Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

computed tomography

 

Trombosis Venosa Cerebral: Consideraciones Actuales. Brain Venous Thrombosis: Current Considerations

Introduction: Cerebral venous thrombosis (CVT) is an uncommon cause of cerebrovascular disease that mainly affects children and young adults, mostly in fertile-age-women.

Objectives: A contemporary review of the epidemiological, anatomical, pathophysiological, diagnostic and treatment characteristics of CVT.

Materials and methods: A bibliographic research was performed in the PubMed / MEDLINE database and including studies published in the period 2015-2020.

Development: The estimated-annual-incidence has been increasing in last years. Its diagnosis is established by clinical studies and neuroimaging, and laboratory studies. Although, the diagnosis is generally late due to a highly variable and nonspecific clinical presentation. Treatment target is preventing potential mortal complications, followed by anticoagulant therapy. In some cases, surgical thrombolytic procedures are indicated.

Conclusions: The diagnosis is based on a combination of MRI or CT studies. The current gold-standard treatment is low molecular weight heparin and warfarin.

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Sub-estudio de Neuroimagen del Proyecto Atahualpa. Neuroimaging Substudy Of The Atahualpa Project

The Atahualpa Project includes a Neuroimaging sub-study, which consists in the practice of MRIs and MRAs to all participants aged ≥60 years, as well as those presenting with specific neurological complains. Likewise, all participants aged ≥20 years have been invited for the practice of a head CT. MRIs and MRAs have been performed with the use of a Philips Intera 1.5T MRI machine, and TCs with the use of a Philips Brilliance 64 CT scanner, following established protocols. All exams have been independently reviewed by a neurologist and a neuroradiologist, with adequate kappa coefficients for inter-rater agreement. MRIs studies have been focused on the evaluation of global cortical atrophy, posterior parietal atrophy, bicaudate index, Evans index, hippocampal atrophy, signatures of cerebral small vessel disease, and lesions consistent with ischemic or hemorrhagic strokes. By the use of MRI, we have assessed the prevalence of intracranial artery stenosis, intracranial dolichoectasia and variations in the configuration of the circle of Willis. Using CT, we have focused on the diagnosis of neurocysticercosis, pineal gland calcifications, as well as in variations and characteristics of skull bones, cerebellar atrophy, and severity of carotid siphon calcifications. In the present study, we focused on the description of basic protocols used for assessment of previously mentioned lesions of interest.

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