Hyperhomocysteinemia and other thrombophilic risk factors in 26 patients with cerebral venous thrombosis.
Despite the continuous description of new conditions pre-disposing for cerebral venous thrombosis (CVT), no apparent cause is found in about 30% of cases. Hyperhomocysteinemia (hyper-Hcy) is an established risk factor for deep venous thrombosis and stroke but has not been clearly associated with increased risk of CVT. We assessed the prevalence of hyper-Hcy and other thrombophilic risk factors in a population of 26 consecutive patients with non-pyogenic CVT, by review of a prospectively maintained database. The prevalences of hyper-Hcy and prothrombin G20210A, factor V G1691A and methylenetetrahydrofolate reductase (MTHFR) C677T mutations in these patients were compared with those in 100 healthy controls and 100 patients with cerebroarterial disease. The prevalence of hyper-Hcy was greater in patients with CVT (10/26, 38.5%) than healthy controls (13/100; OR 4.18, 95% CI 1.58-11.16) and comparable with that in patients with cerebroarterial disease (42/100). No significant differences were found in the prevalences of prothrombin or MTHFR mutation. No factor V mutation was found. Our findings indicate that hyper-Hcy is associated with an increased risk of CVT. Additional prospective cohort studies on large series of patients are required to clarify the time relationship between hyper-Hcy and the thrombotic event.
Boncoraglio
G
G
Department of Neurology, Istituto Nazionale Neurologico Carlo Besta, Milan, Italy.
Carriero
M R
MR
Chiapparini
L
L
Ciceri
E
E
Ciusani
E
E
Erbetta
A
A
Parati
E A
EA
D020016:Activated Protein C Resistance; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004252:DNA Mutational Analysis / Q000379:methods; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology*