Study Of Etiology Of Cerebral Venous Thrombosis

OBJECTIVE Cerebral venous thrombosis (CVT) is an infrequent disease with a large variety of causes However, in 20% to 35% of cases, no cause is found Studies in recent years have shown that besides acqured risk factors, inherited blood coagulation disorders play an important role in the development of CVT This study is to clarity the etiology of CVT by investigating the 52 cases retrospectively, examining the coagulation parameters including protein C( PC), protein S (PS) , activated protein C resistance (APCR) , antithrombin III (AT III) and identifying the gene polymorphism of coagulation factor V Leiden and factor II (prothrombin) G20210A of 20 CVT patients, which have not been found any causes by regular investigationMATERIAL and METHODS Records of 52 hospitalized adult patients with angiographically confirmed diagnosis of CVT were reviewed to investigate the etiologies retrospectively ②In the 20 CVT patients of unknown causes, the activity of PC and PS and the phenomenon of APCR were determined by clotting end-point, while the activity of AT III was measured by chromogenic assay @Detect the mutant factor V gene(factor V Leiden) in the 20 patients and 50 controls by DNA extraction, polymerase chain reaction, Mn!— I restriction and DNA sequence analysis ④Detect the mutant factor II gene (factor II G20210A) in the 20 patients and 50 controls by DNA extraction, polymerase chain reaction, Mn!— I and Hind—HI restriction,4and DNA sequence analysisRESULTS①52 patients (men womenl 1), aged 20 to 60 years (36 ± 8 years) were identified In 52 patients, 5(10 % ) had upper respiratory infection, 4(7 % ) were found anemia, 3(6 % ) took oral contraceptives, 2(4 % ) had gingivitis, 2(4 % ) were found dural arteriovenous fistula, 1(2% ) was identified with Bechet's disease, migraine and cranial operation respectively 3 3(63 %) patients hadn't found the causes ②6 cases of thrombophilia (30%) were found in the 20 "idiopathic" CVI patients 2 PC deficiency(10%), 1 PS deficiency(5%) and 3 APCR(15%) None of the patients had AT Ill deficiency @I~Factor V Leiden mutation and factor II G20210A mutation were not found in 20 patients and 50 controls, which was proved by DNA sequence analysisConclusion ②Most of our 52 patients were young and not found etiologies or predisposing factors by regular investigation ~Inherited coagulation disorders tend to play an important role in the development of CVI, so it is important for routine screening the PC, PS deficiency and APCR, especially when CVI has no cause ②Factor V Leiden mutation and factor II G20210A mutation may have racial background and be not the key risk factors of CVI in Chinese ~The APCR in Chinese may not be caused by the factor V Leiden mutation A further investigation should be performed on the etiology of CVI and the mechanism of APCR in Chinese...