title: D-dimer and clinicoradiologic features in cerebral venous thrombosis.
abstract: OBJECTIVE
  Cerebral venous thrombosis (CVT) is a disease with varying clinical presentation and diagnosis presents many challenges in clinical practice. We investigated, whether D-dimer levels reflect clinical presentation, radiologic features, and outcome in CVT.
  
  
  METHODS
  We included all consecutive patients with CVT treated in our hospital from 1987 to 2010 with D-dimer levels measured before initiation of anticoagulant treatment. D-dimer was categorized as low (<0.5mg/L), intermediate (0.6-2.0mg/L), and high (>2.0mg/L). Based on delay from symptom onset to hospital presentation mode of onset was categorized as acute (<2 days), subacute (2-14 days), or chronic (>14 days).
  
  
  RESULTS
  In 71 patients included median level of D-dimer was 1.40 mg/L (range 0.05-13.0mg/L). In 9 (12%) patients D-dimer was low, and of these, 7 presented with subacute and 2 with chronic mode of symptom duration. Elevated D-dimer levels were associated with thrombosis in multiple sinuses (P=0.044). Longer symptom duration was correlated with low D-dimer levels (P=0.010).
  
  
  CONCLUSIONS
  In clinical practice, low levels of D-dimer cannot rule out CVT in patients with subacute or chronic disease. High D-dimer levels correlate with greater thrombus extension and acute onset of symptoms.
authors: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. sini.hiltunen@helsinki.fi
authors: Sini
authors: S
authors: Hiltunen
authors: Jukka
authors: J
authors: Putaala
authors: Elena
authors: E
authors: Haapaniemi
authors: Oili
authors: O
authors: Salonen
authors: Turgut
authors: T
authors: Tatlisumak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D020767:Intracranial Thrombosis / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D