Inflammation is Correlated with Severity and Outcome of Cerebral Venous Thrombosis

Overview

Journal J Neuroinflammation

Publisher Biomed Central

Date 2018 Nov 28

PMID 30477534

Citations 29

Authors

Liyan Wang

Jiangang Duan

Tingting Bian

Ran Meng

Longfei Wu

Zhen Zhang

Xuxiang Zhang

Chunxiu Wang

Xunming Ji

Affiliations

Soon will be listed here.

Abstract

Background: Few studies have suggested a relationship between inflammation and cerebral venous thrombosis (CVT). This retrospective study aimed to explore the changes in inflammation in different CVT stages and the correlation between inflammation and severity and outcome of CVT.

Methods: In total, 95 suitable patients with CVT and 41 controls were compared. Patients with CVT were divided into three groups. The inflammatory factors studied included hypersensitive C-reactive protein (Hs-CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood and immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) in the cerebrospinal fluid (CSF). The severity of CVT was evaluated with the modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), fundus condition, intracranial pressure (ICP), and complications on admission. The short-term outcome was evaluated with the mRS at discharge.

Results: The following results were obtained: (1) Inflammatory factor levels in patients with CVT were higher than those in the controls. (2) Inflammatory factor levels in the acute and subacute stages were significantly higher than those in the chronic stage (all P < 0.05). (3) Serum NLR and CSF IgM levels were positively related to baseline degree of disability (odds ratio [OR], 1.279, 95% confidence interval [CI] 1.009-1.621, P = 0.042; OR 1.402, 95% CI 1.036-1.896, P = 0.028). The Hs-CRP level was positively correlated with the baseline occurrence of seizure (OR 1.040, 95% CI 1.001-1.080, P = 0.043). The baseline serum NLR (r = 0.244, P = 0.017), CSF IgA (r = 0.615, P < 0.001), CSF IgM (r = 0.752, P < 0.001), and CSF IgG (r = 0.248, P = 0.015) levels were positively associated with NIHSS. (4) The baseline NLR was significantly associated with high risk of poor outcome at discharge (OR 1.339, 95% CI 1.097-1.784, P = 0.007). Moreover, the ROC showed that NLR ≥ 4.205 could better predict the poor outcome at discharge. The data were analyzed using SPSS.

Conclusions: Inflammation may develop after CVT and gradually decrease during the course. Inflammation was significantly correlated with severity on admission and short-term poor outcome at discharge in CVT.

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References

Stouthard J, Levi M, Hack C, Veenhof C, Romijn H, Sauerwein H . Interleukin-6 stimulates coagulation, not fibrinolysis, in humans. Thromb Haemost. 1996; 76(5):738-42. View

van der Poll T, Levi M, Hack C, ten Cate H, van Deventer S, Eerenberg A . Elimination of interleukin 6 attenuates coagulation activation in experimental endotoxemia in chimpanzees. J Exp Med. 1994; 179(4):1253-9. PMC: 2191443. DOI: 10.1084/jem.179.4.1253. View

Zhao H, Li G, Ma Q, Tao Z, Wang R, Fan Z . MicroRNA-99a-5p in circulating immune cells as a potential biomarker for the early diagnosis of ischemic stroke. Brain Circ. 2018; 3(1):21-28. PMC: 6126231. DOI: 10.4103/bc.bc_1_17. View

Wang F, Hu S, Ding Y, Ju X, Wang L, Lu Q . Neutrophil-to-Lymphocyte Ratio and 30-Day Mortality in Patients with Acute Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis. 2015; 25(1):182-7. DOI: 10.1016/j.jstrokecerebrovasdis.2015.09.013. View

van Aken B, den Heijer M, Bos G, van Deventer S, Reitsma P . Recurrent venous thrombosis and markers of inflammation. Thromb Haemost. 2000; 83(4):536-9. View

Roumen-Klappe E, den Heijer M, van Uum S, van der Ven-Jongekrijg J, van der Graaf F, Wollersheim H . Inflammatory response in the acute phase of deep vein thrombosis. J Vasc Surg. 2002; 35(4):701-6. DOI: 10.1067/mva.2002.121746. View

Nagai M, Terao S, Yilmaz G, Yilmaz C, Esmon C, Watanabe E . Roles of inflammation and the activated protein C pathway in the brain edema associated with cerebral venous sinus thrombosis. Stroke. 2009; 41(1):147-52. PMC: 2799535. DOI: 10.1161/STROKEAHA.109.562983. View

Vormittag R, Hsieh K, Kaider A, Minar E, Bialonczyk C, Hirschl M . Interleukin-6 and interleukin-6 promoter polymorphism (-174) G > C in patients with spontaneous venous thromboembolism. Thromb Haemost. 2006; 95(5):802-6. View

Qun S, Tang Y, Sun J, Liu Z, Wu J, Zhang J . Neutrophil-To-Lymphocyte Ratio Predicts 3-Month Outcome of Acute Ischemic Stroke. Neurotox Res. 2017; 31(3):444-452. DOI: 10.1007/s12640-017-9707-z. View

10.

Eylev Akboga Y, Bektas H, Anlar O . Usefulness of platelet to lymphocyte and neutrophil to lymphocyte ratios in predicting the presence of cerebral venous sinus thrombosis and in-hospital major adverse cerebral events. J Neurol Sci. 2017; 380:226-229. DOI: 10.1016/j.jns.2017.07.036. View

11.

Varma M, Varga A, Knipp B, Sukheepod P, Upchurch G, Kunkel S . Neutropenia impairs venous thrombosis resolution in the rat. J Vasc Surg. 2003; 38(5):1090-8. DOI: 10.1016/s0741-5214(03)00431-2. View

12.

Rust R, Hofer A, Schwab M . Stroke Promotes Systemic Endothelial Inflammation and Atherosclerosis. Trends Mol Med. 2018; 24(7):593-595. DOI: 10.1016/j.molmed.2018.04.008. View

13.

Levi M, van der Poll T, Buller H . Bidirectional relation between inflammation and coagulation. Circulation. 2004; 109(22):2698-704. DOI: 10.1161/01.CIR.0000131660.51520.9A. View

14.

Prasad R . Immunoglobulins in certain CNS disorders: a study of CSF Ig classes G, A, M, D, and E concentrations. Am J Clin Pathol. 1985; 83(2):190-5. DOI: 10.1093/ajcp/83.2.190. View

15.

Alshoabi S . Cerebral venous sinus thrombosis: A diagnostic challenge in a rare presentation. Brain Circ. 2018; 3(4):227-230. PMC: 6057707. DOI: 10.4103/bc.bc_27_17. View

16.

Nuzzo D, Picone P, Caruana L, Vasto S, Barera A, Caruso C . Inflammatory mediators as biomarkers in brain disorders. Inflammation. 2013; 37(3):639-48. DOI: 10.1007/s10753-013-9780-2. View

17.

Arauz A, Vargas-Gonzalez J, Arguelles-Morales N, Barboza M, Calleja J, Martinez-Jurado E . Time to recanalisation in patients with cerebral venous thrombosis under anticoagulation therapy. J Neurol Neurosurg Psychiatry. 2015; 87(3):247-51. DOI: 10.1136/jnnp-2014-310068. View

18.

Pandey A, Shrivastava A, Saxena K . Neuron specific enolase and c-reactive protein levels in stroke and its subtypes: correlation with degree of disability. Neurochem Res. 2014; 39(8):1426-32. DOI: 10.1007/s11064-014-1328-9. View

19.

Hu Y, Meng R, Zhang X, Guo L, Li S, Wu Y . Serum neuron specific enolase may be a marker to predict the severity and outcome of cerebral venous thrombosis. J Neurol. 2017; 265(1):46-51. DOI: 10.1007/s00415-017-8659-9. View

20.

Khasawneh A, Garling R, Harris C . Cerebrospinal fluid circulation: What do we know and how do we know it?. Brain Circ. 2018; 4(1):14-18. PMC: 6057699. DOI: 10.4103/bc.bc_3_18. View