CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(04): 719-724
DOI: 10.4103/ajns.AJNS_21_21
Original Article

The effects of temperature and prothrombotic conditions on cerebral venous sinus thrombosis frequency: An institutional experience

Fatima Mustansir
Department of Surgery, The Aga Khan University, Karachi
,
Maha Inam
Department of Surgery, The Aga Khan University, Karachi
,
Aneela Darbar
Department of Surgery, The Aga Khan University, Karachi
› Author Affiliations

Objectives: The pathogenesis of cerebral venous sinus thrombosis (CVST) is complex and involves the interplay of underlying provocative factors. Upon observing a higher frequency of CVST cases presenting to our hospital in summer, we hypothesized that CVST may be influenced by variations in climate. Materials and Methods: A retrospective review of all patients who were diagnosed with CVST at a tertiary care hospital in Pakistan between January 2010 and December 2019 was conducted. After dividing patients into groups based on the type of risk, the frequency of CVST in these groups between four seasons (spring, summer, fall, and winter) was compared. Results: A total of 256 patients diagnosed with CVST were included, of which 129 were female and 127 were male. The mean age was 41.7 ± 15.2 years. Of the total patients, 91.4% had some sort of risk factor, either systemic (162 patients) or local (72 patients), while 22 patients did not have any identifiable risk factor. The number of patients with more than one known risk factor was 93 (36.3%). Of the total number of patients, 96 (37.5%) patients had hyperhomocysteinemia, followed by 85 patients (33.2%) with a prothrombotic risk factor other than hyperhomocysteinemia and 44 (17.2%) patients with central nervous system infections. The most commonly affected sinuses were a combination of the transverse sinus and sigmoid sinus (21%), There was a statistically significant seasonal variation in CVST cases among all patients (P = 0.03) and in the systemic risk factor group (P = 0.05), with the highest number of cases occurring in the summer season. Conclusions: CVST may be influenced by seasonal changes in atmospheric temperatures and humidity, especially in patients with underlying prothrombotic risk factors.

Financial support and sponsorship

Nil.




