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Baptestini, Gheila Corrêa Ferres, Antonio Teixeira Matos, Paulo Roberto Cecon, and Suymara Toledo Miranda. "CARACTERIZAÇÃO DOS SÓLIDOS INTERSTICIAIS DE SISTEMAS ALAGADOS CONSTRUÍDOS DE ESCOAMENTO HORIZONTAL SUBSUPERFICIAL - DOI: 10.13083/1414-3984/reveng.v23n6p562-574." REVISTA ENGENHARIA NA AGRICULTURA - REVENG 23, no. 6 (March 17, 2016): 562–74. http://dx.doi.org/10.13083/reveng.v23i6.610.
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Com a realização deste estudo, objetivou-se avaliar o efeito da inversão no sentido do escoamento em sistemas alagados construídos de escoamento horizontal subsuperficial (SACs-EHSS) nas características qualitativas e quantitativas do material colmatante do meio poroso. Para isso, ao fim do período experimental, foram coletadas amostras do leito de seis SACs-EHSS: dois não cultivados (SACs-EHSS 1 e 4), dois cultivados com capim tifton 85 (Cynodon spp.) (SACs-EHSS 2 e 5) e dois cultivados com alternantera (Alternanthera philoxeroides) (SACs-EHSS 3 e 6). Das amostras retiradas do material poroso dos SACs foram separados e analisados os sólidos que ocupavam os poros. Nesse material foram quantificadas a massa de sólidos totais (CST), sólidos voláteis totais (CSVT) e sólidos fixos totais (CSFT) por volume de meio poroso (kg m-3) dos SACs-EHSS. Cada espécie vegetal influenciou de modo distinto a distribuição dos CST, CSFT e CSVT nos SACs-EHSS cultivados. Mesmo em condições de relação CSVT/CST baixa a fração orgânica dos sólidos proporcionou estruturação do material suporte superficial dos SACs-EHSS. A inversão no sentido do escoamento não proporcionou redução no acúmulo de matéria orgânica no meio poroso. O alto grau de colmatação dos SACs-EHSS impediu ou tornou menos perceptíveis e prolongados os efeitos positivos da inversão no sentido do escoamento na condição do meio poroso.
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Ranta, Susanna, Nadine Gretenkort Andersson, Ulf R. Tedgard, Tony Frisk, Maria Winther Gunnes, Jon Helgestad, Ólafur G. Jónsson, et al. "A Retrospective Multicenter Study from the Nordic Society of Pediatric Hematology and Oncology (NOPHO) on Cerebral Sinus Venous Thromboses in Children with Acute Lymphoblastic Leukemia." Blood 124, no. 21 (December 6, 2014): 584. http://dx.doi.org/10.1182/blood.v124.21.584.584.
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Abstract Introduction Cerebral sinus venous thrombosis (CSVT) is potentially life-threatening thrombosis with mortality around 10%. Venous thromboembolism (VTE) is a common complication in children with cancer. These children have several thrombotic risk factors such as the malignancy itself, severe infections, prothrombotic medication and immobilization. The treatment of acute lymphoblastic leukemia (ALL) includes steroids and asparaginase (ASP), raising the VTE risk. In children with ALL the central nervous system (CNS) is a common localization for VTE. However, retrospective studies on small numbers of patients, larger studies and population-based data in children are scarce. The five Nordic countries, Estonia and Lithuania have a common treatment protocol for children with ALL between 1 and 18 years of age with prospective registration of toxicities, including CSVT offering a unique opportunity to study CSVT in this patient group. This is to our knowledge the largest report of children with ALL and CSVT describing the incidence, symptoms, treatment and the effect of CSVT on ALL treatment. Methods We assessed the symptoms, treatment, clinical risk factors and outcome of all children between ages 1 and 17 years at diagnosis of B-cell precursor or T-cell ALL between June 2008 and July 2013 and with CSVT. Data were collected from the patients’ medical records and the NOPHO leukemia registry. Results In total, 20 (1.9%) of the 1038 children with ALL treated according to the NOPHO ALL 2008 protocol developed CSVT. The cumulative incidence of CSVT was 2.0%. All the thromboses occurred within the first 5 months of treatment. The most common symptoms at the diagnosis of CSVT were headache, convulsions, weakness/fatigue and cerebral nerve palsy/hemiparesis/hemiplegia. The most frequent localizations for CSVT were sinus sagittalis (n=16) and sinus transversus (n=10). However, in most cases multiple cerebral veins were involved ( 70%). Median D-dimer at time of the CSVT diagnosis was 0.85 mg/L (range 0.19-4.7 mg/L) with 5 patients having normal D-dimer. We could not identify any clinical risk factors for CSVTs. CSVT was associated with steroids (treatment within 2 weeks before the diagnosis of CSVT) in 16/20 and with Pegylated asparaginase in 16/20. Fifteen patients were later screened for the inherited thrombophilic factors; one child had heterozygous prothrombin G20110A mutation and another heterozygous factor V (R506Q) Leiden mutation. Most patients (19/20) were treated with anticoagulants: mostly low molecular weight heparin (LMWH). The median treatment with LMWH was 26 weeks (range 14-119 weeks). No bleeding complications were observed in connection with LMWH. Two deaths were directly related to CSVT. Asparaginase was omitted from the treatment in 7 and delayed or reduced in 5 of the cases raising the risk for subsequent suboptimal leukaemia treatment. Of the surviving 18 patients, follow-up imaging revealed complete recanalization in 7 and partial recanalization in 7 cases. No imaging was available for the remaining 4 patients. Conclusions The incidence of CSVT in children with ALL was approximately 2%. No statistically significant clinical predictors for CSVT were identified. The mortality related to CSVT was 10%. Anticoagulation with LMWH was the treatment of choice in most cased and was well tolerated. Disclosures No relevant conflicts of interest to declare.
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Garrido-Barbero, Maria, Juan Arnaez, Begoña Loureiro, Gemma Arca, Thais Agut, and Alfredo Garcia-Alix. "The Role of Factor V Leiden, Prothrombin G20210A, and MTHFR C677T Mutations in Neonatal Cerebral Sinovenous Thrombosis." Clinical and Applied Thrombosis/Hemostasis 25 (January 1, 2019): 107602961983435. http://dx.doi.org/10.1177/1076029619834352.
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Little is known about the pathogenesis of cerebral sinovenous thrombosis (CSVT) in the neonate. Although thrombophilia has been described as increasing the risk of CSVT in adults, it remains controversial in pediatric patients, and prospective case–control studies regarding neonatal CSVT are lacking. From 2008 to 2017, all 26 consecutive newborn infants ≥35 weeks of gestation diagnosed with neonatal CSVT, and their mothers, were tested for factor V Leiden (FV) G1691A, FII G20210A, and methylenetetrahydrofolate reductase C677T (MTHFR C677T) mutations. Eighty-five mother–infant pairs were recruited as controls. All infants except 1 with CSVT were suspected due to clinical symptoms, mainly seizures (22/25). Magnetic resonance imaging was performed in 24/26 infants. Heterozygous FV G1691A, FII G20210A, and homozygous MTHFR C677T mutations were present in 1/26, 3/26, and 3/20 infants with CSVT, respectively. FII (odds ratio: 10.96; 95% confidence interval [CI]: 1.09-110.35) and male sex (3.93; 95% CI: 1.43-10.76) were associated with CSVT. When FII G20210A analysis was adjusted for sex, the OR for FII G20210A was 6.70 (95% CI: 0.65-69.22). No differences were found for FV G1691A or homozygous MTHFR mutations between neonates with CSVT and their mothers, compared to controls.
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Sellers, Austin R., Anh Thy Nguyen, Marisol Betensky, Katie Mills, Neil A. Goldenberg, and Nir Shimony. "Risk Factors for Pediatric Cerebral Sinovenous Thrombosis: A Case-Control Study with Pediatric Neuroradiologist Case Validation." Blood 134, Supplement_1 (November 13, 2019): 2427. http://dx.doi.org/10.1182/blood-2019-130906.
