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Cerebral Venous Thrombosis in Hematological Malignancy: Balancing the Risks.
Maria João Pinto1, Pedro Bettencourt Medeiros2, Fernando Príncipe2
1Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal.
Summary
Hematological neoplasms are a rare cause of cerebral venous thrombosis (CVT). While anticoagulation is a reasonable long-term option, managing thrombotic and hemorrhagic risks requires careful, multidisciplinary consideration.
Area of Science:
- Neurology
- Hematology
- Oncology
Background:
- Cerebral venous thrombosis (CVT) coexisting with hematological neoplasms is uncommon.
- Therapeutic strategies for CVT in this context face challenges in balancing thrombotic and hemorrhagic risks.
Purpose of the Study:
- To characterize cases of CVT with concurrent hematological malignancy.
- To identify predisposing factors and evaluate treatment strategies for this rare condition.
Main Methods:
- A descriptive retrospective analysis was conducted.
- Data from 111 CVT cases diagnosed between 2006 and 2015 were reviewed.
- Seven cases with coexisting hematological malignancy were identified and analyzed.
Main Results:
- Seven cases of CVT with hematological malignancy (lymphoma, leukemia, multiple myeloma, myelodysplastic syndromes) were identified.
- All patients had additional prothrombotic conditions contributing to CVT risk.
- One patient died from cerebral hemorrhage during acute treatment; the remaining six had no CVT recurrence or anticoagulation complications with long-term warfarin in five cases.
Conclusions:
- Hematological malignancy is a predisposing factor for CVT, often in conjunction with other risk factors.
- Anticoagulation presents a delicate balance between thrombotic and hemorrhagic risks, as evidenced by one fatal hemorrhagic complication.
- Long-term anticoagulation was beneficial for most patients, highlighting the need for a multidisciplinary approach in management decisions.
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