Publication History

Received: 16 January 2021

Accepted: 19 July 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Ferro JM, Aguiar de Sousa D. Cerebral venous thrombosis: An update. Curr Neurol Neurosci Rep 2019;19:74.
  • 2 Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005;352:1791-8.
  • 3 Bousser MG, Ferro JM. Cerebral venous thrombosis: An update. Lancet Neurol 2007;6:162-70.
  • 4 Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012 Dec;43(12):3375-7.
  • 5 Sharon D, Ben W, James L, Timothy K. Cerebral venous sinus thrombosis incidence is higher than previously thought. Stroke 2016;47:2180-2.
  • 6 Janghorbani M, Zare M, Saadatnia M, Mousavi SA, Mojarrad M, Asgari E. Cerebral vein and dural sinus thrombosis in adults in Isfahan, Iran: Frequency and seasonal variation. Acta Neurol Scand 2008;117:117-21.
  • 7 Borhani Haghighi A, Ashjazadeh N, Safari A, Cruz-Flores S. Cerebral venous sinus thrombosis in Iran: Cumulative data, shortcomings and future directions. Iran Red Crescent Med J 2012;14:805-10.
  • 8 Dash D, Prasad K, Joseph L. Cerebral venous thrombosis: An Indian perspective. Neurol India 2015;63:318-28.
  • 9 Al-Sulaiman A. Clinical aspects, diagnosis and management of cerebral vein and dural sinus thrombosis: A literature review. Saudi J Med Med Sci 2019;7:137-45.
  • 10 Patil VC, Choraria K, Desai N, Agrawal S. Clinical profile and outcome of cerebral venous sinus thrombosis at tertiary care center. J Neurosci Rural Pract 2014;5:218-24.
  • 11 Zavanone C, Panebianco M, Yger M, Borden A, Restivo D, Angelini C, et al. Cerebral venous thrombosis at high altitude: A systematic review. Rev Neurol (Paris) 2017;173:189-93.
  • 12 Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F; ISCVT Investigators. Prognosis of cerebral vein and dural sinus thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004;35:664-70.
  • 13 Stone J, Hangge P, Albadawi H, Wallace A, Shamoun F, Knuttien MG, et al. Deep vein thrombosis: Pathogenesis, diagnosis, and medical management. Cardiovasc Diagn Ther 2017;7:S276-84.
  • 14 Bousser MG. Cerebral venous thrombosis: Diagnosis and management. J Neurol 2000;247:252-8.
  • 15 deVeber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, et al. Cerebral Sinovenous Thrombosis in Children. N Engl J Med 2001;345:417-23.
  • 16 Yadegari S, Ghorbani A, Miri SR, Abdollahi M, Rostami M. Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran. J Neurosci Rural Pract 2016;7:554-8.
  • 17 Yuen HW, Gan BK, Seow WT, Tan HK. Dural sinus thrombosis after minor head injury in a child. Ann Acad Med Singap 2005;34:639-41.
  • 18 Elkatatny AA, Elreheem YA, Hamdy T. Traumatic dural venous sinuses injury. Open Access Maced J Med Sci 2019;7:3225-34.
  • 19 Adler JT, Chang DC, Chan AT, Faiz O, Maguire LH. Seasonal variation in diverticulitis: Evidence from both hemispheres. Dis Colon Rectum 2016;59:870-7.
  • 20 Peterson RA, Polgreen LA, Sewell DK, Polgreen PM. Warmer weather as a risk factor for cellulitis: A population-based investigation. Clin Infect Dis 2017;65:1167-73.
  • 21 Durkin MJ, Dicks KV, Baker AW, Lewis SS, Moehring RW, Chen LF, et al. Seasonal variation of common surgical site infections: Does season matter? Infect Control Hosp Epidemiol 2015;36:1011-6.
  • 22 Zangbar B, Rhee P, Pandit V, Hsu CH, Khalil M, Okeefe T, et al. Seasonal variation in emergency general surgery. Ann Surg 2016;263:76-81.
  • 23 Salehi G, Sarraf P, Fatehi F. Cerebral venous sinus thrombosis may follow a seasonal pattern. J Stroke Cerebrovasc Dis 2016;25:2838-43.
  • 24 Ferro JM, Lopes GC, Rosas MJ, Araújo C, Henriques I; Venoport Investigators. Chronobiology of cerebral vein and dural sinus thrombosis. Cerebrovasc Dis 2002;14:265.
  • 25 Stolz E, Klötzsch C, Rahimi A, Schlachetzki F, Kaps M. Seasonal variations in the incidence of cerebral venous thrombosis. Cerebrovasc Dis 2003;16:455-6.
  • 26 Aaron S, Lakshmanan J, Sudarsanam TD, Benjamin K, Durairaj J, Mathew V, et al. Cerebral venous thrombosis, seasonal trends, and climatic influence: A region-specificstudy. Ann Indian Acad Neurol 2020;23:522-7.
  • 27 Keatinge WR, Coleshaw SR, Cotter F, Mattock M, Murphy M, Chelliah R. Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: Factors in mortality from coronary and cerebral thrombosis in winter. Br Med J (Clin Res Ed) 1984;289:1405-8.
  • 28 Masotti L, Ceccarelli E, Forconi S, Cappelli R. Seasonal variations of pulmonary embolism in hospitalized patients. Respir Med 2005;99:1469-73.
  • 29 Lim YH, Park MS, Kim Y, Kim H, Hong YC. Effects of cold and hot temperature on dehydration: A mechanism of cardiovascular burden. Int J Biometeorol 2015;59:1035-43.
  • 30 Saleem SG, Ansari T, Ali AS, Fatima S, Rizvi MH, Samad MA. Risk factors for heat related deaths during the June 2015 heat wave in Karachi, Pakistan. J Ayub Med Coll Abbottabad 2017;29:320-4.
  • 31 Shah DA, Najib T. Heat stroke in Karachi: An unprecedented medical emergency. Infect Public Health 2016;9:370-1.
  • 32 Masood I, Majid Z, Sohail S, Zia A, Raza S. The deadly heat wave of Pakistan, June 2015. Int J Occup Environ Med 2015;6:247-8.
  • 33 Huisse MG, Pease S, Hurtado-Nedelec M, Arnaud B, Malaquin C, Wolff M, et al. Leukocyte activation: The link between inflammation and coagulation during heatstroke. A study of patients during the 2003 heat wave in Paris. Crit Care Med 2008;36:2288-95.
  • 34 Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20;346(25):1978-88.
  • 35 Wasay M, Kaul S, Menon B, Dai AI, Saadatnia M, Malik A, et al. Asian study of cerebral venous thrombosis. J Stroke Cerebrovasc Dis 2019;28:104247.
  • 36 Khealani BA, Wasay M, Saadah M, Sultana E, Mustafa S, Khan FS, et al. Cerebral venous thrombosis: A descriptive multicenter study of patients in Pakistan and Middle East. Stroke 2008;39:2707-11.
  • 37 Martinelli I, Battaglioli T, Pedotti P, Cattaneo M, Mannucci PM. Hyperhomocysteinemia in cerebral vein thrombosis. Blood 2003;102:1363-6.
  • 38 Marie-Anne D, Jacqueline C, Hélène HM, Alain A, Maurice P, François C, et al. Coagulation studies, factor V leiden, and anticardiolipin antibodies in 40 cases of cerebral venous thrombosis. Stroke 1996;27:1724-30.
  • 39 de Freitas GR, Bogousslavsky J. Risk factors of cerebral vein and sinus thrombosis. Front Neurol Neurosci. 2008;23:23-54.