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BACKGROUND: Cerebral sinovenous thrombosis (CSVT) is a rare but serious disease process among all patients, with a slightly higher prevalence in pediatric patients. Despite its low frequency, CSVT represents the second most common type of venous thromboembolism (VTE) in children, next to deep vein thrombosis (DVT) of the limbs. Current literature lacks robust evidence on risk factors for CSVT, especially in the pediatric population. We sought to determine risk factors of CSVT in pediatric patients, via a single-institutional case-control study. METHODS: A case-control study was conducted at Johns Hopkins All Children's Hospital from patients admitted between March 31st 2006 and April 1st 2018. Cases were identified based on ICD-9 and ICD-10 codes and confirmed via electronic medical record (EMR) review and neuroradiologist confirmation of radiologic testing. Two controls were then randomly selected for each CSVT case, matched by month and year of admission. Clinical and demographic parameters were collected via abstraction from the EMR, including: age at admission, prior history of VTE, previous hospitalization within 30 days, head/neck surgery, other major surgery, congenital or acquired heart disease, dehydration, cancer, serious infection (included meningitis, sepsis, pneumonia, osteomyelitis, fungemia, pyelonephritis, head/neck infection, abscess involving anatomic sites other than skin or head/neck), prematurity, mechanical ventilation, chronic inflammatory disease, cystic fibrosis, nephrotic syndrome, obesity, and head/neck trauma. Associations between CSVT and putative risk factors were evaluated via logistic regression, using odds ratios (ORs) and 95% confidence intervals (95%CIs). Those risk factors with P-values <0.1 in univariate logistic regression were included in adjusted (multivariate) logistic regression modeling; results of the latter employed a threshold of P<0.05 for statistical significance. RESULTS: A total of 60 CSVT cases and 120 controls were identified. Median (and interquartile range in) age was 4.79 years (0.02-13.56 years) for cases and 5.58 years (1.16-10.78 years) for controls. Factors putatively associated with CSVT in unadjusted analyses were: presence of central venous catheter; serious infection; mechanical ventilation; chronic inflammatory disease; and head/neck trauma. In the multivariate model, mechanical ventilation (OR=9.01, 95%CI=2.19-37.02) and head/neck trauma (OR=11.52, 95% CI=2.63-50.41) remained independent, statistically-significant risk factors for CSVT. CONCLUSIONS: This single-institutional case-control study reveals that mechanical ventilation and head/neck trauma are independent risk factors for pediatric CSVT. These findings will be further investigated via the multicenter Children's Hospital-Acquired Thrombosis (CHAT) registry dataset, by which a risk model for CSVT in children will be further developed and validated, in order to inform future preventive strategies in pediatric patients at heightened risk of CSVT. Table Disclosures Goldenberg: NIH: Other: research support and salary support.
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Waldman, Dalia, Aharon Lubetsky, Nurit Kornbrut, Abdalla Khalil, Ariel Koren, Baruch Wolach, Aviva Fattal, et al. "Paediatric cerebral sinus vein thrombosis." Thrombosis and Haemostasis 92, no. 10 (2004): 713–18. http://dx.doi.org/10.1160/th04-03-0182.
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SummaryThe etiology and pathophysiology of cerebral sinus venous thrombosis (CSVT) in the paediatric population is still poorly understood, and the role of thrombophilic risk factors remains to be elucidated. In our multi-center case-controlled study we studied 46 patients with CSVT diagnosed from April 1996 to December 2003, consecutively referred for thrombophilia work-up. The results of thrombophilia screen were compared to 112 healthy paediatric controls. Anticoagulant therapy was applied according to treating physicians’ decisions, and all cases were prospectively followed for a median of 4.1 years. Of 46 children, 8 had CSVT diagnosed in the neonatal period and therefore were analyzed separately. The prevalence of single thrombophilia markers and combinations of thrombophilic risk factors were similar among cases and controls. Among children with CSVT co-morbid systemic illness was present in most patients at diagnosis. Seven out of 8 children with idiopathic CSVT had thrombophilic risk factors as compared to 31/38 patients with co-morbid conditions. Anticoagulation was initiated in most patients, 11/46 patients continued therapy for a total of one year or more post event. Neither clinical presentation nor initial treatment decisions were affected by presence of thrombophilic risk factors in our study group. Thrombophilia prevalence was not increased in children with CSVT as compared to controls, however thrombophilia was more frequent among children with idiopathic CSVT. Thus, those selected patients would benefit most from thrombophilia work-up, required for long-term therapy considerations.
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Alvis-Miranda, Hernando Hernando, Sandra Milena Castellar-Leones, Gabriel Alcala-Cerra, and Luis Rafael Moscote-Salazar. "Cerebral sinus venous thrombosis." Journal of Neurosciences in Rural Practice 04, no. 04 (October 2013): 427–38. http://dx.doi.org/10.4103/0976-3147.120236.
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ABSTRACTCerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.
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Manorenj, Sandhya, and Sudhaker Barla. "Cerebral sinus venous thrombosis." International Journal of Research in Medical Sciences 5, no. 1 (December 19, 2016): 177. http://dx.doi.org/10.18203/2320-6012.ijrms20164544.
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Background: Intracranial Sino venous occlusive disease is an infrequent condition and accounts only 0.5-1% of all strokes. Objective of the study was to know the prevalence, pattern and risk factors involved in patients of cerebral sinus venous thrombosis (CSVT).Methods: Hospital databases were searched retrospectively and patients diagnosed with CSVT from December 2014 to February 2016 were identified. Data on clinical presentation, risk factor, cerebral sinus involved, hospital stay and outcome were analyzed.Results: Fifteen patients (3.4%) were identified as CSVT out of a total acute stroke case of 430. Mean age of patients was 31 years and 11 (73.3%) were males. The presenting symptoms included headache (n=14), altered sensorium (n=1) and seizures (n=5); signs included hemi paresis (n=4), papilledema (n=8) and bilateral VI nerve palsy (n=3). Majority had aseptic CSVT (n=14), and one patient had septic CSVT associated with tuberculous meningitis (TBM). Radiological findings included brain parenchyma involvement (n=8), subdural hematoma (SDH) (n=1), subarachnoid haemorrhage (SAH) (n=1) and normal brain parenchyma (n=5). Multiple cerebral sinuses were involved in seven patients. Most common site of CSVT was observed in sigmoid sinus. Risk factors included hyperhomocystenemia (n=3), protein S deficiency (n=8), protein C deficiency (n=6) and antithrombin III deficiency (n=3) as primary hypercoagulable state. ANA positive was observed in one patient and four had history of alcohol use. All fifteen patients received low molecular weight heparin (LMWH) for 1 week along with bridging oral anticoagulant. None of the patients required intrasinus thrombolysis and decompression surgery. Average hospital stay was 9 days. All had modified Rankin scale (MRS) ≤ 2 at 6 months follow up.Conclusions: Prevalence of CSVT is higher than that reported from Asian studies. Younger age and male predominance was observed. Protein S deficiency was the major risk factor for CSVT.
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Khan, Imad S., Travis R. Ladner, Komal F. Satti, Moneeb Ehtesham, Lori C. Jordan, and Robert J. Singer. "Endovascular thrombolysis for pediatric cerebral sinus venous thrombosis with tissue plasminogen activator and abciximab." Journal of Neurosurgery: Pediatrics 13, no. 1 (January 2014): 68–71. http://dx.doi.org/10.3171/2013.9.peds13335.
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Cerebral sinus venous thrombosis (CSVT) is a relatively rare but potentially devastating disease. Medical management of CSVT with systemic anticoagulation has been the mainstay treatment strategy with these patients. However, some patients may not respond to this treatment or may present with very severe symptoms indicating more aggressive management strategies. The authors present the case of a pediatric patient who presented with severe CSVT, who underwent successful recanalization with endovascular tissue plasminogen activator (tPA) and abciximab. To the authors' knowledge there are no cases of endovascular thrombolysis for CSVT described in the literature in which abciximab has been used in conjunction with tPA. The authors also review the literature regarding the agents used and outcome in pediatric patients with CSVT after endovascular thrombolysis. The use of abciximab in conjunction with tPA may be considered in patients whose blood is hypercoagulable and in whom the treatment strategy is to obtain acute recanalization and long-term venous patency. However, the use of adjunctive agents increases the risk of hemorrhagic complications and must be done judiciously.
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Rueda-Morales, G., and J. Ortiz-López. "CSVT Growth of Fullerene Polycrystalline Films." Fullerene Science and Technology 6, no. 5 (September 1998): 827–51. http://dx.doi.org/10.1080/10641229809350243.
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El-Khoury, Habib, Khaled M. Ghanem, Yaacoub Mubarak, Nidale Tarek, Hassan El Solh, Anthony K. C. Chan, Carole Aridi, Miguel R. Abboud, Raya Saab, and Samar A. Muwakkit. "Mediastinal Mass, Triglycerides Level Above 1000mg/Dl and Intensive Dexamethasone and Asparaginase Treatment Are Risk Factors for Cerebral Sinus Venous Thrombosis in Children Treated for Acute Lymphoblastic Leukemia at the Children's Cancer Center of Lebanon." Blood 132, Supplement 1 (November 29, 2018): 5163. http://dx.doi.org/10.1182/blood-2018-99-119638.
