.М., Белова Л.А., Машин В.В., Белов В.Г. Венозная гемодинамика головного мозга у больных с гипертонической энцефалопатией (клинико-ультразвуковое исследование). Клиническая физиология кровообращения. 2011; 4: 49–54.

  62. Колотик-Каменева О.Ю. Состояние церебральной венозной гемодинамики у больных гипертонической энцефалопатией с конституциональной венозной недостаточностью в процессе нейропротективной терапии. Клиническая физиология кровообращения. 2013; 3: 28–36.

  63. Белова Л.А., Машин В.В. Венозная дисциркуляция при хронических формах цереброваскулярной патологии: монография. Ульяновск: УлГУ; 2015. 132.

  64. Стулин И.Д. Особенности изучения венозной церебральной циркуляции в норме и патологии. Современные минимально-инвазивные технологии: материалы VI Международного симпозиума. СПб., 2001: 78–80.

  65. Bousser M.G., Ferro J.M. Cerebral venous thrombosis: an update. The Lancet Neurology. 2007; 6 (2): 162–170.

  66. Богданов Э.И., Заббарова А.Т. Церебральные венозные тромбозы. Неврологический вестник. 2003; XXXV (1–2): 52–57.

  67. Tadi P., Behgam B., Baruffi S. Cerebral Venous Thrombosis. StatPearls Publishing. 2020. URL: https://www.ncbi.nlm.nih.gov/books/NBK459315/#article-19194.s2 (дата обращения: 12.03.2020).

  68. Lodigiani C., Iapichino G., Carenzo L. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb. Res. 2020; 191: 9–14.

  69. Cavalcanti D.D., Shapiro M., Dehkharghani S., Yaghi S., Lillemoe K., Nossek E., Torres J., Jain R., Riina H., Radmanesh A., Nelson P.K. Cerebral venous thrombosis associated with COVID-19. Am. J. Neuroradiol. 2020; 41 (8): 1370–1376.

  70. Hess D.C., Eldahshan W., Rutkowski E. COVID-19-related stroke. Transl. Stroke Res. 2020; 11: 322–325.

  71. Hughes C., Nichols T., Pike M., Subbe C., Elghenzai S. Cerebral Venous Sinus Thrombosis as a Presentation of COVID-19. European Journal of Case Reports in Internal Medicine. 2020; 7 (5).

  72. Mehta P., McAuley D.F., Brown M. COVID-19: consider cytokine storm syndromes and immuno-suppression. Lancet. 2020; 395: 1033–1034.

  73. Connors J.M., Levy J.H. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020; 135. URL: http://www.ncbi.nlm.nih.gov/pubmed/32339221 (дата обращения: 12.03.2020).

  74. Bolaji P. Extensive cerebral venous sinus thrombosis: a potential complication in a patient with COVID-19 disease. BMJ Case Rep. 2020; 13 (8): e236820.

Поступила в редакцию 30.07.2020; принята 20.08.2020.

 

Авторский коллектив

Белова Людмила Анатольевна – доктор медицинских наук, профессор, декан медицинского факультета Института медицины, экологии и физической культуры им. Т.З. Биктимирова, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-9585-5604

Машин Виктор Владимирович – доктор медицинских наук, профессор, заведующий кафедрой неврологии, нейрохирургии, физиотерапии и лечебной физкультуры, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-0085-3727

Ситникова Анастасия Ивановна – аспирант кафедры неврологии, нейрохирургии, физиотерапии и лечебной физкультуры, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-4392-4225

Белов Дмитрий Вячеславович – студент 4 курса, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-1766-0032

 

Образец цитирования

Белова Л.А., Машин В.В., Ситникова А.И., Белов Д.В. Современные представления о факторах риска церебральных венозных тромбозов. Ульяновский медико-биологический журнал. 2020; 3: 8–20. DOI: 10.34014/2227-1848-2020-3-8-20.