Cerebral Venous Thrombosis: Clinical, Radiological, Biological, and Etiological Characteristics of a French Prospective Cohort (FPCCVT)-Comparison With ISCVT Cohort

Sandrine Canaple (1, 2) , Bertrand Roussel , Nicolas Gaillard (3) , Emilie Scavazza , Veronique Le Cam Duchez (4) , Aude Triquenot Bagan , Isabelle Crassard (5) , Ludovic Drouet (5) , Marianne Barbieux-Guillot , Raphael Marlu (6, 7) , Emmanuelle Robinet-Borgomino , Pierre-Emmanuel Morange (8, 9) , Valerie Wolff (10) , Lelia Grunebaum (11) , Frederic Klapczynski , Elisabeth Andre-Kerneis , Fernando Pico (12) , Brigitte Martin-Bastenaire , Emmanuel Ellie (13) , Fanny Menard , Francois Rouanet (14) , Genevieve Freyburger (15) , Gaelle Godeneche , Hong-An Allano , Thierry Moulin (16) , Guillaume Mourey (16) , Laurent Derex (17) , Micheline Berruyer , Gwenaelle Runavot (18) , Catherine Trichet (19) , Fausto Viader (20) , Agnes Le Querrec , Thomas Tarek Husein , Sophie Cluet-Dennetiere , Francisco Macian-Montoro (21) , Magali Donnard (22) , Benoit Guillon (23) , Catherine Ternisien (23) , Mathieu Zuber (24) , Sophie Laplanche (25) , Philippe Tassan , Jean-Yves Peeltier

1 Service de neurologie [Amiens]
2 LNFP - Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559
3 CHU Montpellier
4 UNIROUEN - Université de Rouen Normandie
5 Hôpital Lariboisière-Fernand-Widal [APHP]
6 CREAK - Centre de référence national des angiœdèmes
7 CHU - Centre Hospitalier Universitaire [Grenoble]
8 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
9 TIMONE - Hôpital de la Timone [CHU - APHM]
10 Service de Neurologie [Strasbourg]
11 CHU Strasbourg
12 Service de Neurologie [CHU Pitié-Salpêtrière]
13 CHCB - Centre Hospitalier de la Côte Basque
14 Pôle des Neurosciences Cliniques [Bordeaux]
15 Laboratoire d'Hématologie
16 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
17 HESPER - Health Service and Performance Research
18 CHU Sud Saint Pierre [Ile de la Réunion]
19 HUPNVS - Hôpitaux Universitaires Paris Nord Val-de-Seine
20 NIMH - Neuropsychologie et imagerie de la mémoire humaine
21 Hôpital Dupuytren [CHU Limoges]
22 Service d'Hématologie biologique [CHU Limoges]
23 CHU Nantes - Centre hospitalier universitaire de Nantes
24 Centre hospitalier Saint-Joseph [Paris]
25 Service de Biologie [GH Saint-Joseph - APHP]

Introduction: Cerebral venous thrombosis (CVT) is a rare disease with highly variable clinical presentation and outcome. Etiological assessment may be negative. The clinical and radiological presentation and evolution can be highly variable. The mechanisms involved in this variability remain unknown.Objective: The aim of this multicenter French study registered on ClinicalTrials.gov (NCT02013635) was therefore to prospectively recruit a cohort of patients with cerebral venous thrombosis (FPCCVT) in order to study thrombin generation and clot degradation, and to evaluate their influence on clinical radiological characteristics. The first part of the study was to compare our cohort with a reference cohort.Methods: This prospective, multicenter, French study was conducted from July 2011 to September 2016. Consecutive patients (aged >15 years) referred to the stroke units of 21 French centers and who had a diagnosis of symptomatic CVT were included. All patients gave their written informed consent. The diagnosis of CVT had to be confirmed by imaging. Clinical, radiological, biological, and etiological characteristics were recorded at baseline, at acute phase, at 3 months and at last follow-up visit. Thrombophilia screening and the choice of treatment were performed by the attending physician. All data were compared with data from the International Study on CVT published by Ferro et al.Results: Two hundred thirty-one patients were included: 117 (50.6%) had isolated intracranial hypertension, 96 (41.5%) had focal syndrome. During hospitalization, 229 (99.1%) patients received anticoagulant treatment. Median length of hospital stay was 10 days. Five patients died during hospitalization (2.2%). At 3 months, 216 patients (97.0%) had follow-up with neurological data based on an outpatient visit. The mean duration of antithrombotic treatment was 9 months, and the mean time to last follow-up was 10.5 months. At the end of follow-up, eight patients had died, and 26 patients were lost to follow-up. At least one risk factor was identified in 200 patients.Conclusions: We demonstrated that the FPCCVT cohort had radiological, biological, and etiological characteristics similar to the historical ISCVT cohort. Nevertheless, the initial clinical presentation was less severe in our study probably due to an improvement in diagnostic methods between the two studies.

Mots clés: cerebral veins; thrombosis; French cohort; prospective observational study; sinus

Domaines: Sciences du Vivant [q-bio]

Sandrine Canaple, Bertrand Roussel, Nicolas Gaillard, Emilie Scavazza, Veronique Le Cam Duchez, et al.. Cerebral Venous Thrombosis: Clinical, Radiological, Biological, and Etiological Characteristics of a French Prospective Cohort (FPCCVT)-Comparison With ISCVT Cohort. Frontiers in Neurology, 2021, 12, pp.753110. ⟨10.3389/fneur.2021.753110⟩. ⟨hal-03607029⟩