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Abstract Background: Cerebral sinus venous thrombosis (CSVT) is a serious complication of childhood acute lymphoblastic leukemia (ALL) therapy. No universal consensus exists regarding its risk factors due to rarity of cases. The effect of CSVT on outcome is not limited to its own complications but extends to its possible negative impact on ALL therapy. Age above 10 years, T-cell immunophenotype and risk stratification (intermediate/high risk) were previously shown to be statistically significant risk factors for CSVT in our cohort of patients with an odds ratio of 3.56, 2.32 and 3.40 respectively and a P-Value of 0.03, 0.02 and 0.04 respectively (Ghanem et al. 2017). Aims and Methods: This is a prospective study of a pediatric cohort of children between 1 and 18 years of age treated for Acute Lymphoblastic Leukemia at the Children's Cancer Center of Lebanon (CCCL) between 2007 and 2017 with a protocol adopted from St Jude TOT XV. The aim of this analysis is to study the effect of decreasing asparginase and dexamethasone doses on the incidence of CSVT in addition to studying the effect of the following potential risk factors: presence of mediastinal mass at diagnosis, triglycerides level above 1000mg/dL and elevated initial blast count. In 2015, L-asparginase doses were decreased during induction from 10,000IU/m2/dose to 6,000IU/m2/dose and Dexamethasone doses were decreased from 12mg/m2/dose to 8mg/m2/dose for intermediate/high risk patients and from 8mg/m2/dose to 6mg/m2/dose for low risk patients. Patients were divided into two groups: group I for individuals treated between 2007 and 2015 and group I for individuals treated between 2015 and 2017. Results: A total of 202 patients were recruited (Group I, N=126 and Group II, N=76). The incidence of CSVT was 10.3% in group I and 1.3 % in group II. Univariate analysis showed that, treatment with intensive dexamethasone and asparginase in group I was a significant risk factor for CSVT (OR: 9.3, 95% CI: 1.2 - 72, P=0.03). Initial mediastinal mass (OR: 19.3, 95% CI: 5.4 - 68.6, P<0.0001) and triglycerides level above 1000mg/dL (OR: 3.4, 95% CI: 0.98 - 12, P=0.05) were also associated with increased risk of CSVT. Initial peripheral blast count ≥10,000 (OR: 0.57, 95% CI: 0.19 - 1.7, P=0.31), ≥50,000 (OR: 0.7, 95% CI: 0.14-3.35, P=0.66), and ≥100,000 (OR: 1.53, 95% CI: 0.29-7.82, P=0.61) were not risk factors for CSVT in our cohort. Conclusion: Decreasing the doses of dexamethasone and asparginase significantly lowered the risk of CSVT in our patient population. Initial mediatinal mass and triglycerides levels above 1000mg/dL during asaparginase therapy were significantly associated with increased risk of developing CSVT. If future studies confirm our findings, mediastinal mass and elevated triglycerides level may be considered amongst other factors predisposing to CSVT and may help identify candidates for thromboprophylaxis in the future. Disclosures No relevant conflicts of interest to declare.
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Holzhauer, Susanne, Christine Heller, Knöfler Ralf, Kentouche Karim, Krümpel Anne, Kurnik Karin, and Ulrike Nowak-Gottl. "Cerebral Venous Thrombosis in Neonates, Children and Adolescents; Results from the German Pediatric Surveillance Unit for Rare Pediatric Diseases (ESPED)." Blood 128, no. 22 (December 2, 2016): 420. http://dx.doi.org/10.1182/blood.v128.22.420.420.
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Abstract INTRODUCTION: Cerebral sinovenous thrombosis (CSVT) is a serious disease, that leads to longterm neurological sequaelae in the majority of survivors. There is uncertainty with regard to age specific individual risk factors, the impact of hereditary thrombophilia or underlying diseases on development of thrombosis or outcome. Previously published cohort studies have described epidemiology, treatment practices and outcomes, but those studies are limited due to small sample size or diversity of the populations included. Neonatal CSVT is seen as a disease entity different from cerebral thrombosis in older children with regard to etiology and outcome, evidence is lacking. OBJECTIVES: To evaluate the influence of transient risk factors and hereditary thrombophilia on clinical course, treatment practices and early outcome in a population based national cohort of children with CSVT. To study the influence of age (neonatal versus pediatric) on risk factors and outcome in CSVT. METHODS: We conducted a prospective nationwide surveillance study in pediatric patients <18 years through the hospital-based German Pediatric Surveillance Unit (ESPED). We included consecutive patients from 0-18 years of age admitted to hospitals in Germany with diagnosis of a first CSVT with an enrolment period between 2001-2010. Diagnosis was confirmed using MRI or CT imaging. Laboratory analysis of coagulation parameters have either been analyzed according to standardized thrombophilia screening protocols in the local hospitals or centrally in study center at the University of Muenster. We followed the course of disease over a period of 36 months. Follow up investigation included repetitive MRI or CT imaging and questionnaires on clinical outcome and recurrence. RESULTS: A total of 599 patients, from birth to 18 years with a diagnosis of CSVT were enrolled in the study. We have observed a male predominance with 61%. 138 (23%) CSVT cases were diagnosed during the neonatal period, 461 (77%) patients were older than one month at time of diagnosis. In our cohort 40% of neonates and 20% of older infants/children developed thrombosis without identified underlying predisposing diseases. The majority of transient triggers associated with the development of thrombosis were local (mastoiditis, 18%) or systemic (sepsis, meningitis, 13%) infections or asparaginase administration during treatment for leukemia or lymphoma (12%). Outcome, dependent both on age at onset and existence of transient triggers was worse in children with spontaneous CSVT compared to triggered CSVT with regard to mortality rate (11 vs. 3%), patency of the veins and neurological impairment. Moreover, presenting symptoms as well as the clinical course differed between neonates and older infants/children. CONCLUSION: In the pediatric population studied most of CSVT events were associated with infections as transient trigger. CSVT in neonates and children older than 1 months of age differed both with regard to underlying risk factors, treatment and outcome. Age specific, randomized controlled trials comparing treatment strategies are needed to optimize care in these patients. Disclosures No relevant conflicts of interest to declare.
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Ghedira Besbes, L., S. Haddad, A. Gabsi, M. Hassine, Ch Ben Meriem, and M. N. Guediche. "Cerebral Sinovenous Thrombosis in a Child with Idiopathic Nephrotic Syndrome." Case Reports in Nephrology 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/724950.
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Nephrotic syndrome (NS) is a renal disorder characterized by heavy proteinuria, hypoalbuninemia, edema and hypercholesterolemia. Nephrotic syndrome in children is known to be associated with an hypercoagulable state and thromboembolic complications. However cerebral sinovenous thrombosis (CSVT) is very rare. Here we report a seven-year-old child with steroid-dependent idopathic nephrotic syndrome resulting from a minimal change disease, developed multiple cerebral sinovenous thrombosis, presenting with headache, left sixth nerve palsy, and papilledema. The diagnosis of CSVT was established by cranial computed tomography, magnetic resonance imaging, and magnetic resonance angiography. He gradually recovered after anticoagulant therapy. CSVT is very rare in nephrotic children. The diagnosis of CSVT should be considered in any patient with nephrotic syndrome who develops neurologic symptoms. This report highlights the importance of suspecting and recognizing this potentially life threatening complication and initiating early treatment.
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Chen, Hsian-Min, Clayton Chi-Chang Chen, Fong Y. Tsai, Cherng-Gueih Shy, Chen-Hoa Wu, Wen-Shien Chen, and Hao-Chun Hung. "Cerebral Sinovenous Thrombosis." Interventional Neuroradiology 14, no. 2_suppl (November 2008): 35–40. http://dx.doi.org/10.1177/15910199080140s208.
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Cerebral sinovenous thrombosis (CSVT) is an uncommon disorder that affects the dural venous sinus and cerebral vein. In our study, thirty-four patients were examined. Pre and/or post contrast-enhanced CT was done in 28 patients. MRI studies were done in 24 patients. 2-D TOF MR venography (MRV) and contrast-enhanced MRV (CEMRV) were done in 19 cases. Digital subtraction angiography (DSA) was done in 18 patients. Sixteen patients received systemic intravenous heparinization, and 12 received endovascular thrombolytic treatment with urokinase combined with anticoagulant therapy. Neuroimages of CSVT can be acquired by direct visualization of the thrombus within the dural sinus or by parenchymal changes secondary to venous occlusion. As there are some pitfalls to MRI in the diagnosis of CSVT, the combination of MRI and MRV is now the gold standard in the diagnosis of CSVT. Usually, accuracy can be improved by applying 2-D TOF MRV and CE MRV. Furthermore, the source image of MRV is critical in differentiating between normal sinus variations and diseased ones. DSA is the best tool for demonstrating dynamic intracranial circulation in CSVT and mostly is used for endovascular treatment. Systemic intravenous anticoagulant therapy with heparin is accepted as a first line treatment. Except for clinical manifestations after systemic heparinization, abnormal MR findings of parenchymal change can be used to determine when to initiate thrombolytic treatment. Endovascular therapy can be finished at the ante-grade flow within the dural sinus and continuous anticoagulation is sufficient to facilitate clinical improvement. Clinical suspicion and excellent neuroimaging are crucial in making the diagnosis of CSVT. Proper management with anticoagulants and/or endovascular thrombolytic therapy is mandatory in preventing propagation of the thrombosis and improving the clinical outcome.
