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Exploring thrombus composition in cerebral venous thrombosis: the first case report with initial insights and implications for treatment advancements.

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Title: Exploring thrombus composition in cerebral venous thrombosis: the first case report with initial insights and implications for treatment advancements.
Authors: Schwarz, Ghil (AUTHOR), Rizzo, Angelo Cascio (AUTHOR), Di Como, Martina (AUTHOR), Pero, Guglielmo (AUTHOR), Cervo, Amedeo (AUTHOR), Macera, Antonio (AUTHOR), Aquilano, Maria Costanza (AUTHOR), Motto, Cristina (AUTHOR), Bacigaluppi, Marco (AUTHOR), Protti, Alessandra (AUTHOR), Bonoldi, Emanuela (AUTHOR), Piano, Mariangela (AUTHOR), Agostoni, Elio Clemente (AUTHOR)
Source: Neurological Sciences. May2024, Vol. 45 Issue 5, p2341-2345. 5p.
Subjects: Venous thrombosis, Cerebral embolism & thrombosis, Thrombosis, Endovascular surgery, Intrauterine contraceptives, Sinus thrombosis
Abstract: Background: Endovascular thrombectomy (EVT) is a treatment option in patients with a cerebral venous thrombosis (CVT) who deteriorate despite anticoagulant treatment. Assessment of thrombus composition in CVT may provide insights into the pathophysiology of the disease and suggest new therapeutic strategies. Case report: A 47-year-old woman (smoking habit and estradiol/progesterone-releasing intra-uterine device) diagnosed with massive CVT underwent EVT (complete recanalization via aspiration catheter and stentriever) due to acute-onset left-sided weakness and dysarthria despite 72 h of full-dose subcutaneous low-molecular heparin. Two main reddish clots (maximum diameter 15 mm) were retrieved. Microscopic assessment showed an erythrocyte-rich thrombus (83.9% of entire thrombus surface) with layers of platelets/fibrin (lines of Zahn: 13.9% fibrin and 38.5% platelet [CD61+]). The immunological profile was dominated by neutrophils (30% MPO+), with neutrophil extracellular traps (NETs) in 1.9% of thrombus surface. T- (CD3+), B-lymphocytes (CD20+), and monocytes/macrophages (CD68+) were rather rare (2.2%, 0.7%, and 2.0% respectively). We found no evidence (0.0%) of hemosiderin and endothelial cells (CD34+). Full clinical recovery occurred prior to discharge. Conclusion: This is the first case report of a CVT with histologic assessment of the thrombus retrieved via EVT. Evaluating thrombi in CVT can provide key insights into disease pathophysiology and guide treatment advancements. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Exploring thrombus composition in cerebral venous thrombosis: the first case report with initial insights and implications for treatment advancements.
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  Data: <searchLink fieldCode="AR" term="%22Schwarz%2C+Ghil%22">Schwarz, Ghil</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rizzo%2C+Angelo+Cascio%22">Rizzo, Angelo Cascio</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Di+Como%2C+Martina%22">Di Como, Martina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pero%2C+Guglielmo%22">Pero, Guglielmo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cervo%2C+Amedeo%22">Cervo, Amedeo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Macera%2C+Antonio%22">Macera, Antonio</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aquilano%2C+Maria+Costanza%22">Aquilano, Maria Costanza</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Motto%2C+Cristina%22">Motto, Cristina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bacigaluppi%2C+Marco%22">Bacigaluppi, Marco</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Protti%2C+Alessandra%22">Protti, Alessandra</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bonoldi%2C+Emanuela%22">Bonoldi, Emanuela</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Piano%2C+Mariangela%22">Piano, Mariangela</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Agostoni%2C+Elio+Clemente%22">Agostoni, Elio Clemente</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. May2024, Vol. 45 Issue 5, p2341-2345. 5p.
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  Data: <searchLink fieldCode="DE" term="%22Venous+thrombosis%22">Venous thrombosis</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebral+embolism+%26+thrombosis%22">Cerebral embolism & thrombosis</searchLink><br /><searchLink fieldCode="DE" term="%22Thrombosis%22">Thrombosis</searchLink><br /><searchLink fieldCode="DE" term="%22Endovascular+surgery%22">Endovascular surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Intrauterine+contraceptives%22">Intrauterine contraceptives</searchLink><br /><searchLink fieldCode="DE" term="%22Sinus+thrombosis%22">Sinus thrombosis</searchLink>
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  Data: Background: Endovascular thrombectomy (EVT) is a treatment option in patients with a cerebral venous thrombosis (CVT) who deteriorate despite anticoagulant treatment. Assessment of thrombus composition in CVT may provide insights into the pathophysiology of the disease and suggest new therapeutic strategies. Case report: A 47-year-old woman (smoking habit and estradiol/progesterone-releasing intra-uterine device) diagnosed with massive CVT underwent EVT (complete recanalization via aspiration catheter and stentriever) due to acute-onset left-sided weakness and dysarthria despite 72 h of full-dose subcutaneous low-molecular heparin. Two main reddish clots (maximum diameter 15 mm) were retrieved. Microscopic assessment showed an erythrocyte-rich thrombus (83.9% of entire thrombus surface) with layers of platelets/fibrin (lines of Zahn: 13.9% fibrin and 38.5% platelet [CD61+]). The immunological profile was dominated by neutrophils (30% MPO+), with neutrophil extracellular traps (NETs) in 1.9% of thrombus surface. T- (CD3+), B-lymphocytes (CD20+), and monocytes/macrophages (CD68+) were rather rare (2.2%, 0.7%, and 2.0% respectively). We found no evidence (0.0%) of hemosiderin and endothelial cells (CD34+). Full clinical recovery occurred prior to discharge. Conclusion: This is the first case report of a CVT with histologic assessment of the thrombus retrieved via EVT. Evaluating thrombi in CVT can provide key insights into disease pathophysiology and guide treatment advancements. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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