UKRAINIAN BULLETIN OF PSYCHONEUROLOGY

The Scientific and Practical Journal of Medicine
ISSN 2079-0325
DOI 10.36927/2079-0325

DETERMINING THE LEVEL OF AWARENESS OF DOCTORS OF VARIOUS SPECIALTIES ON THE TOPIC OF CEREBRAL VENOUS THROMBOSIS

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Abstract

Thrombosis of the cerebral venous sinus, or cerebral venous thrombosis, is one of the rarest forms of stroke, occurring on average in 0,5 to 3 % of patients, predominantly those of a young age. Given the variety of clinical manifestations, the low incidence rate and the specific nature of diagnostic markers, this condition is not usually the first one a doctor would suspect. It was therefore decided to conduct a survey amongst doctors of various specialities to assess their level of awareness regarding cerebral venous sinus thrombosis.

A total of 69 doctors aged between 25 and 71 took part in the survey. Among them were 44 neurologists, of whom 31 worked in hospitals and 13 in outpatient clinics; 10 were general practitioners; and 15 were doctors from other specialities. During the survey, participants were asked to select the correct answer to five questions from a choice of 3–5 statements. The questions covered the definition of the condition, the clinical presentation, gender-related factors, and methods of diagnosis and treatment of cerebral venous thrombosis (CVT).

More than half of all doctors surveyed (55,07 %) correctly identified the definition of cerebral venous thrombosis. Regarding awareness of the clinical variability of cerebral venous sinus thrombosis, 68,12 % of respondents demonstrated a good level of knowledge. It should be noted that 62,32 % of respondents were also aware of the higher incidence rate among females. According to the survey, the majority of doctors opted for a comprehensive approach in both diagnosis and treatment (34,78 % and 44,93 % respectively). However, only 31,88 % of doctors correctly identified the most optimal method for verifying central venous pressure, namely magnetic resonance imaging with intravenous contrast. Furthermore, only 27,54 % selected anticoagulant therapy, the treatment method recommended by current evidence-based clinical guidelines.

The survey revealed that doctors have a reasonable understanding of the diagnosis and clinical features of DVT; however, only a third of respondents selected the diagnostic and treatment methods recommended by evidence-based medicine. This highlights the need for wider dissemination of evidence-based medicine recommendations on the diagnosis and treatment of CVD amongst the medical community concerned with this issue.

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References

  1. Saposnik G, Bushnell C, Coutinho J, et al. Diagnosis and Management of Cerebral Venous Thrombosis: A Scientific Statement From the American Heart Association. Stroke. 2024;55(3):e77-e90. DOI:10.1161/STR.0000000000000456
  2. Silvis SM, de Sousa DA, Ferro JM, Coutinho JM. Cerebral venous thrombosis. Nat Rev Neurol. 2017;13:555-565. DOI:10.1038/nrneurol.2017.104
  3. Saposnik G, Barinagarrementeria F, Brown RD, et al. American Heart Association Stroke Council and the Council on Epidemiology and Prevention. Diagnosis and management of cerebral venous thrombosis: a  statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:1158-1192. DOI:10.1161/STR.0b013e31820a8364
  4. Bakradze E, Shu L, Henninger N, et al. Delayed Diagnosis in Cerebral Venous Thrombosis: Associated Factors and Clinical Outcomes. Journal of the American Heart Association. 2023;12(19):e030421. DOI:10.1161/JAHA.123.030421
  5. Rezoagli E, Martinelli I, Poli D, et al. The effect of  recanalization on long-term neurological outcome after cerebral venous thrombosis. J Thromb Haemost. 2018;16:718-724. DOI:10.1111/jth.13954
  6. Karsy M, Harmer JR, Guan J, et al. Outcomes in adults with cerebral venous sinus thrombosis: a retrospective cohort study. J Clin Neurosci. 2018;53:34-40. DOI:10.1016/j.jocn.2018.03.004
  7. Ferro JM, Bousser MG, Canhão P, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis — endorsed by the European Academy of Neurology. Eur J Neurol. 2017;24:1203-1213. DOI:10.1111/ene.13381
  8. Hiltunen S, Putaala J, Haapaniemi E, Tatlisumak T. Longterm outcome after cerebral venous thrombosis: analysis of functional and vocational outcome, residual symptoms, and adverse events in 161 patients. J Neurol. 2016;263:477-484. DOI:10.1007/s00415-015-7996-9
  9. Ji K, Zhou C, Wu L, et al. Risk Factors for Severe Residual Headache in Cerebral Venous Thrombosis. Stroke. 2021;52(2):531- 536. DOI:10.1161/STROKEAHA.120.029820
  10. Coutinho JM, Ferro JM, Canhão P, et al. Cerebral Venous and Sinus Thrombosis in Women. Stroke. 2009;40(7): 2356-61. DOI:10.1161/STROKEAHA.108.543884
  11. Field TS, Hill MD. Cerebral Venous Thrombosis. Stroke. 2019;50(6):1598-1604. DOI:10.1161/STROKEAHA.119.025334
  12. Herweh C, Griebe M, Geisbüsch C, et al. Frequency and temporal profile of recanalization after cerebral vein and sinus thrombosis. Eur J Neurol. 2016;23:681-687. DOI:10.1111/ene.12901