Cerebral venous thrombosis in elderly patients.

Autor: Garcia V; Stroke Units and Department of Neurology of Hôpital Bicêtre, Le Kremlin Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris Saclay University, Paris, France., Bicart-Sée L; Stroke Units and Department of Neurology of Hôpital Bicêtre, Le Kremlin Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris Saclay University, Paris, France., Crassard I; Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University of Paris City, INSERM 1144, Paris, France., Legris N; Stroke Units and Department of Neurology of Hôpital Bicêtre, Le Kremlin Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris Saclay University, Paris, France., Zuber M; Hôpital Saint-Joseph, Paris, France., Pico F; Hôpital André Mignot, Versailles, France., Guidoux C; Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France., Obadia M; Hôpital Fondation Rothschild, Paris, France., Boulenoir N; Stroke Units and Department of Neurology of Hôpital Bicêtre, Le Kremlin Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris Saclay University, Paris, France., Smadja D; Hôpital Sud Francilien, Paris, France., Mazighi M; Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University of Paris City, INSERM 1144, Paris, France., Lavenu-Bombled C; Department of Hematology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France., Baudry E; Department of Geriatry, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris, France., Lapergue B; Hôpital Foch, Suresnes, France., Turc G; Hôpital Sainte-Anne, Paris, France., Tuppin P; French National Health Insurance (CNAM), Paris, France., Denier C; Stroke Units and Department of Neurology of Hôpital Bicêtre, Le Kremlin Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris Saclay University, Paris, France.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2024 Dec; Vol. 31 (12), pp. e16504. Date of Electronic Publication: 2024 Oct 04.
DOI: 10.1111/ene.16504
Abstrakt: Background and Purpose: We aimed to report the characteristics of cerebral venous thrombosis (CVT) in elderly people (aged ≥65 years).
Methods: This multicenter retrospective cohort included elderly patients hospitalized for a first CVT in nine Paris-Ile-de-France hospitals between 2011 and 2021. The estimated incidence was compared to CVT recorded by the French health insurance data system. Lariboisière Hospital's CVT registry allowed comparisons of our elderly cohort with individuals younger than 65 years.
Results: One hundred fourteen patients were included in this study (mean age = 74.2 years, range = 65-93, 61% female). The CVT annual incidence in Ile-de-France was 5.9-7.1 per million elderly individuals versus 8.5 per million nationwide. Headaches and focal deficits were the most common initial clinical features (50% and 51%, respectively), followed by seizures and confusion (40% and 27%). Treatment included anticoagulation (93%) and, rarely, endovascular procedure (2%) or craniectomy (1%). Compared with adult patients aged <65 years (younger adults), elderly patients presented fewer headaches (50% vs. 96%, p < 0.01) and intracranial hypertension (7% vs. 22%, p < 0.01) but more seizures and focal deficits (40% vs. 27% and 51% vs. 38%, respectively, p < 0.01). Underlying cancer, hemopathy, and locoregional infections were more frequent in elderly patients than among younger adults (p < 0.01). The prognosis of patients from our elderly cohort was poorer than that of younger adults; 8% died in the acute phase, and 73% had a favorable outcome at 1 year (vs. 1.7% and 87%, respectively, p < 0.01).
Conclusions: CVT in elderly patients has a specific clinical presentation, epidemiology, and risk factors such as cancer or hemopathy, justifying specialized management.
(© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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