Dural Venous Sinus Thrombosis after Vestibular Schwannoma Surgery: The Anticoagulation Dilemma
| Autor: | Ravi S. Nunna, Bledi C Brahimaj, Matthew J. Urban, André Beer-Furlan, Gary Wu, Richard W. Byrne, Mehmet Kocak, Vikrant Chauhan, Fred Crawford, Lorenzo F. Munoz, Richard M. Wiet, Eric Abello |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Sigmoid sinus
medicine.medical_specialty Translabyrinthine approach business.industry 030204 cardiovascular system & hematology Schwannoma medicine.disease Thrombosis Asymptomatic Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Dural venous sinuses medicine Neurology (clinical) Thrombus medicine.symptom business Complication 030217 neurology & neurosurgery |
| Zdroj: | J Neurol Surg B Skull Base |
| Popis: | Introduction Dural venous sinus thrombosis (DVST) is a relatively understudied complication of vestibular schwannoma (VS) surgery. Several studies have examined this topic; however, there is limited data on the incidence, clinical progression, and proper management of this patient population. Methods A retrospective review was performed for patients undergoing surgery for VS at a single institution. All postoperative imaging was reviewed for incidence of DVST. Demographic data were collected including tumor and surgical characteristics along with postoperative course. Results A total of 63 patients underwent resection of their VS. The incidence of DVST was 34.9%. The operative time was greater in the dural venous sinus thrombosis (DSVT) group, at an average of 6.69 hours versus 4.87 in the no DSVT cohort (p = 0.04). Tumor size was correlationally significant (p = 0.051) at 2.75 versus 2.12 cm greatest diameter. The translabyrinthine approach was most prevalent (68.2%). The side of the thrombosis was ipsilateral to the tumor and surgery in all patients. The sigmoid sinus was most commonly involved (95.5%). Of them, 85% patients had a codominant or thrombus contralateral to the dominant sinus. All patients were asymptomatic. No patients were treated with anticoagulation. Resolution of thrombus was seen in five (22.7%) of the patients on last follow-up imaging. There were no hemorrhagic complications. Conclusion The overall incidence of DVST was (34.9%) of 63 patients who underwent VS surgery. All patients were asymptomatic and none were treated with anticoagulation. In our study, continuing to observe asymptomatic patients did not lead to any adverse events. |
| Databáze: | OpenAIRE |
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