Cerebral venous sinus thrombosis laboratory findings
From Wikidoc - Reading time: 3 min
|
Cerebral venous sinus thrombosis Microchapters |
|
Differentiating Cerebral venous sinus thrombosis from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Cerebral venous sinus thrombosis laboratory findings On the Web |
|
American Roentgen Ray Society Images of Cerebral venous sinus thrombosis laboratory findings |
|
Cerebral venous sinus thrombosis laboratory findings in the news |
|
Blogs on Cerebral venous sinus thrombosis laboratory findings |
|
Directions to Hospitals Treating Cerebral venous sinus thrombosis |
|
Risk calculators and risk factors for Cerebral venous sinus thrombosis laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sharmi Biswas, M.B.B.S
Overview[edit | edit source]
No specific lab finding is related to diagnose cerebral venous sinus thrombosis. MRI venography is the confirmatory brain imaging to diagnose cerebral venous sinus thrombosis.
Laboratory Findings[edit | edit source]
The diagnosis may be suspected on the basis of the symptoms (e.g. the combination of headache, signs of raised intracranial pressure and focal neurological abnormalities), or when alternative causes of headache and neurological abnormalities (such as a subarachnoid hemorrhage) have been excluded.[1]
Lumbar Puncture[edit | edit source]
A cerebrospinal fluid(CSF) study is not very useful in diagnosing Cerebral venous thrombosis(CVT) unless there is a suspicion of meningitis. In 80% of patients, there is an elevated opening pressure of CSF. Patients presenting with headache in the emergency department, elevated opening pressure of CSF might be considered as a clue. In 50% of patients with CVT, elevated cell counts and protein levels are found but absence of these findings dont exclude CVT.[2]
D-Dimer[edit | edit source]
A 2004 German study suggested that the D-dimer blood test, already in use for the diagnosis of other forms of thrombosis, was abnormal (above 500 μg/l) in 34 out of 35 patients with cerebral sinus thrombosis, giving it a sensitivity of 97.1%, a negative predictive value of 99.6%, a specificity of 91.2%, and a positive predictive value of 55.7%. Furthermore, the level of the D-dimer correlated with the extent of the thrombosis.[3] A subsequent 2005 study performed in France showed that 10% of patients with confirmed thrombosis had a normal D-dimer, and in those who had presented with only a headache 26% had a normal D-dimer. The study concludes that D-dimer is not useful in the situations where it would make the most difference (low-probability settings).[4]
Further Tests[edit | edit source]
In most patients, the direct cause for the cerebral sinus thrombosis is not readily apparent. Identifying a source of infection is crucial, but it is common practice to screen for various forms of thrombophilia (a propensity to form blood clots).[1]
References[edit | edit source]
- ↑ 1.0 1.1 Stam J (2005). "Thrombosis of the cerebral veins and sinuses". N. Engl. J. Med. 352 (17): 1791–8. doi:10.1056/NEJMra042354. PMID 15858188.
- ↑ Saposnik, Gustavo; Barinagarrementeria, Fernando; Brown, Robert D.; Bushnell, Cheryl D.; Cucchiara, Brett; Cushman, Mary; deVeber, Gabrielle; Ferro, Jose M.; Tsai, Fong Y. (2011). "Diagnosis and Management of Cerebral Venous Thrombosis". Stroke. 42 (4): 1158–1192. doi:10.1161/STR.0b013e31820a8364. ISSN 0039-2499.
- ↑ Kosinski CM, Mull M, Schwarz M; et al. (2004). "Do normal D-dimer levels reliably exclude cerebral sinus thrombosis?". Stroke. 35 (12): 2820–5. doi:10.1161/01.STR.0000147045.71923.18. PMID 15514174.
- ↑ Crassard I, Soria C, Tzourio C; et al. (2005). "A negative D-dimer assay does not rule out cerebral venous thrombosis: a series of seventy-three patients". Stroke. 36 (8): 1716–9. doi:10.1161/01.STR.0000173401.76085.98. PMID 16020765.
EncycloReader
is supported by the 
KSF