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Torres, Marcela, Tyler Hamby, Sarah Philip, and Jo Ann Tilley. "Catheter Directed Thrombolytic Therapy for Pediatric Cerebral Sinus Vein Thrombosis." Blood 134, Supplement_1 (November 13, 2019): 3666. http://dx.doi.org/10.1182/blood-2019-132082.
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Background: Cerebral sinus vein thrombosis (CSVT) involves the thrombosis of the dural sinus and/or cerebral veins and it is considered a form of stroke. The estimated incidence of CSVT in children is 0.6 per 100,000 children per year. Poor outcomes, including death, happen in 9 to 29% of patients affected by CSVT. In addition, neurologic deficits, affecting primarily cognition and behavior, are seen in 50% of affected children. No randomized clinical trials have been conducted on pediatric CSVT so current guidelines for treatment have been extrapolated primarily from adult studies. Published guidelines by the American College of Chest Physicians, American Heart Association and American Society of Hematology, support the use of anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH). These same guidelines also suggest that catheter directed thrombolysis (CDT) with tissue plasminogen activator (tPA) and mechanical thrombectomy (MT) could be used when there has been clinical deterioration or no improvement (clot progression) despite anticoagulation. In all cases, these are based on uncontrolled case series and expert opinion. There is very little data on the safety and efficacy of CDT and/or MT for pediatric CSVT. Method: Pediatric patients with CSVT seen at Cook Children's Medical Center from January 1, 2008 to December 31, 2018 were identified by searching EMR using ICD-9 and ICD-10 codes. From this group, patients treated with MT and CDT in addition to anticoagulation were selected and reviewed. Results: Five children (4 to 14 y/o) were treated with MT and CDT after failing anticoagulation with UFH or LMWH. Diagnosis was made by MRI/MRV and all had CSVT of multiple sinuses. Four patients had more than one underlying disorders/factors that increased their risk for thrombosis including: Ulcerative Colitis in 2, severe anemia in 2, Systemic Lupus Erythematosus (SLE) in 1, use of oral contraceptives together with obesity and bacterial sepsis in 1. Two patients did have a thrombophilia: Protein S deficiency in 1 and Protein S and C deficiency in another. One patient with SLE had a positive hexagonal phase neutralization test but rest of evaluation was negative. Three patients had systemic bleeding prior initiation of UFH and MT/CDT. All children were treated with UFH, and due to clinical neurologic deterioration and/or worsening of imaging findings (4 comatose and 1 with persistent increased ICP), all underwent thromboaspiration and catheter directed infusion of tPA for 17 to 48 hours at a dose of 1 to 2 mg/hr. All patients continued anticoagulation with UFH during catheter directed tPA infusion and after the catheter was removed. All cases had partial resolution of the sinus vein thrombosis, although 1 had quick reocclusion. Post procedure bleeding happened in 1 patient who had also had an external ventricular drainage placed and developed parenchymal and intraventricular hemorrhage that led to discontinuation of tPA infusion, and 2 patients developed petechial brain hemorrhages. Four patients had great neurologic recovery and minimal deficits, but 1 had significant neurologic deficits. One patient died from lupus complications. (Table) Conclusion: Endovascular therapy including MT and CDT with tPA in conjunction with systemic UFH, may have a role in pediatric patients with CSVT who have deterioration despite initial anticoagulation. In our series, after procedures, all patients had partial resolution of their CSVT (but 1 had quick reocclusion) and 4 out of 5 patients had good neurologic outcomes despite bad predictor signs (coma, extensive CSVT). Further studies are needed to identify which patients would benefit from early endovascular treatment. Table Disclosures No relevant conflicts of interest to declare.
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Perrier, G., R. Philippe, and J. P. Dodelet. "Growth of semiconductors by the close-spaced vapor transport technique: A review." Journal of Materials Research 3, no. 5 (October 1988): 1031–42. http://dx.doi.org/10.1557/jmr.1988.1031.
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The close-spaced vapor transport (CSVT) is an efficient and cost-effective technique that allows the growth of polycrystalline as well as epitaxial thin layers of semiconductors. The close spacing between a source and a substrate, introduced in 1963 as a special feature in the vapor phase method, has been applied to about 18 semiconductors with a special focus on CdTe and GaAs. This paper reviews the close-spaced technique, the models presented to explain the film growth rates, the transport reactions, and film characteristics for all the semiconductors that have been obtained by CSVT. All-thin-film structures for solar cells or other applications are certainly feasible with the use of the CSVT technique when a good lattice matching exists between the successive layers.
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Suppiej, Agnese, Chiara Gentilomo, Paola Saracco, Stefano Sartori, Manuela Agostini, Rossana Bagna, Bianca Bassi, et al. "Paediatric arterial ischaemic stroke and cerebral sinovenous thrombosis." Thrombosis and Haemostasis 113, no. 06 (November 2015): 1270–77. http://dx.doi.org/10.1160/th14-05-0431.
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SummaryData from large case series of children with cerebral thrombotic events are pivotal to improve prevention, early recognition and treatment of these conditions. The Italian Registry of Pediatric Thrombosis (R. I. T. I.) was established in 2007 by a multidisciplinary team, aiming for a better understanding of neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols. We analysed data relative to the paediatric cerebral thrombotic events of the R. I. T. I. which occurred between January 2007 and June 2012. In the study period, 79 arterial ischaemic stroke (AIS) events (49 in males) and 91 cerebral sinovenous thrombosis (CSVT) events (65 in males) were enrolled in the R. I. T. I. Mean age at onset was 4.5 years in AIS, and 7.1 years in CSVT. Most common modes of presentation were hemiparesis, seizures and speech disturbances in AIS, and headache, seizures and lethargy in CSVT. Most common etiologies were underlying chronic diseases, vasculopathy and cardiopathy in AIS, and underlying chronic diseases and infection in CSVT. Time to diagnosis exceeded 24 hours in 46 % AIS and 59 % CSVT. Overall data from the Italian Registry are in substantial agreement with those from the literature, despite small differences. Among these, a longer time to diagnosis compared to other registries and case series poses the accent to the need of an earlier recognition of paediatric cerebrovascular events in Italy, in order to enable prompt and effective treatment strategies.
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Idiculla, Pretty Sara, Dhineshreddy Gurala, Manikandan Palanisamy, Rajendran Vijayakumar, Sindhu Dhandapani, and Elanagan Nagarajan. "Cerebral Venous Thrombosis: A Comprehensive Review." European Neurology 83, no. 4 (2020): 369–79. http://dx.doi.org/10.1159/000509802.
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Background: Cerebral sinus venous thrombosis (CSVT) is a relatively rare, potentially fatal neurological condition that can be frequently overlooked due to the vague nature of its clinical and radiological presentation. A literature search on PubMed using the keyword “Cerebral sinus venous thrombosis” was performed. We searched for the epidemiology, risk factors, pathophysiology, clinical features, diagnosis, and treatment of CSVT. All full-text articles in the last 10 years, in adults (>18 years), and the English language were included. We aim to give a comprehensive review of CSVT, with a primary focus on the management of the disease. Summary: The literature search revealed 404 articles that met our criteria. CSVT is a relatively rare condition that accounts for approximately 1% of all forms of stroke. They can be subdivided into acute, subacute, and chronic forms based on the time of onset of clinical symptoms. It is a multifactorial disease, and the major forms of clinical presentation include isolated intracranial hypertension syndrome, focal neurological deficits, and cavernous sinus syndrome. MRI with magnetic resonance venogram (MRV) is considered the gold standard for diagnosis. Anticoagulation with heparin or low-molecular-weight heparin is the mainstay of treatment. Endovascular management is indicated for those cases with severe symptoms or worsening of symptoms despite anticoagulation therapy. Favorable outcomes have been reported in patients who receive early diagnosis and treatment. Conclusion: CSVT is a potentially fatal neurological condition that is often under-diagnosed due to its nonspecific presentation. Timely diagnosis and treatment can reduce morbidity and mortality, remarkably improving the outcome in affected individuals.
