A negative D-dimer assay does not rule out cerebral venous thrombosis: a series of seventy-three patients.
OBJECTIVE
Cerebral venous thrombosis (CVT) is an infrequent variety of cerebrovascular disease with a wide spectrum of clinical presentations and a notoriously difficult diagnosis. Previous reports have emphasized the potential clinical utility of D-dimer assay in CVT diagnosis.


METHODS
A rapid sensitive D-dimer assay was performed at entry in 73 patients with CVT <30 days duration, examined in our institution between 1999 and 2003.


RESULTS
The mean value of D-dimer levels was 1521 ng/mL; 7 patients (10% of all patients and 26% of those presenting with isolated headache) had values <500 ng/mL. In a multivariate analysis, isolated headache was the only variable associated with a negative D-dimer assay.


CONCLUSIONS
A negative D-Dimer assay does not confidently rule out CVT, particularly in the setting of recent isolated headache.
Crassard
Isabelle
I
Neurology Department, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France. isabelle.crassard@lrb.aphp.fr
Soria
Claudine
C
Tzourio
Christophe
C
Woimant
France
F
Drouet
Ludovic
L
Ducros
Anne
A
Bousser
Marie-Germaine
MG
D000328:Adult; D019963:Clinical Chemistry Tests / Q000379:methods*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000096:biosynthesis*; D006261:Headache / Q000097:blood / Q000175:diagnosis; D006801:Humans; D020767:Intracranial Thrombosis / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis*
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D