Blood, 15 August 2006, Vol. 108, No. 4, pp. 1129-1134.
Prepublished online as a Blood First Edition Paper on April 11, 2006; DOI 10.1182/blood-2005-12-4795.
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REVIEW ARTICLES
Natural history of cerebral vein thrombosis: a systematic review
Francesco Dentali,
Monica Gianni,
Mark A. Crowther, and
Walter Ageno
From the Department of Medicine, McMaster University, Hamilton; and the Division of Cardiology, Department of Medicine, McMaster University, Hamilton, ON, Canada; and the Department of Clinical Medicine, University of Insubria, Varese, Italy.
Cerebral vein thrombosis (CVT) has been considered, until a few years ago, an uncommon disease with significant long-term morbidity and high mortality rate. New noninvasive diagnostic techniques have increased the frequency with which this disease is diagnosed; despite this, there continues to be little data on its natural history. The objectives of this study were to evaluate the mortality rate, the rate of disability at long-term follow-up, and the incidence of recurrence after a first episode of CVT; to determine clinical and radiologic predictors of death and dependence; and to identify possible risk factors for recurrence. (Data source: MEDLINE and EMBASE databases, reference lists of selected articles and authors' libraries.) Nineteen studies were identified. Mortality rate during peri-hospitalization period is 5.6% (range, 0%-15.2%) and 9.4% (range, 0%-39%) at the end of follow-up period. Eighty-eight percent of surviving patients recover completely or have only a mild functional or cognitive deficit. Two thirds of patients with CVT recanalized within the first few months after presentation, and 2.8% (range, 0%-11.7%) had objectively confirmed recurrence. We conclude that patients with CVT have a low risk of death and that most patients have a good long-term prognosis.
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