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Corrales-Medina, Fernando F., Nidra Rodriguez, Daniela E. Egas-Bejar, Zoila Valdivia-Ascuna, Leon Grant, and Pedro Mancias. "Cerebral Sinovenous Thrombosis Related to Iron Deficiency Anemia As a Result of Severe Menorrhagia: A Case Report." Blood 120, no. 21 (November 16, 2012): 5143. http://dx.doi.org/10.1182/blood.v120.21.5143.5143.
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Abstract Abstract 5143 Cerebral sinovenous thrombosis (CSVT) is a rare condition with a wide spectrum of non-specific symptoms, which makes it occasionally difficult to diagnose. CSVT has been associated with various etiologies including dehydration, hypercoagulable states, neoplasmic invasion of a venous sinus, intracranial and systemic infections, use of oral contraceptives, puerperium and pregnancy. Although iron deficiency anemia (IDA) has been reported as a cause of CSVT in several pediatric cases, this association is extremely rare. To our knowledge, IDA-associated CSVT in teenagers has been rarely reported. Here, we present the case of a 13-year old female with complete thrombosis of the vein of Galen, the straight sinus, and the left internal cerebral vein related to iron deficiency anemia as a result of severe menorrhagia. She initially presented with three-week history of headaches, nausea and vomiting. She was initially diagnosed and treated for bacterial sinusitis by her primary pediatrician, without symptom relief. She then suffered a syncopal episode, reason why she was evaluated at our institution. Initial laboratories revealed a slightly increased PT (15. 6 secs), hemoglobin of 5. 1 g/dL, MCV 63. 6 and D-dimer 1. 31. Non-contrast brain CT demonstrated no evidence of stroke, hemorrhage or mass. However, an abnormal hyperdensity in the straight sinus, inferior sagittal sinus, vein of Galen, and deep cerebral veins, were suggestive of venous thrombosis. Findings were then confirmed by brain MRI/MRV/MRA and CT angiogram. A bleeding work-up performed based on her history of heavy menses was normal. Her ferritin level was significantly decreased (6 ng/mL). Iron supplementation was initiated as well as progestin-only hormonal therapy for menstrual cycle regulation. The patient's clinical status improved back to baseline during her 8-day admission. She was discharged home on anticoagulation with scheduled follow up. Brain MRI/MRV six months later showed patency of the cerebral veins and dural venous sinuses. IDA should be considered as an underlying cause of CSVT in pediatric patients, particularly in patients with other risk factors for thrombosis including dehydration, regardless of their age. Early recognition and management of CSVT is critical to minimize the possibility of permanent neurologic damage. Physicians should be aware of the non-specific signs and symptoms of CSVT and should have a high index of suspicion in patients with anemia. Disclosures: No relevant conflicts of interest to declare.
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Okunola, P. O., G. E. Ofovwe, M. T. Abiodun, and C. P. Azunna. "Superior Sagittal Sinus Thrombosis Complicating Typhoid Fever in a Teenager." Case Reports in Pediatrics 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/201203.
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Cerebral venous sinus (sinovenous) thrombosis (CSVT) is a rare life-threatening disorder in childhood that is often misdiagnosed. CSVT encompasses cavernous sinus thrombosis, lateral sinus thrombosis, and superior sagittal sinus thrombosis (SSST). We present an adolescent girl who was well until two weeks earlier when she had a throbbing frontal headache and fever with chills; she later had dyspnoea, jaundice, melena stool, multiple seizures, nuchal rigidity, and monoparesis of the right lower limb a day before admission. Urine test forSalmonellatyphi Vi antigen was positive, and Widal reaction was significant. Serial cranial computerized tomography scans revealed an expanding hypodense lesion in the parafalcine region consistent with SSST or a parasagittal abscess. Inadvertent left parietal limited craniectomy confirmed SSST. She recovered completely with subsequent conservative management. Beyond neuropsychiatric complications of Typhoid fever, CSVT should be highly considered when focal neurologic deficits are present.
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Poduva, Gopal. "Post partum hypernatremia with necrotizing myopathy and CSVT." MRIMS Journal of Health Sciences 6, no. 4 (2018): 116. http://dx.doi.org/10.4103/2321-7006.303087.
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Benhalima, O., F. Chouia, B. Chouial, B. Hadjoudja, S. Silini, and A. Chibani. "Effect of iodine utilisation conditions on CSVT deposited CuInSe2films." Surface Engineering 31, no. 10 (April 2, 2015): 752–56. http://dx.doi.org/10.1179/1743294415y.0000000020.
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Komwilaisak, Patcharee, Leonardo Brandao, Susan Blaser, Peter Dirks, Gabrielle deVeber, Suzan Williams, Anthony K. C. Chan, and Kulkarni Ahbaya. "Cerebral Sinovenous Thrombosis Post Head Injury - 10 Year Experience in Children." Blood 106, no. 11 (November 16, 2005): 4132. http://dx.doi.org/10.1182/blood.v106.11.4132.4132.
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Abstract Cerebral sinovenous thrombosis (CSVT) post head injury is infrequently diagnosed in children. We retrospectively reviewed 323 patients with histories of head injury and a computerized tomography scan of the head from June 1996 to June 2005. Twelve patients (3.7%) were diagnosed with CSVT. The mean age was 6 years (range from 2 to 15 years). Male to female ratio was 10:2. The mechanism of injury included motor vehicle accidents in 5 patients, and falls in 7 patients. Nine patients had minor head injuries (GCS> 8) whereas 3 patients had severe head injuries (GCS<8). The most common presenting symptom was vomiting in 5 patients and other less common symptoms including: headache, seizure and irritability. The commonest locations of thrombosis were sigmoid and transverse sinus. Four patients had extensive thrombus involving more than 3 sinuses. Of the 12 patients, 9 (75%) patients had skull fractures and 6 (50%) had epidural hematomas in association with CSVT. Seven patients (58%) received anticoagulant treatment. The duration of anticoagulant therapy was from 2 days to 6 months. Anticoagulation was discontinued in 3 patients (25%) due to extension of CNS bleeding. All patients receiving anticoagulation were therapeutic with an anti-factor Xa level of 0.5–1 units/mL on enoxaparin, 0.35–0.7 units/mL on standard heparin and INR level of 2–3 on Coumadin. There was complete resolution in 6 patients with the imaging done in a mean followup of 78.5 days, partial resolution in 3 patients with the mean followup imaging in 95.6 days, unchanged status in 1 patient 6 days after the diagnosis and no followup imaging in 2 patients. Six patients had thrombophilic work-up and all were normal. Of the 7 patients with full recovery, 3 patients did not receive anticoagulation. Four patients had seizure and headache, left hemiparesis, panhypopituitarism and optic atrophy, and attention deficit disorder, respectively. In conclusion, the prevalence of CSVT post head injury in children was approximately 3.7%. The etiology of CSVT in this situation might be associated with skull fracture and hematoma, which could compress the cerebral sinus. Large prospective studies involving multiple centers are required to ascertain whether prothrombotic investigations are necessary and if anticoagulation improves neurologic outcome in patients with CVST post head injury.
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Terashima, Mari, Hiroshi Kataoka, Hirosei Horikawa, Hiroyuki Nakagawa, Toshiaki Taoka, Masanori Matsumoto, Kozue Saito, Kimihiko Kichikawa, and Satoshi Ueno. "Cerebral Sinus and Venous Thrombosis Associated with von Willebrand Factor, Independently of Factor VIII." Clinical Medicine: Case Reports 1 (January 2008): CCRep.S737. http://dx.doi.org/10.4137/ccrep.s737.
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Background and purpose Previous studies have linked procoagulant factor VIII (F VIII) to an increased risk of venous thrombosis, whereas the relation between plasma von Willebrand factor (VWF) and venous thrombosis remains poorly understood. Elevated VWF levels are frequently found in patients with cerebral sinus and venous thrombosis (CSVT), always in association with high F VIII levels. We describe a patient with CSVT accompanied by elevated VWF levels without high F VIII levels. Case description A 23-year-old healthy man who had headache noticed difficulty in moving the right hand. On the following day, he lost consciousness and had partial seizures of the right hand. After regaining consciousness, weakness of the right extremities developed. The cranial angiogram confirmed occlusion of the superior sagittal sinus. The levels of VWF and F VIII were 238% and 101.9 IU/dl, respectively. We performed balloon percutaneous transluminal angioplasty and mechanical thrombectomy, leading to successful recanalization of the intracranial sinuses. VWF levels were decreased along with radiographic improvement, independently of F VIII. Conclusion VWF may contribute to CSVT and that inhibition of VWF activity potentially has a role in the future treatment of pathological conditions related to venous thrombosis.
