Cerebral Vein Thrombosis: Symptoms and Diagnosis
Author Information
Author(s): Tanislav Christian, Siekmann Ralf, Sieweke Nicole, Allendörfer Jens, Pabst Wolfgang, Kaps Manfred, Stolz Erwin
Primary Institution: Justus Liebig University, Giessen, Germany
Hypothesis
What is the predictive value of clinical signs and symptoms and D-dimer measurements for diagnosing cerebral vein thrombosis (CVT)?
Conclusion
Imaging has a 10 to 20% chance of detecting CVT when typical symptoms are present, and D-dimer measurements have limited clinical value due to false positive and negative results.
Supporting Evidence
- CVT was found in 39 out of 239 patients (16.3%).
- D-dimer testing showed a 9% false positive and 24% false negative rate.
- The area under the ROC curve for D-dimer was 0.921.
Takeaway
Cerebral vein thrombosis can be hard to diagnose because its symptoms are very common, and tests like D-dimer can give wrong results.
Methodology
Retrospective analysis of consecutive patients suspected of CVT who underwent MRI and/or CT angiography.
Potential Biases
Potential selection bias due to the treating neurologist's awareness of the imaging results.
Limitations
The study's retrospective design may introduce selection bias, and treating neurologists were not blinded to imaging results.
Participant Demographics
239 patients, 170 (71%) females and 69 (29%) males.
Statistical Information
P-Value
0.001
Confidence Interval
0.864 - 0.977
Statistical Significance
p<0.01
Digital Object Identifier (DOI)
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