Thromboelastography in patients with cerebral venous thrombosis.
BACKGROUND
Cerebral venous thrombosis (CVT) is a rare presentation of venous thrombosis and has been associated with many conditions. In about 20% no risk factor is identified. The aim of this study was to assess the clot formation by thromboelastography (TEG) in patients with a history of CVT compared with healthy controls.


METHODS
TEG analysis was performed on recalcified blood samples of 19 CVT patients from a single centre cohort and 1:1 sex/ age (+/-3 year) matched controls. Four TEG parameters were monitored: reaction time (r) to clot initiation, time to reach a 20 mm level of clot formation (K), slope angle alpha from r to K (alpha) and maximum vertical amplitude (MA). Patients were tested for thrombophilic defects, including deficiencies of antithrombin, protein C and protein S, factor V Leiden, prothrombin G20210A mutation, lupus anticoagulant, antiphospholipid antibodies, and high factor VIII levels.


RESULTS
Thrombophilia testing identified a prothrombotic abnormality in 11 patients (58%). Sixteen patients (84%) had one or more transient risk factor. There were no significant differences in TEG parameters between CVT patients and controls, neither between the subgroup of patients with a thrombophilic defect and controls. Seven of all patients (37%), including 5 patients with abnormal thrombophilia testing, and 5 controls (26%) had one or more TEG hypercoagulable parameters.


CONCLUSIONS
A persistent hypercoagulable state which could have predisposed to venous thrombosis in CVT patients and in the subgroup of patients with a thrombophilic defect could not be demonstrated by TEG.
Koopman
Karen
K
Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands. k.koopman@neuro.umcg.nl
Uyttenboogaart
Maarten
M
Hendriks
Herman G D
HG
Luijckx
Gert-Jan
GJ
Cramwinckel
Ivo R
IR
Vroomen
Patrick C
PC
De Keyser
Jacques
J
van der Meer
Jan
J
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002550:Cerebral Veins / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013916:Thrombelastography / Q000379:methods*; D020246:Venous Thrombosis / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult