London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 813 882 Intracerebral/subarachnoid haemorrhage and venous diseases ANTICOAGULATION IS BENEFICIAL IN CEREBRAL VENOUS THROMBOSIS IRRE-SPECTIVE OF TYPE AND SEVERITY OF LESION N. AKHTAR1, S. KAMRAN2, G. MELIKYAN3, A. D’SOUZA4, Y. OSMAN5, Y. IMAM6, A. SHE-HAB7, F. IBRAHIM8, D. DELEU9 NEUROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QATAR1, NEU-ROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QATAR2, NEUROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QATAR3, NEUROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QATAR4, NEUROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QATAR5, NEUROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QATAR6, NEUROLOGY SECTION, HAMAD MEDICAL CORPO-RATION, DOHA, QATAR7, NEUROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QATAR8, NEUROLOGY SECTION, HAMAD MEDICAL CORPORATION, DOHA, QA-TAR9 Anticoagulation therapy is the most commonly accepted therapy in cerebral venous sinus thrombo-sis (CVST). But its role in different types of lesional and severe CVST is not well studied. AIM: To analyze the whether anticoagulation is equally beneficial in CVST with different lesions and se-verity. METHOD: We did a retrospective analysis of patients with CVST treated at Hamad Medical Corporation from January 2000 to October 2012. We recorded the demographic, etiologic, clinical, radiologic, treat-ment and prognostic features. Severity was defined as presence of intracranial bleed, rapidly wors-ening symptoms, coma, posterior fossa involvement, deep venous sinus involvement, and occlusion of 4 or more sinuses. RESULTS: Sixty-four patients identified, with M: F ratio of 1.6:1. Lesional CVT was found in 37 patients. This included infarction in 13 patients, hemorrhagic infarction in 16 patients, and pure intracerebral bleed 8 patients. Five patients had associated subarachnoid bleed, while one patient found to have asso-ciated subdural and other with intraventricular bleeds. Severe CVST was found in 32 patients, in whom 14 had coma, nine required intubation, 28 patients had four or more sinuses occlusion, 6 had deep sinus occlusion, and 7 had hydrocephalus. Severity of CVST was found to be associated with presence of rapidly worsening symptoms (p= 0.005), coma (p= 0.001), pure ICH (p= 0.004), hydro-cephalus (p= 0.002), occlusion of 4 or more sinuses (p= 0.005). Treatment with warfarin was given to 92% of patients, and 36% improved within 4-12 weeks. At three months 41% patients (n=26) had complete, 36% patients (n=23) had partial recanalization; while 24% had no repeat imaging. Six-ty- one patients (95%) were asymptomatic at 3 months. RESULT: Anticoagulation is beneficial in CVST, regardless of lesion type and severity. Large randomized controlled trials are required to further clarify this issue. 883 Intracerebral/subarachnoid haemorrhage and venous diseases Cerebral venous thrombosis and venous thromboembolism in inflammatory bowel disease S.M. Zuurbier1, A.C. van Dissel2, Y.A. Alderlieste3, J. Stam4, J.M. Academic Medical Centre, Amsterdam, THE NETHERLANDS1, Academic Medical Centre, Amsterdam, THE NETHERLANDS2, Academic Medical Centre, Amsterdam, THE NETHER-LANDS3, Academic Medical Centre, Amsterdam, THE NETHERLANDS4, Academic Medical Cen-tre, Amsterdam, THE NETHERLANDS5 Background. Venous thrombosis is a well-known complication of inflammatory bowel disease (IBD). Venous thromboembolism (VTE) - i.e. deep venous thrombosis and pulmonary embolism - accounts for 75% of thrombotic events among IBD patients, while cerebral venous thrombosis (CVT) is less frequent. We studied whether IBD patients with CVT differed from those with VTE with regard to clinical characteristics, treatment and outcome. Methods. We identified all IBD patients admitted to our hospital who suffered a venous thrombosis between 1998 and 2012. Patients were retrieved from 2 databases: a prospective database of consec-utive patients with confirmed IBD, and a database of consecutive CVT patients. Relevant data were extracted from the patient records. Results. Of 2485 patients from the IBD database and 130 patients from the CVT database, we iden-tified 37 IBD patients with venous thrombosis and IBD. There were 7 CVT patients (4 women) with a median age of 35 years (range 25-45) and 30 VTE patients (16 women) with a median age of 33 (range 14-72). CVT only occurred in patients with ulcerative colitis, whereas VTE was distribut-ed evenly between patients with ulcerative colitis and Crohn’s disease (43% and 57% respectively, p=0.007). In both groups, almost half of the thrombotic events occurred in the first year after the diagnosis of IBD (42% versus 43%, for CVT and VTE respectively), and thrombosis frequently oc-curred during an IBD flare (67% versus 65%, respectively). All CVT patients presented with head-ache, and 43% had one or more seizures. The majority of patients were treated with heparin (86% and 93%, for CVT and VTE respectively). One patient with a CVT died during the acute phase. 30% of the VTE patients experienced a recurrent thrombotic event, compared to no recurrences in the CVT group (p=0.16). Conclusion. In contrast to VTE, CVT had a predilection for ulcerative colitis in our study. Throm-botic recurrences appear to be more common among VTE patients.
Karger_ESC London_2013
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