{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T19:58:00Z","timestamp":1775159880497,"version":"3.50.1"},"reference-count":76,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Cerebral venous thrombosis (CVT) has recently been reported as a common thrombotic manifestation in association with vaccine-induced thrombotic thrombocytopenia, a syndrome that mimics heparin-induced thrombocytopenia (HIT) and occurs after vaccination with adenovirus-based SARS-CoV-2 vaccines. We aimed to systematically review the incidence, clinical features, and prognosis of CVT occurring in patients with HIT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The study protocol was registered with PROSPERO (CRD42021249652). MEDLINE, EMBASE and Cochrane CENTRAL were searched up to June 1, 2021 for HIT case series including &gt;20 patients, or any report of HIT-related CVT. Demographic, neuroradiological, clinical, and mortality data were retrieved. Meta-analysis of proportions with random-effect modeling was used to derive rate of CVT in HIT and in-hospital mortality. Pooled estimates were compared with those for CVT without HIT and HIT without CVT, to determine differences in mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              From 19073 results, we selected 23 case series of HIT (n=1220) and 27 cases of HIT-related CVT (n=27, 71% female). CVT developed in 1.6% of 1220 patients with HIT (95% CI,1.0%\u20132.5%,\n              <jats:italic>I<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              =0%). Hemorrhagic brain lesions occurred in 81.8% of cases of HIT-related CVT and other concomitant thrombosis affecting other vascular territory was reported in 47.8% of cases. In-hospital mortality was 33.3%. HIT-related CVT carried a 29% absolute increase in mortality rate compared with historical CVT controls (33.3% versus 4.3%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and a 17.4% excess mortality compared with HIT without CVT (33.3% versus 15.9%,\n              <jats:italic>P<\/jats:italic>\n              =0.046).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>CVT is a rare thrombotic manifestation in patients with HIT. HIT-related CVT has higher rates of intracerebral hemorrhage and a higher mortality risk, when compared with CVT in historical controls. The recently reported high frequency of CVT in patients with vaccine-induced thrombotic thrombocytopenia was not observed in HIT, suggesting that additional pathophysiological mechanisms besides anti-platelet factor-4 antibodies might be involved in vaccine-induced thrombotic thrombocytopenia-related CVT.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.036824","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T10:00:25Z","timestamp":1646388025000},"page":"1892-1903","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Cerebral Venous Thrombosis in Patients With Heparin-Induced Thrombocytopenia a Systematic Review"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6702-7924","authenticated-orcid":true,"given":"Diana","family":"Aguiar de Sousa","sequence":"first","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universit\u00e1rio de Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal (D.A.d.S., J.M.F.)."},{"name":"Faculdade de Medicina, Universidade de Lisboa, Portugal (D.A.d.S., J.M.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-8543","authenticated-orcid":true,"given":"Michele","family":"Romoli","sequence":"additional","affiliation":[{"name":"Neurology and Stroke Unit, \u201cMaurizio Bufalini\u201d Hospital, Cesena, Italy (M.R.)."},{"name":"Neurology Clinic, University of Perugia \u2013 S. Maria della Misericordia Hospital, Italy (M.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5614-9689","authenticated-orcid":true,"given":"Mayte","family":"S\u00e1nchez Van Kammen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam University Medical Center, the Netherlands (M.S.V.K., J.M.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-2159","authenticated-orcid":true,"given":"Mirjam R.","family":"Heldner","sequence":"additional","affiliation":[{"name":"Department of Neurology, University hospital and University of Bern, Switzerland (M.R.H., M.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1486-4507","authenticated-orcid":true,"given":"Andrea","family":"Zini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Bologna, Italy (A.Z.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8284-982X","authenticated-orcid":true,"given":"Jonathan M.","family":"Coutinho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam University Medical Center, the Netherlands (M.S.V.K., J.M.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Neurology, University hospital and University of Bern, Switzerland (M.R.H., M.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2343-9097","authenticated-orcid":true,"given":"Jos\u00e9 M.","family":"Ferro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universit\u00e1rio de Lisboa Norte - 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