22. European Stroke Conference 873 Intracerebral/subarachnoid haemorrhage and venous diseases The Clinical Features of cerebral vein and sinus thrombosis in Chinese elderly patients H. Y. Ding1, J. Jiang2, Q. Dong3 Department of Neurology, Huashan Hospital, Fudan University, Shanghai, CHINA1, Labo-ratory of pharmacology, Aichi Medical University, Nagoya, JAPAN2, Department of Neurology, Huashan Hospital, Fudan University, Shanghai, CHINA3 Background: Cerebral vein and sinus thrombosis (CVST) predominates in young and middle-aged adults, as the increasing aging of the world population, the clinical features of CVST in elderly pa-tients should draw our attention to. Methods: During past nine years，82 cases of CVST were di-agnosed in Huashan Hospital. All the medical records, including sex, age, clinical manifestations, findings of imaging, treatment and prognosis were analyzed retrospectively. Patients were divided two groups according to age, young(<50 years) and elderly(≥50 years) age groups then analyzed the differences of features and prognosis between two groups. Results: Total 82 cases(52 men，30 women) mean age was 36.3±14.4 years（8-73 years）, 14 cases(17.1%) were aged≥50 years. There were no differences between the elderly and young groups concerning gender and causes. Presenta-tion as an isolated intracranial hypertension syndrome such as headache was less frequent in elderly patients(57.1% vs 89.7%, P <0.01), whereas local neurological injury signs such as hemiplegia was higher in elderly patients(78.6% vs 41.2%, P<0.05). There were no differences about depressed con-sciousness and mental status changes between two groups. There were higher occurrence of dural arteriovenous fistula(DAVF) accompanying with CVST in elderly group(21.4% vs 1.4%, P <0.01). There were no differences about the prognosis between two groups, however, the prognosis of pa-tients who had cerebral parenchyma damages were worse than that of patients with no parenchyma damages(P <0.05, modified Rankin scake≤2 indicated prognosis was good). Conclusion: Elderly pa-tients of CVST have the characteristics of less headache and higher local neurological injury symp-toms and more frequently accompanying with DAVF. The prognosis is worse in patients with brain parenchyma damages. 【Key words】 elderly patients ; cerebral vein and sinus thrombosis; clinical features Fig1，2 Male, 54 years old, DSA indicated left transverse sinus(TS) had DAVF, accompanying with superior sagittal sinus and bilateral TS thrombosis. 808 © 2013 S. Karger AG, Basel Scientific Programme 874 Intracerebral/subarachnoid haemorrhage and venous diseases POLYARTERITIS NODOSA IN ASSOCIATION WITH SUBARACHNOID HAEMOR-RHAGE : A CASE REPORT J.C. LACOUR1, S. RICHARD2, L. HUMBERTJEAN3, A.L. DERELLE4, R. ANXIONNAT5, X. DUCROCQ6 Service de Neurologie Bâtiment JEAN LEPOIRE, NANCY, FRANCE1, Service de Neurologie Bâtiment Jean LEPOIRE, NANCY, FRANCE2, Service de Neurologie Bâtiment Jean LEPOIRE, NANCY, FRANCE3, Service de Neuroradiologie Bâtiment Jean LEPOIRE, NANCY, FRANCE4, Service de Neuroradiologie Bâtiment Jean LEPOIRE, NANCY, FRANCE5, Service de Neurologie Bâtiment Jean LEPOIRE, NANCY, FRANCE6 BACKGROUND : Polyarteritis Nodosa is a rare systemic necrotising vasculitis of the medium size arteries that leads to aneurysms in various tissues. The central nervous system is sometimes involved but subarach-noid haemorrhage from ruptured aneurysm is extremely rare. We report a new case with perimesen-cephalic haemorrhage with an anterior spinal artery aneurysm. CASE REPORT : A 27 year-old man was admitted to our department complaining of sudden onset of lateral cervical pain and headache. He had previously experienced HTA, fugax amaurosis, livedo with subcutane-ous nodules, abdominal pain with urinary incontinence and weight loss. On admission, he appeared slight disorientated with Glasgow Scale Score of 13. Head CT and MRI revealed a moderate per-imesencephalic subarachnoid haemorrhage without hydrocephalus. Subsequent conventional angi-ography found an aneurysm on the anterior spinal artery with a dissecting aneurysm of the dominant left vertebral artery, another distal fusiform aneurysm of the parietal branch of the left middle cere-bral artery and several irregularities of the both external carotid arteries suggesting a diffuse vascu-litis. In laboratory findings, erythrocyte sedimentation ratio was increased to 67 mm/h with 38 mg/l CRP but serum tiers of ANA were all negative. Biopsy of a temporal artery failed but a subsequent skin analysis confirmed a diffuse leucoclasic vasculitis consistent with Polyarteritis Nodosa. We ad-ministered methylprednisolone 1000 mg day intravenously for 3 days, then prednisolone 60 mg day orally and the clinical status plainly improved with conservative therapy. DISCUSSION : Aneurysm associated with Polyarteritis Nodosa are common findings in visceral arteries and al-lowed the diagnosis. However, intracranial aneurysms are extremely rare with few cases reported in the literature. Thus, it seems to occur more frequently in the posterior circulation and as multiple le-sions compared with saccular aneurysms.Optimal management remains controversial but neurosur-gical treatment seems not always necessary.
Karger_ESC London_2013
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