Cerebral venous thrombosis in elderly patients

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2024-10-04 DOI:10.1111/ene.16504

Victor Garcia, Louise Bicart-Sée, Isabelle Crassard, Nicolas Legris, Mathieu Zuber, Fernando Pico, Céline Guidoux, Michael Obadia, Naouel Boulenoir, Didier Smadja, Mikael Mazighi, Cecile Lavenu-Bombled, Elodie Baudry, Bertrand Lapergue, Guillaume Turc, Philippe Tuppin, Christian Denier

{"title":"Cerebral venous thrombosis in elderly patients","authors":"Victor Garcia, Louise Bicart-Sée, Isabelle Crassard, Nicolas Legris, Mathieu Zuber, Fernando Pico, Céline Guidoux, Michael Obadia, Naouel Boulenoir, Didier Smadja, Mikael Mazighi, Cecile Lavenu-Bombled, Elodie Baudry, Bertrand Lapergue, Guillaume Turc, Philippe Tuppin, Christian Denier","doi":"10.1111/ene.16504","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and purpose</h3>\n \n <p>We aimed to report the characteristics of cerebral venous thrombosis (CVT) in elderly people (aged ≥65 years).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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%, <i>p</i> < 0.01) and intracranial hypertension (7% vs. 22%, <i>p</i> < 0.01) but more seizures and focal deficits (40% vs. 27% and 51% vs. 38%, respectively, <i>p</i> < 0.01). Underlying cancer, hemopathy, and locoregional infections were more frequent in elderly patients than among younger adults (<i>p</i> < 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, <i>p</i> < 0.01).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>CVT in elderly patients has a specific clinical presentation, epidemiology, and risk factors such as cancer or hemopathy, justifying specialized management.</p>\n </section>\n </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554858/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ene.16504","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

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.

Abstract Image

查看原文本刊更多论文

老年患者的脑静脉血栓。

背景和目的：我们旨在报告老年人（年龄≥65 岁）脑静脉血栓（CVT）的特征：该多中心回顾性队列包括2011年至2021年期间在巴黎大区九家医院因首次CVT住院的老年患者。估计的发病率与法国医疗保险数据系统记录的CVT进行了比较。Lariboisière 医院的 CVT 登记系统可将我们的老年人群与 65 岁以下的人进行比较：本研究共纳入了 114 名患者（平均年龄为 74.2 岁，年龄范围为 65-93 岁，61% 为女性）。法兰西岛的CVT年发病率为每百万老年人5.9-7.1例，而全国为每百万老年人8.5例。头痛和局灶性障碍是最常见的初期临床特征（分别占50%和51%），其次是癫痫发作和意识模糊（分别占40%和27%）。治疗方法包括抗凝治疗（93%）和极少数的血管内手术（2%）或颅骨切除术（1%）。结论：与成年老年患者相比，老年患者的冠状动脉血栓形成具有特殊性：老年患者的 CVT 有其特殊的临床表现、流行病学和风险因素（如癌症或血液病），因此需要进行专门的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).