Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis

CNS Neurosci Ther. 2021 Nov;27(11):1396-1408. doi: 10.1111/cns.13719. Epub 2021 Aug 16.

Abstract

Aims: To explore the effect of nonthrombotic internal jugular venous stenosis (IJVS) exerted on cerebral venous thrombosis (CVT).

Methods: Patients with imaging confirmed CVT were enrolled into this real-world case-control study consecutively from January 2018 through April 2021, and were divided into CVT and IJVS-CVT groups, according to whether or not with non-thrombotic IJVS. Chi-square and logistic regression models were utilized for between-group comparison of thrombotic factors.

Results: A total of 199 eligible patients entered into final analysis, including 92 cases of CVT and 107 cases of IJVS-CVT. Chi-square revealed that thrombophilic conditions were found in majority of CVT, while only minority in the IJVS-CVT group (83.7% vs. 20.6%, p < 0.001). Multivariate logistic regression indicated that most identified thrombophilia were negatively related to IJVS-CVT (all p < 0.05), including oral contraceptive use (β = -1.38), hyperhomocysteinemia (β = -1.58), hematology (β = -2.05), protein C/S deficiency (β = -2.28), connective tissue disease (β = -1.18) and infection (β = -2.77). All recruited patients underwent standard anticoagulation, 10 cases in IJVS-CVT group also received jugular angioplasty for IJVS correction. Most participants obtained alleviations during 1-year follow-up. However, both clinical and imaging outcomes in IJVS-CVT group were not as good as those in CVT group (both p < 0.05). Moreover, 8 cases with CVT and 7 cases with IJVS-CVT were rehospitalized for CVT recurrences and underwent customized treatment.

Conclusion: Nonthrombotic IJVS may be one of the risk factors of CVT. Anticoagulation might need to be suggested for IJVS patients.

Keywords: cause; cerebral venous thrombosis; internal jugular venous stenosis; relationship.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anticoagulants / therapeutic use
  • Case-Control Studies
  • Constriction, Pathologic
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Thrombosis
  • Jugular Veins / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroimaging
  • Risk Factors
  • Thrombophilia / pathology
  • Treatment Outcome
  • Venous Thrombosis / pathology

Substances

  • Anticoagulants