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    Assessment of patients with intracerebral hemorrhage or hemorrhagic transformation in the VENOST study
    (Karger, 2021) Duman, Taşkın; Yayla, Vildan; Uludüz, Derya; Göksu, Eylem Özaydin; Yürekli, Vedat Ali; Genç, Hamit; Utku, Uygar; Çınar, Nilgün; Tekeli, Hakan; Sungur, Mehmet Ali; Tokuç, Firdevs Ezgi; Uzuner, Nevzat; Şenol, Mehmet Güney; Yılmaz, Arda; Gökçe, Mustafa; Demirci, Seden; Küsbeci, Özge Yılmaz; Uzuner, Gülnur Tekgöl; Şahin, Şevki; Çağlayan, Hale Zeynep Batur; Açıkgöz, Mustafa; Özdağ, Fatih; Baybaş, Sevim; Ekmekçi, Hakan; Çabalar, Murat; Yaman, Mehmet; Bektaş, Hesna; Kaplan, Yüksel; Göksel, Başak Karakurum; Milanlıoğlu, Aysel; Örken, Dilek Necioğlu; Aluçlu, Mehmet Ufuk; Çolakoğlu, Senalu; Tüfekçi, Ahmet; Bakar, Mustafa; Nazlıel, Bijen; Taşçılar, Nida; Göksan, Baki; Kozak, Hasan Hüseyin; Mısırlı, Handan; Küçükoğlu, Hayriye; Midi, İpek; Mengüllüoğlu, Necdet; Aytaç, Emrah; Yeşilot, Nilüfer; İnce, Birsen; Yalın, Osman Özgür; Güneş, Taşkın; Oruç, Serdar; Domaç, Füsun Mayda; Öztürk, Şerefnur; Karahan, Ali; Erdoğan, Hacı Ali; Afşar, Nazire
    Introduction: Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group. Materials and Methods: In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded. Results: CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was >= 3 in 23.1% of the patients in the CH group. Discussion and Conclusion: CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.
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    Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study
    (Hindawi Limited, 2020) Uludüz, Derya Uğurlu; Sahin, Sevki; Duman, Taskin; Öztürk, Şerefnur; Yayla, Vildan Ayşe; Afşar, Nazire; Nevzat, Uzuner; Midi, İpek; Çınar, Nilgün; Sungur, Mehmet Ali; Domaç, Füsun Mayda; İnce, Birsen; Göksan, Baki; Mısırlı, Cemile Handan; Bakar, Mustafa; Kozak, Hasan Hüseyin; Çolakoǧlu, Sena; Karahan, Ali Yavuz; Göksu, Eylem Özaydın; Özdağ, Fatih Mehmet; Şenol, Mehmet Güney; Yürekli, Vedat Ali; Aluçlu, Ufuk; Demir, Serkan; Küçükoğlu, Hayriye; Oruç, Serdar; Yesilot, Nilufer; Küsbeci, Özge Yılmaz; Nazlıel, Bijen; Tokuç, Firdevs Ezgi Ucan; Bektaş, Hesna; Taşçılar, Fatma Nida; Aytaç, Emrah; Gökçe, Mustafa; Çaǧlayan, Hale Zeynep Batur; Tüfekçi, Ahmet; Uzuner, Gülnur Tekgöl; Örken, Dilek Necioǧlu; Yalın, Özgür Osman; Utku, Uygar; Yılmaz, Arda; Genc, Hamit; Çabalar, Murat; Milanlıoğlu, Aysel; Ekmekçi, Hakan Ahmet; Zeydan, Burcu; Baybaş, Sevim; Kablan, Yüksel; Göksel, Başak Karakurum; Açıkgöz, Mustafa; Kurucu, Hatice; Demirci, Seden; Güneş, Taşkın
    ackground. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results. The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34±9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38±9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.