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Goiz, O., F. Chávez, C. Felipe, R. Peña-Sierra, and N. Morales. "CSVT as a Technique to Obtain Nanostructured Materials: WO3-x." Journal of Nano Research 9 (February 2010): 31–37. http://dx.doi.org/10.4028/www.scientific.net/jnanor.9.31.
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The growth of tungsten oxide nanowires on silicon substrates without using any catalyst is demonstrated by means of close-spaced vapor transport (CSVT) technique at atmospheric pressure. The source was formerly prepared from a tungsten foil to produce a tungsten oxide film. CSVT array is completed with silicon substrates located at a distance of ~350 m over the tungsten oxide source at moderate temperatures (~750°C). Two distinct kinds of nanostructures were produced; a uniform distribution of free standing tungsten oxide wires of several micrometers in length with diameters less than 150 nm; and wires assembled to form nanowire bundle. The X-ray diffraction characterizations show that the phases of WO2.7 and WO2.9 are present.
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Gorthi, S. P., N. Ashwini, M. Thumbi, and P. Varsha. "Treatment patterns and outcome in cerebral venous sinus thrombosis (CSVT)." Journal of the Neurological Sciences 405 (October 2019): 100–101. http://dx.doi.org/10.1016/j.jns.2019.10.407.
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Felling, Ryan J., Sahar M. A. Hassanein, Jennifer Armstrong, Luis Aversa, Lori Billinghurst, Neil A. Goldenberg, Jo Ellen Lee, Emily C. Maxwell, Michael J. Noetzel, and Warren Lo. "Treatment and outcome of childhood cerebral sinovenous thrombosis." Neurology: Clinical Practice 10, no. 3 (September 12, 2019): 232–44. http://dx.doi.org/10.1212/cpj.0000000000000720.
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ObjectiveTo test our hypothesis that anticoagulation is associated with better neurologic outcomes in childhood cerebral sinovenous thrombosis (CSVT), we analyzed treatment and outcomes in a population of 410 children from the International Pediatric Stroke Study (IPSS).MethodsWe included patients enrolled in the IPSS registry with a diagnosis of CSVT at age >28 days with radiologic confirmation, in isolation or with concomitant arterial ischemic stroke. The primary outcome was the neurologic status at discharge. We defined unfavorable outcome as severe neurologic impairment or death at discharge. The Pediatric Stroke Outcome Measure was used for long-term outcome in those with follow-up. Predictors of anticoagulation use and outcome were analyzed by logistic regression.ResultsMost children (95%) had identifiable risk factors, and 82% received anticoagulation. Shift analysis demonstrated better outcomes at discharge in children who were anticoagulated, and this persisted with longer-term outcomes. In multivariable analysis, anticoagulation was significantly associated with favorable outcomes (adjusted odds ratio [aOR] unfavorable 0.32, p = 0.007) whereas infarct was associated with unfavorable outcome (aOR unfavorable 6.71, p < 0.001). The trauma/intracranial surgery was associated with a lower odds of anticoagulation use (aOR 0.14, p < 0.001).ConclusionsWithin the IPSS registry, children with risk factors of trauma or intracranial surgery were less likely to receive anticoagulation for CSVT. Anticoagulation was associated with a lower odds of severe neurologic impairment or death at hospital discharge, but this finding is limited and needs further confirmation in randomized, controlled, prospective studies.
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Cossement, D., Z. Huang, G. Perron, B. Jean, and J. P. Dodelet. "GaAs epitaxial layers obtained by close-spaced vapor transport in H2 + H2O and H2 + CO2 ambients: Fine control of the growth rate and its effect on the electrical properties of the layers." Canadian Journal of Physics 72, no. 1-2 (January 1, 1994): 44–50. http://dx.doi.org/10.1139/p94-008.
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In view of developing the close-spaced vapor transport technique (CSVT) to obtain III/V homojunction solar cells, it is necessary to finely control the growth rate of GaAs epitaxial layers. This has been performed either by controlling the water vapor pressure, [Formula: see text] injected in the reactor along with H2, in H2 + H2O ambient, or by controlling the water vapor pressure generated in situ by the reaction of H2 + CO2 in the reactor. For H2 + CO2 ambient, [Formula: see text], controls [Formula: see text] according to the following reaction: [Formula: see text]. The growth rates calculated with a diffusion controlled model are in agreement with the experimental values for both ambients, including the observation of a maximum in the evolution of the growth rate with [Formula: see text], Controlling the growth rate of GaAs by changing [Formula: see text] affects the carrier density (NA–ND) of p-type layers grown from Zn-doped GaAs sources. In both ambients (NA–ND) is a function of [Formula: see text]. Such a behavior is also obtained for the calculated carrier densities. It is the result of the transport of Zn as ZnO in CSVT. In H2 + CO2 ambient, where H2O and C are generated in situ, carbon is not incorporated as a major p-type doping impurity, contrarily to expectations, n-type GaAs layers were also obtained from Te-doped GaAs sources. In that case, the measured NA–ND values are not affected by changes in [Formula: see text] because water is not involved in the transport of Te in CSVT.
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Chávez, F., C. Felipe, E. Lima, E. Haro-Poniatowski, C. Ángeles-Chávez, O. Goiz, R. Peña-Sierra, and M. A. Camacho-López. "HFCVD and CSVT techniques working together to produce nanostructured tungsten oxide." Materials Letters 62, no. 26 (October 2008): 4191–94. http://dx.doi.org/10.1016/j.matlet.2008.06.038.
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Somogyi, K., Sz Varga, and J. F. Rommeluere. "A low temperature photoluminescence study of CSVT grown GaAs epitaxial layers." physica status solidi (c), no. 3 (February 2003): 902–6. http://dx.doi.org/10.1002/pssc.200306329.
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Massé, G., M. F. Lawrence, and J. M. Lacroix. "Dominant donor trap in n-type epitaxial GaAs grown by CSVT." Journal of Physics and Chemistry of Solids 49, no. 11 (January 1988): 1349–53. http://dx.doi.org/10.1016/0022-3697(88)90218-1.
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Chale-Lara, F., M. Zapata-Torres, M. Melendez-Lira, and H. Peraza-Vazquez. "Optical and structural properties of CdS films grown by CSVT technique." physica status solidi (c) 2, no. 10 (August 2005): 3694–97. http://dx.doi.org/10.1002/pssc.200461738.
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deVeber, G. "Paediatric stroke." Hämostaseologie 29, no. 01 (2009): 88–90. http://dx.doi.org/10.1055/s-0037-1616948.
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SummaryThe past decade has seen a dramatic increase in pediatric stroke research. However few studies have addressed anti-thrombotic safety or effectiveness. Three paediatric stroke guidelines combining research data with expert consensus have been published in the past five years. For most patients treatment recommendations are consistent. Newborns with arterial ischaemic stroke (AIS) rarely require antithrombotic treatment given their extremely low risk of recurrence. In children with AIS a substantial recurrence risk means that antithrombotic treatment is required unless contraindicated. Anticoagulation (heparins, warfarin) is recommended for possible or established dissection and cardiogenic embolism. Antiplatelet treatment is recommended for other children with AIS. For neonatal cerebral sinovenous thrombosis (CSVT) most centers provide initial anticoagulation in the absence of haemorrhagic contra indications, and otherwise, monitor for propagation. Children with CSVT, even with haemorrhagic infarction, more consistently receive anticoagulation, as in adults. While more studies are necessary, current treatment guidelines offer an interim option for guiding the treatment of paediatric stroke.
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Nalawade, Rohan, Mohan Kannam, Butchi Raju Garuda, and Virender Sachdeva. "Unilateral persistent disc oedema due to cerebral sinus venous thrombosis (CSVT): diagnostic and management challenge." BMJ Case Reports 13, no. 12 (December 2020): e234997. http://dx.doi.org/10.1136/bcr-2020-234997.
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A 50-year-old woman was incidentally diagnosed to have unilateral disc oedema during comprehensive ophthalmological evaluation. She had a prior history of ulcerative colitis. She had normal visual function and was initially diagnosed to have incipient non-arteritic anterior ischaemic optic neuropahty. Risk factor evaluation revealed hyperhomocysteinaemia. She was asked to come for a follow-up in 2 months. However, she was lost to follow-up and returned to the clinic for the evaluation for headaches, 23 months later. Her ocular examination was stable and she had persistent unilateral disc oedema unchanged from the prior visit. Repeat MRI brain and MR venogram brain with contrast-established diagnosis of cerebral sinus venous thrombosis (CSVT). She denied any neurological symptoms. Later on, she was diagnosed to have hyperhomocysteinaemia with methyl tetrahydrofolate reductase gene mutation. This case highlights the importance of recognising although rare, unilateral disc oedema secondary to elevated intracranial pressure from CSVT.
