Derya Uluduz1, Ipek Midi2, Taskin Duman3, Vildan Yayla4, Ali Yavuz Karahan5, Nazire Afsar6, Eylem Ozaydin Goksu7, Necdet Mengulluoglu8, Emrah Aytac9, Mehmet Ali Sungur10, Nilufer Yesilot11, Birsen Ince1, Osman Ozgur Yalin12, Serdar Oruc13, Mehmet Guney Senol14, Arda Yilmaz15, Mustafa Gokce16, Seden Demirci17, Ozge Yilmaz Kusbeci18, Gulnur Uzuner19, Hale Zeynep Batur Caglayan20, Mustafa Acikgoz21, Hatice Kurucu1, Fatih Ozdag22, Sevim Baybas23, Hakan Ekmekci24, Murat Cabala4, Mehmet Yaman13, Vedat Ali Yürekli25, Hakan Tekeli26, Hamit Genc15, Uygar Utku16, Sevki Sahin27, Firdevs Ezgi Ucan Tokuc7, Nevzat Uzuner19, Hesna Bektas28, Yuksel Kablan29, Basak Karakurum Goksel30, Aysel Milanlioglu31, Dilek Necioglu Orken32, Ufuk Aluclu33, Sena Colakoglu34, Ahmet Tufekci35, Mustafa Bakar36, Bijen Nazliel20, Nida Tascilar37, Baki Goksan1, Hasan Huseyin Kozak38, Serkan Demir26, Cemile Handan Mısırli39, Hayriye Kucukoglu23, Nilgun Cinar27, Fusun Mayda Domac40, Serefnur Ozturk24, Taskin Gunes12. 1. Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey. 2. Department of Neurology, Marmara University, School of Medicine, Istanbul, Turkey. 3. Department of Neurology, Mustafa Kemal University, School of Medicine, Hatay, Turkey. Electronic address: taskinduman@yahoo.com. 4. Clinic of Neurology, Saglik Bilimleri University, Bakirkoy Sadi Konuk Research and Training, Hospital, Istanbul, Turkey. 5. Department of Physical Medicine and Rehabilitation, Usak University, School of Medicine, Usak, Turkey. 6. Department of Neurology, Acıbadem Mehmet Aydinlar University, Istanbul, Turkey. 7. Clinic of Neurology, Antalya Research and Training Hospital, Antalya, Turkey. 8. Clinic of Neurology, Eskisehir Government Hospital, Eskisehir, Turkey. 9. Department of Neurology, Firat University, School of Medicine, Elazig, Turkey. 10. Department of Biostatistics, Duzce University, School of Medicine, Duzce, Turkey. 11. Department of Neurology, Istanbul University, School of Medicine, Istanbul, Turkey. 12. Clinic of Neurology, Saglik Bilimleri University, Istanbul Research and Training Hospital, Istanbul, Turkey. 13. Department of Neurology, Kocatepe University, School of Medicine, Afyon, Turkey. 14. Clinic of Neurology, Sisli Hamidiye Research and Training Hospital, Istanbul, Turkey; Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey. 15. Department of Neurology, Mersin University, School of Medicine, Mersin, Turkey. 16. Department of Neurology, Sütçü İmam University, School of Medicine, Kahramanmaraş, Turkey. 17. Department of Neurology, Aspendos Anatolian Hospital, Antalya, Turkey; Department of Neurology, Süleyman Demirel University, School of Medicine, Isparta, Turkey. 18. Clinic of Neurology, Bozyaka Research and Training Hospital, Izmir, Turkey. 19. Department of Neurology, Osmangazi University, School of Medicine, Eskisehir, Turkey. 20. Department of Neurology, Gazi University, School of Medicine, Ankara, Turkey. 21. Department of Neurology, Bülent Ecevit University, School of Medicine, Zonguldak, Turkey. 22. Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey. 23. Clinic of Neurology, Bakirkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey. 24. Department of Neurology, Selçuk University, School of Medicine, Konya, Turkey. 25. Department of Neurology, Süleyman Demirel University, School of Medicine, Isparta, Turkey. 26. Clinic of Neurology, Saglik Bilimleri University, II. Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey; Clinic of Neurology, Sancaktepe Research and Training Hospital, Istanbul, Turkey. 27. Department of Neurology, Maltepe University, School of Medicine, Istanbul, Turkey. 28. Clinic of Neurology, Ataturk Research and Training Hospital, Ankara, Turkey. 29. Department of Neurology, Inonu University, School of Medicine, Malatya, Turkey. 30. Department of Neurology, Baskent University, School of Medicine, Adana, Turkey. 31. Department of Neurology, Yüzüncü Yıl University, School of Medicine, Van, Turkey. 32. Department of Neurology, Demiroglu Bilim University, Istanbul, Turkey. 33. Department of Neurology, Dicle University, School of Medicine, Diyarbakir, Turkey. 34. Department of Neurology, Mustafa Kemal University, School of Medicine, Hatay, Turkey. 35. Department of Neurology, Recep Tayyip Erdoğan University, School of Medicine, Rize, Turkey. 36. Department of Neurology, Uludağ University, School of Medicine, Bursa, Turkey. 37. Department of Neurology, Bülent Ecevit University, School of Medicine, Zonguldak, Turkey; Department of Neurology, Medipol University, Istanbul, Turkey. 38. Department of Neurology, Necmettin Erbakan University, School of Medicine, Konya, Turkey. 39. Clinic of Neurology, Saglik Bilimleri University, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey. 40. Clinic of Neurology, Erenkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey.
Abstract
PURPOSE: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). METHOD: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. RESULTS: The mean age of the patients in the ES group was 39.73 ± 12.64 and 40.17 ± 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. CONCLUSIONS: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.
PURPOSE: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosispatients (CVST). METHOD: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. RESULTS: The mean age of the patients in the ES group was 39.73 ± 12.64 and 40.17 ± 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. CONCLUSIONS: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.