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      Inflammation is correlated with severity and outcome of cerebral venous thrombosis

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          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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          Most cited references28

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          Bidirectional relation between inflammation and coagulation.

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            Cerebral venous thrombosis

            Cerebral venous thrombosis (CVT) is a prominent cause of stroke, particularly in young adults. Knowledge of this condition has greatly increased in the past two decades, primarily owing to new data from international patient registries. This Review provides an overview of the epidemiology, pathophysiology, diagnosis and treatment of CVT, with a focus on new advances in the field.
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              Interleukin-6 stimulates coagulation, not fibrinolysis, in humans.

              The role of IL-6 as a mediator of haemostatic changes during severe inflammation is controversial. To assess the effect of IL-6 on haemostasis we conducted a controlled cross-over study in eight patients with metastatic renal cell cancer. In all subjects coagulation and fibrinolysis were monitored during and after a 4-h infusion of either 150 micrograms recombinant human (rh) IL-6, or during infusion of saline (control study). Mean maximum IL-6 concentrations were 1418.0 +/- 755.8 pg/ml. Compared to the control study, rhIL-6 induced activation of coagulation as reflected by a 190 +/- 55% increase in the plasma levels of thrombin-antithrombin III complexes (p < 0.001) and by a 24 +/- 11% increase in the plasma levels of in the prothrombin activation fragment F1 + 2 (p < 0.001). In contrast, fibrinolysis was not affected. We conclude that in severe inflammation IL-6 may contribute to the activation of coagulation, whereas other factors mediate changes in fibrinolysis.
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                Author and article information

                Contributors
                wangliyandyx@163.com
                djg333@163.com
                1187429614@qq.com
                victor65@162.com
                wlf_713@163.com
                gzhenzhang@sina.com
                Zhang_xuxiang@hotmail.com
                wang-chunxiu@163.com
                jixm@ccmu.edu.cn
                Journal
                J Neuroinflammation
                J Neuroinflammation
                Journal of Neuroinflammation
                BioMed Central (London )
                1742-2094
                26 November 2018
                26 November 2018
                2018
                : 15
                : 329
                Affiliations
                [1 ]ISNI 0000 0004 0632 3337, GRID grid.413259.8, Neurosurgery Department of Xuanwu Hospital Capital Medical University, ; Changchun st 45, Xicheng District, Beijing, China
                [2 ]ISNI 0000 0004 0632 3337, GRID grid.413259.8, Emergency Department of Xuanwu Hospital Capital Medical University, ; Changchun street 45, Xicheng District, Beijing, China
                [3 ]ISNI 0000 0004 0632 3337, GRID grid.413259.8, Ophtalmology Department of Xuanwu Hospital Capital Medical University, ; Changchun street 45, Xicheng District, Beijing, China
                [4 ]ISNI 0000 0004 0632 3337, GRID grid.413259.8, Evidence-based Medicine Department of Xuanwu Hospital Capital Medical University, ; Changchun street 45, Xicheng District, Beijing, China
                Article
                1369
                10.1186/s12974-018-1369-0
                6260678
                30477534
                34d68776-ab22-4126-a609-3dcdbf460d54
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 July 2018
                : 15 November 2018
                Funding
                Funded by: The Scientific and Technological plan of Beijing Municipal Commission of Science and Technology
                Award ID: Z181100001918026
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Neurosciences
                cerebral venous thrombosis,inflammation,stage,severity,outcome
                Neurosciences
                cerebral venous thrombosis, inflammation, stage, severity, outcome

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