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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Postoperative cerebral venous sinus thrombosis following posterior fossa – tumor surgery – incidence, risk factors and therapeutic options

Postoperative Zerebrale Sinusvenenthrombose nach neurochirurgischen Eingriffen in der hinteren Schädelgrube: Inzidenz, Risikofaktoren und therapeutisches Management

Meeting Abstract

  • presenting/speaker Ehab Shabo - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Johannes Wach - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Motaz Hamed - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Ági Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Leonie Weinhold - University Hospital Bonn, Department of Medical Biometry, Informatics and Epidemiology, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV219

doi: 10.3205/22dgnc212, urn:nbn:de:0183-22dgnc2129

Veröffentlicht: 25. Mai 2022

© 2022 Shabo et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Cerebral venous sinus thrombosis (CVST) is a known complication of posterior fossa surgery near the sigmoid and transverse sinus. The incidence and treatment of postoperative asymptomatic CVST are controversial. This study aims to analyze the incidence, risk factors and the strategy of management of postoperative CVST after tumor surgery.

Methods: In this retrospective, single-center study, we included all patients who underwent tumor surgery in the posterior fossa in the sitting position between January 2013 and December 2020. We analyzed the effect of demographical and surgical data on the incidence of postoperative CVST. The two management options of postoperative CVST and the incidence of intracranial hemorrhage were analyzed.

Results: In total, 266 patients were identified and included. Thirty-three of 266 patients (12.4%) developed a postoperative CVST. 13 of the 33 patients received therapeutic anticoagulation, and 20 patients did not. Risk factors for the development of a postoperative CVST, were tumor entity: meningioma (p<0.001, OR 11.3, CI 95% 4.1-31.2), and vestibular schwannoma (p=0.013, OR 4.4, CI 95% 1.3-16.3). Age (p=0.562), sex (p=0.197), ASA status (p=0.125), BMI (p=0.591), and length of surgery (p=0.176) were not statistically correlated with new postoperative CVST. The use of therapeutic anticoagulation to treat postoperative CVST was associated with a higher rate of intracranial hemorrhage (n=4) in the univariate (p=0.017) as well as in the multivariate analysis (p<0.001, OR 47.1, 95% 6.6-334.18).

Conclusion: Tumor entity influences the incidence of new CVST. In clinically asymptomatic patients, careful decision-making is necessary whether to initiate therapeutic anticoagulation or not.

Table 1 [Tab. 1], Table 2 [Tab. 2]