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Uluduz, Derya, Sevki Sahin, Taskin Duman, Serefnur Ozturk, Vildan Yayla, Nazire Afsar, Nevzat Uzuner, et al. "Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study." Stroke Research and Treatment 2020 (September 1, 2020): 1–8. http://dx.doi.org/10.1155/2020/8610903.
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Background. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results. The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34±9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38±9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.
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Koskiahde, E., D. Cossement, R. Paynter, J. P. Dodelet, A. Jean, and B. A. Lombos. "Doping of GaAs epitaxial layers grown on (100) GaAs by close-spaced vapor transport." Canadian Journal of Physics 67, no. 4 (April 1, 1989): 251–58. http://dx.doi.org/10.1139/p89-044.
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Using H2O as a transport agent, epitaxial GaAs layers were grown by the close-spaeed vapor transport technique (CSVT) on (100) heavily Si-doped GaAs substrates. Three kinds of GaAs sources were used for the deposition: (100) GaAs, heavily doped with Te or Si, and undoped semi-insulating (SI) (100) GaAs. The growth rates obtained with SI and Te-doped GaAs are quite similar and show a clear tendency to be superior to the growth rates measured for Si-doped GaAs sources. Uncompensated charge carrier density (ND – NA) profiles have been measured electrochemically for the layers grown with the three kinds of sources. When Te-doped GaAs is used, (ND – NA) obtained for the epitaxy is the same as that of the source, implying a complete transfer of the Te impurity. (ND – NA) values varying from 1016 to 1018 cm−3 are obtained from SI GaAs sources, depending upon the thickness of the epitaxial layer. (ND – NA) < 1015 cm−3 are measured for layers grown from Si-doped GaAs sources. In this case, layers thicker than 10 μm cannot be mesured electrochemically because of their excessively high resistance. The small (ND – NA) values obtained in that case are explained by the reaction of Si contained in the source with the transport agent (H2O), resulting in the formation, at the Si-doped GaAs surface, of a passivating SiOx layer revealed by Auger spectroscopy. This passivating layer also explains the smaller growth rates measured with these sources. p–n Junctions have been prepared by Zn diffusion in CSVT layers grown from SI GaAs sources. Their I–V characteristics show good rectification behavior, indicating that the CSVT layers could be used for photovoltaic purposes.
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Lütkhoff, Lisa K., Manuela Albisetti, Timothy J. Bernard, Mariana Bonduel, Leonardo R. Brandao, Stephane Chabrier, Anthony Chan, et al. "Impact of Thrombophilia On Arterial Ischemic Stroke or Cerebral Venous Sinus Thromboses in Children: A Systematic Review & Meta-Analysis of Observational Studies." Blood 114, no. 22 (November 20, 2009): 3993. http://dx.doi.org/10.1182/blood.v114.22.3993.3993.
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Abstract Abstract 3993 Poster Board III-929 Background The incidence of stroke in children is estimated at about 2.6 per 100,000 per year. Risk factors include congenital heart malformations, trauma, hemolytic anemias, collagen tissue diseases, inborn metabolic disorders, and infectious diseases. Apart from acquired thrombophilic risk factors, such as the presence of antiphospholipid antibodies, inherited thrombophilias (IT) have been found to be associated with stroke in infants and children. However, results of single studies on the risk of stroke onset associated with IT have been contradictory or inconclusive, mainly due to lack of statistical power. The aim of this study was to estimate the impact of thrombophilia (IT) on risk of childhood stroke via meta-analysis of published observational studies. Methods and Results A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1970 to 2009 was conducted using key words in combination both as MeSH terms and text words. Citations were independently screened by two authors and those meeting the a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, stroke type (arterial ischemic stroke [AIS]; cerebral venous sinus thrombosis [CSVT]) were abstracted. Publication bias indicator and heterogeneity across studies were evaluated, and summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using both fixed-effects and random-effects models. Twenty-one of 185 references found met inclusion criteria. 1698 patients (AIS: 1291; CSVT: 407) and 2913 controls aged neonate to 18 years were enrolled. No significant heterogeneity was discerned across studies, and no publication bias was detected. A statistically significant association with stroke onset was demonstrated for each IT trait evaluated, with no difference found between AIS (table) and CSVT. Summary ORs/CIs (random-effects model) for AIS & CSVT cohorts were as follows: Protein C-deficiency (8.76/4.53-16.96), FV G1691A (3.34/2.66-4.26), FII G20210A (2.50/1.67-3.74), MTHFR T677T (1.61/1.21-2.14), antiphospholipid antibodies (5.84/3.06-11.18), elevated lipoprotein (a) (6.24/4.51-8.64), and combined ITs (8.85/3.32-23.57). Carrier rates reported for antithrombin- or protein S deficiency among patients were 1.5% and 1.6% as compared with 0.06% (p<0.001) and 0.4% (p=0.003) in healthy controls. Conclusions The present meta-analysis indicates that IT serve as risk factors for incident stroke. However, the impact of IT upon outcome and recurrence risk needs to be further investigated. Disclosures: Manco-Johnson: Baxter BioScience: Honoraria; Bayer HealthCare: Honoraria; CSL Behring: Honoraria; NovoNordisk: Honoraria; Octapharma: Honoraria. Off Label Use: Enoxaparin (LMWH) is used off-label in children to prevent symptomatic thromboembolism.
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Guelton, N., R. G. Saint-Jacques, G. Lalande, D. Cossement, and J. P. Dodelet. "Antiphase boundaries and misfit dislocations in gaAs grown on ge(001)." Proceedings, annual meeting, Electron Microscopy Society of America 50, no. 2 (August 1992): 1436–37. http://dx.doi.org/10.1017/s0424820100131814.
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This work reports TEM investigation of the GaAs/Ge (100) heterojonction grown by close-spaced vapor transport (CSVT). It confirms that i) in layers deposited by this technique, the antiphase boundary (APB) density can be strongly reduced by using annealed misoriented substrates and that ii) the <011> misfit dislocations are mainly of the 60° type. It has been found that they are confined within 150 nm from the interface.The CSVT is an efficient and cost effective technique that allows the growth of epitaxial layers of semiconductors. A temperature gradient is maintained between the closely spaced (1mm) solid source and substrate. A transporting agent (water vapor) is used to react with the source and form volatile compounds which are subsequently decomposed at the surface of the substrate to form a thin film of the source material. Prior to initiation of deposition, the Ge substrate is heated at 825°C for 30 min in H2 atmosphere while the source temperature is maintained at 775°C, i.e. at a lower temperature to avoid any deposition on the substrate. This procedure allows elimination of oxydes and leads to step doubling.
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O'Brien, Sarah H. "Perinatal thrombosis: implications for mothers and neonates." Hematology 2015, no. 1 (December 5, 2015): 48–52. http://dx.doi.org/10.1182/asheducation-2015.1.48.
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Abstract Stroke is more likely to occur in the perinatal period than any other time in childhood, and these events can lead to a lifetime of intellectual and motor disabilities, epilepsy, and behavioral challenges. This review describes the epidemiology and natural history of perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT), risk factors for these complications, recent evidence regarding treatment strategies, and current gaps in knowledge. Existing evidence demonstrates the multifactorial etiology of symptomatic ischemic stroke in neonates, which includes a combination of maternal, delivery, and neonatal factors. The importance of inherited thrombophilia in the pathophysiology and long-term outcomes of perinatal stroke requires additional study. At this time, there is no evidence to support routine extensive thrombophilia screening outside of a research setting. Despite the frequency of perinatal stroke and its association with substantial morbidity, treatment strategies are currently limited, and prevention strategies are nonexistent. Anticoagulation is rarely indicated in PAIS, and more work needs to focus on neuroprotective prevention and alternate treatment strategies. Anticoagulation does appear to be safe in CSVT and may prevent thrombus progression but clinical equipoise remains, and clinical trials are needed to obtain evidence regarding short- and long-term efficacy outcomes.
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Kotal, Raghavendra, Ipe Jacob, Pradeep Rangappa, Karthik Rao, Guruprasad Hosurkar, Satish Kumar Anumula, and Avinasha M. Kuberappa. "A rare case of vaccine-induced immune thrombosis and thrombocytopenia and approach to management." Surgical Neurology International 12 (August 16, 2021): 408. http://dx.doi.org/10.25259/sni_689_2021.
