HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 61, Number 8, October 28, 2003 Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lalive, P. H. Articles by Sztajzel, R. Search for Related Content PubMed PubMed Citation Articles by Lalive, P. H. Articles by Sztajzel, R. Related Collections Stroke in young adults All Cerebrovascular disease/Stroke Cerebral venous thrombosis

Is measurement of D-dimer useful in the diagnosis of cerebral venous thrombosis?

From the Departments of Neurology (Drs. Laline and Sztajzel), Radiology (Dr. Lovblad), Medical and Surgical Emergency (Dr. Sarasin), and Medical Informatics (B. Mermillod) and Division of Angiology and Haemostasis (Dr. de Moerloose), University Hospital, Geneva, Switzerland.

Address correspondence and reprint requests to Dr. R. Sztajzel, Neurology Department, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland; e-mail: Roman.Sztajzel @hcuge.ch

Background: The diagnosis of cerebral venous thrombosis (CVT) is a challenge because its clinical presentation is variable, brain CT may be normal, and MRI is not always available. Furthermore, early treatment may be effective. As D-dimer (DD) measurement is a sensitive test for the exclusion of venous thromboembolism, the authors studied whether this test could be useful in the diagnosis of CVT.

Methods: A prospective study of 54 consecutive patients with headaches suggestive of CVT was conducted between October 2000 and September 2002. DD levels were tested for all patients in the emergency room before brain CT or MRI was performed.

Results: Twelve (22%) of the 54 patients had CVT, and 10 (83%) of these 12 patients had DD level of >500 ng/mL (sensitivity of 83% and negative predictive value of 95%). Two patients with confirmed CVT and DD of <500 ng/mL had a history of chronic headache of >30 days’ duration. In the 42 patients without confirmed CVT, only 4 patients had DD level of >500 ng/mL (specificity of 90% and positive predictive value of 71%).

Conclusions: DD test is useful in the diagnosis of acute CVT. A value below 500 ng/mL makes acute thrombosis unlikely.

Received February 25, 2003. Accepted in final form June 13, 2003.

This article has been cited by other articles:

				B. Vatankhah, A. Furst, F. Schlachetzki, and C. M. Kosinski Do Normal D-Dimer Levels Reliably Exclude Cerebral Sinus Thrombosis? A Solution of Problems? * Response: Stroke, December 1, 2005; 36(12): 2528 - 2529. [Full Text] [PDF]

				I. Crassard, C. Soria, C. Tzourio, F. Woimant, L. Drouet, A. Ducros, and M.-G. Bousser A Negative D-Dimer Assay Does Not Rule Out Cerebral Venous Thrombosis: A Series of Seventy-Three Patients Stroke, August 1, 2005; 36(8): 1716 - 1719. [Abstract] [Full Text] [PDF]

				C. M. Kosinski, M. Mull, M. Schwarz, B. Koch, R. Biniek, J. Schlafer, E. Milkereit, K. Willmes, and J. Schiefer Do Normal D-dimer Levels Reliably Exclude Cerebral Sinus Thrombosis? Stroke, December 1, 2004; 35(12): 2820 - 2825. [Abstract] [Full Text] [PDF]