The role of D-dimer in diagnosis of cerebral sinus venous thrombosis
Archives of Medical Laboratory Sciences,
Vol. 4 No. 3 (2018),
28 December 2019
https://doi.org/10.22037/amls.v4i3.25579
Abstract
Background: Cerebral sinus venous thrombosis (CSVT) is a fatal condition and should be considered in all patients with acute new onset headache. D-dimer has been shown to be a sensitive diagnostic tool in deep vein thrombosis and pulmonary thromboembolism. The purpose of this study was to investigate whether this test could be useful in the diagnosis of CSVT.
Methods: In this prospective study, we reviewed patients referring to Nemazee hospital with presentations suggestive of CSVT. Diagnosis was established, using MRI and MRV. Serum D-dimer level was checked among 24 hours after hospital admission.
Results: From 117 enrolled patients, 37 (31.6%) patients had CSVT. The reported D-dimer levels showed negative (< 500 ng/ml) in 21 (56.76%) and positive level in 16 (43.24 %) patients who had CSVT. Also, D-dimer was negative in 66 (82.5%) and positive in 14 (17.5%) patients who did not have CSVT. These results demonstrated a sensitivity of 43.24%, specificity of 82.5%, positive predictive value of 53.3%, and negative predictive value of 75.86%.
Conclusion: Normal D-dimer levels make the presence of CSVT very unlikely; our study suggests that D-dimer test may guide us to approach patients who are suspected with CSVT in emergency situations with limited access to MRI/MRV. However, every patient with D-dimer level more than 500 ng/mL and high clinical suspicion of CSVT should undergo MRI/MRV. In addition, our results showed a negative D-dimer test was not a reliable assay to completely rule out CSVT. However, we recommend further studies to confirm our results.
- D-dimer
- cerebral sinus venous thrombosis
- diagnosis
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References
Tanislav C, Siekmann R, Sieweke N, Allendörfer J, Pabst W, Kaps M, et al. Cerebral vein thrombosis: clinical manifestation and diagnosis. BMC Neurology. 2011;11(1):69.
Coutinho JM. Cerebral venous thrombosis. Journal of thrombosis and haemostasis : JTH. 2015;13 Suppl 1:S238-44.
Misra UK, Kalita J, Bansal V. D-dimer is useful in the diagnosis of cortical venous sinus thrombosis. Neurology India. 2009;57(1):50-4.
Alons IM, Jellema K, Wermer MJ, Algra A. D-dimer for the exclusion of cerebral venous thrombosis: a meta-analysis of low risk patients with isolated headache. BMC Neurol. 2015;15:118.
Tarek Gouda, Sabry HM. Evaluation of Plasma D-Dimer Assay as A Diagnostic Biomarker for Cerebral Venous Thrombosis. Egypt J Neurol Psychiat Neurosurg 2010;47(2):331-6.
Bousser MG, Crassard I. Cerebral venous thrombosis, pregnancy and oral contraceptives. Thrombosis research. 2012;130 Suppl 1:S19-22.
Tardy B, Tardy-Poncet B, Viallon A, Piot M, Garnier P, Mohamedi R, et al. D-dimer levels in patients with suspected acute cerebral venous thrombosis. The American journal of medicine. 2002;113(3):238-41.
Schrecengost JE, LeGallo RD, Boyd JC, Moons KG, Gonias SL, Rose CE, Jr., et al. Comparison of diagnostic accuracies in outpatients and hospitalized patients of D-dimer testing for the evaluation of suspected pulmonary embolism. Clinical chemistry. 2003;49(9):1483-90.
Sidhom Y, Mansour M, Messelmani M, Derbali H, Fekih-Mrissa N, Zaouali J, et al. Cerebral venous thrombosis: clinical features, risk factors, and long-term outcome in a Tunisian cohort. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2014;23(6):1291-5.
Saadatnia M, Mousavi SA, Haghighi S, Aminorroaya A. Cerebral vein and sinus thrombosis in Isfahan-Iran: a changing profile. The Canadian journal of neurological sciences Le journal canadien des sciences neurologiques. 2004;31(4):474-7.
Haapaniemi E, Tatlisumak T. Is D-dimer helpful in evaluating stroke patients? A systematic review. Acta neurologica Scandinavica. 2009;119(3):141-50.
Hashami L, Rakhshan V, Karimian H, Moghaddasi M. Diagnostic Value of D-Dimer’s Serum Level in Iranian Patients with Cerebral Venous Thrombosis. Neurology International. 2016;8(2):6310.
Kosinski CM, Mull M, Schwarz M, Koch B, Biniek R, Schlafer J, et al. Do normal D-dimer levels reliably exclude cerebral sinus thrombosis? Stroke. 2004;35(12):2820-5.
Meng R, Wang X, Hussain M, Dornbos D, 3rd, Meng L, Liu Y, et al. Evaluation of plasma D-dimer plus fibrinogen in predicting acute CVST. International journal of stroke : official journal of the International Stroke Society. 2014;9(2):166-73.
Lalive PH, de Moerloose P, Lovblad K, Sarasin FP, Mermillod B, Sztajzel R. Is measurement of D-dimer useful in the diagnosis of cerebral venous thrombosis? Neurology. 2003;61(8):1057-60.
Crassard I, Soria C, Tzourio C, Woimant F, Drouet L, Ducros A, et al. A negative D-dimer assay does not rule out cerebral venous thrombosis: a series of seventy-three patients. Stroke. 2005; 36(8):1716-9.
Saposnik G, Barinagarrementeria F, Brown RD, Jr., Bushnell CD, Cucchiara B, Cushman M, et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011; 42(4):1158-92.
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