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Background: The use of the COVID-19 vaccines Vaxzevria from AstraZeneca and Covishield from Janssen has been associated with sporadic reports of thrombosis with thrombocytopenia, a complication referred to as vaccine-induced immune thrombotic thrombocytopenia (VITT) or vaccine-induced prothrombotic immune thrombocytopenia. It presents commonly as cerebral sinus venous thrombosis (CSVT), within 4–30 days of vaccination. Females under 55 years of age are considered to be especially at high risk. Mortality up to 50% has been reported in some countries. Identification of early warning signs and symptoms with prompt medical intervention is crucial. Case Description: We report here a case of VITT in a young female who presented 11 days after receiving the first dose of the Covishield vaccine, with severe headache and hemiparesis. She was diagnosed with CSVT with a large intraparenchymal bleed, requiring decompressive craniectomy and extended period on mechanical ventilation. Conclusion: The patient was successfully treated with intravenous immunoglobulin and discharged after 19 days in ICU. Although she was left with long-term neurological deficits, an early presentation and a multidisciplinary approach to management contributed toward a relatively short stay in hospital and avoided mortality.
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Konan, K., J. K. Saraka ., P. Gbaha ., K. D. Konan ., and B. Hadjoudja . "Absorption Coefficient and Energy Gap of Vacuum Free CSVT Deposited CuInSe2 Thin Films." Journal of Applied Sciences 7, no. 18 (September 1, 2007): 2646–50. http://dx.doi.org/10.3923/jas.2007.2646.2650.
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Vigil-Galán, O., J. Sastré-Hernández, F. Cruz-Gandarilla, J. Aguilar-Hernández, E. Marín, G. Contreras-Puente, E. Saucedo, C. M. Ruiz, V. Bermúdez, and M. Tufiño-Velázquez. "Physical properties of Bi doped CdTe thin films grown by the CSVT method." Solar Energy Materials and Solar Cells 90, no. 15 (September 2006): 2228–34. http://dx.doi.org/10.1016/j.solmat.2006.02.021.
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Carducci, Chiara, Giovanna Stefania Colafati, Lorenzo Figà-Talamanca, Daniela Longo, Tommaso Lunardi, Francesco Randisi, and Bruno Bernardi. "Cerebral sinovenous thrombosis (CSVT) in children: what the pediatric radiologists need to know." La radiologia medica 121, no. 5 (March 30, 2016): 329–41. http://dx.doi.org/10.1007/s11547-016-0630-9.
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Ben Belgacem, J., M. Nouiri, K. Medjnoun, K. Djessas, and Z. Ben Ayadi. "CuInS2 thin films obtained through an innovative CSVT deposition method from solvothermal-generated precursors." Materials Science in Semiconductor Processing 83 (August 2018): 224–30. http://dx.doi.org/10.1016/j.mssp.2018.04.039.
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Kertoatmodjo, S., Nugraha, and F. Guastavino. "Formation reactions of PbTe thin film deposition by close-spaced vapor transport (CSVT) technique." Thin Solid Films 324, no. 1-2 (July 1998): 25–29. http://dx.doi.org/10.1016/s0040-6090(97)01199-1.
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Kannan, M. "Preparation and study of structural and optical properties of CSVT deposited CuInSe2 thin films." Solar Energy Materials and Solar Cells 81, no. 3 (February 26, 2004): 379–95. http://dx.doi.org/10.1016/j.solmat.2003.11.014.
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Cossement, D., J. P. Dodelet, T. Bretagnon, A. Jean, and B. A. Lombos. "Electrical Characterization of GaAs Epitaxial Layers Grown by CSVT from Zn‐doped GaAs Sources." Journal of The Electrochemical Society 138, no. 3 (March 1, 1991): 830–34. http://dx.doi.org/10.1149/1.2085685.
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Turowski, B., D. Hanggi, and M. Siebler. "Intracranial bilateral vertebral artery dissection during anticoagulation after cerebral venous and sinus thrombosis (CSVT)." Acta Neurochirurgica 149, no. 8 (August 2007): 793–97. http://dx.doi.org/10.1007/s00701-007-1247-5.
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García-Salgado, G., J. J. Cruz-Bueno, F. S. Ramírez-González, E. Gastellou, F. G. Nieto-Caballero, E. Rosendo-Andrés, J. A. Luna-López, et al. "GaN obtained on quartz substrates through the nitridation of GaAs films deposited via CSVT." Journal of Alloys and Compounds 887 (December 2021): 161469. http://dx.doi.org/10.1016/j.jallcom.2021.161469.
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Cruz Bueno, J., Godofredo García Salgado, R. Balderas Valadez, J. Luna López, F. Nieto Caballero, Tomás Díaz Becerril, Enrique Rosendo Andrés, et al. "Effect of the Gaseous Atmosphere in GaAs Films Grown by Close-Spaced Vapor Transport Technique." Crystals 9, no. 2 (January 28, 2019): 68. http://dx.doi.org/10.3390/cryst9020068.
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The effect of the gaseous atmosphere in the growth of gallium arsenide (GaAs) films was studied. The films have been grown by close-spaced vapor transport (CSVT) technique in a home-made hot filament chemical vapor deposition (HFCVD) reactor using molecular hydrogen and molecular nitrogen as the transport agent. An important point about the gaseous atmosphere is the ease in creating volatile compounds when it makes contact with the GaAs source, this favors the transport of material in a CSVT system. Chemical reactions are proposed in order to understand the significant difference produced from the gaseous atmosphere. The films grown with hydrogen are (almost) continuous and have homogeneous layers with preferential orientation (111). The films grown with nitrogen are granular and rough layers with the coexistence of the orientations (111), (220) and (311) in the crystals. The incorporation of impurities in the films was corroborated by energy dispersive spectroscopy (EDS) showing traces of oxygen and nitrogen for the case of the samples obtained with nitrogen. Films grown in a hydrogen atmosphere show a higher band gap than those grown in a nitrogen atmosphere. With the results of XRD and micro-Raman we observe a displacement and broadening of the peaks, characteristic of a structural disorder. The calculations of the FWHM allow us to observe the crystallinity degree and determine an approximate crystallite size using the Scherrer’s equation.
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Giladi, Ornit, David Steinberg, Kobi Peleg, David Tanne, Adi Givon, Ehud Grossman, Yoram Klein, et al. "Head Trauma Is the Major Risk Factor for Cerebral Sinus-Vein Thrombosis." Blood 126, no. 23 (December 3, 2015): 1108. http://dx.doi.org/10.1182/blood.v126.23.1108.1108.
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Abstract Cerebral sinus vein thrombosis (CSVT) is a rare disease with significant neurological sequellae and high mortality rate. Incidence of CSVT diagnosis in the western world has increased despite the reduced occurrence of infectious sinus thrombosis related to otitis media and mastoiditis. The objective of this study was to identify risk factors that may explain the predisposition to the site specific thrombosis based on patients from a single tertiary medical center. The study included 90 consecutive patients aged 15 and up that were diagnosed with acute CSVT from January 2002 to September 2014 at the Sheba Medical Center. As a control group we used the data extracted from the national trauma registry for the years 2012 and 2013 and from Maccabi Healthcare Services, the second largest health care maintenance organization (HMO) in Israel. Trauma history up to one month prior to diagnosis of CVST was found in 13 (14%) patients (10 men and 3 women). Six patients had skull fractures, the others had blunt trauma. Data from the national trauma registry were used to compute annual age and gender specific head trauma rates. The overall SMR was 941 (p < 0.0001); the separate results for men and women were 1206 and 543, respectively. Another important risk factor was infections confined to the head and neck in 7% of the cases and brain tumor in 8%. At the time of CVST, 23 of 50 (46%) women had a hormonal risk factor. The SMR for OC use was 1.63 (p=0.0298). Prothrombotic polymorphisms were detected in 16 of 63 (25.4%) patients who were tested for factor V Leiden and prothrombin G20210A mutation (OR=3.47, p=0.002) in comparison to 49% in DVT patients (OR=9.95, p<0.0001). In 29 of 90 patients at least one of the risk factors for atherosclerosis (hypertension, diabetes or hypercholesterolemia) was discerned but this was very close to the expected number adjusted for sex and age and SMR was 0.98. None of the risk factors correlated with severity of disease and outcome. These data suggest that search for CVST in patients with recent trauma and headache even after intact head CT is required. The other risk factors, such as hormone related and prothrombotic polymorphisms, were not specific just for CVST and the latter play a lesser role in CVST than in DVT. Disclosures No relevant conflicts of interest to declare.