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Case Reports
. 2021 Feb 11:11:563037.
doi: 10.3389/fneur.2020.563037. eCollection 2020.

Cyclosporine-A-Induced Intracranial Thrombotic Complications: Systematic Review and Cases Report

Si-Ying Song  1   2   3 , Zhong-Ao Wang  1   2   3 , Yu-Chuan Ding  3   4 , Xun-Ming Ji  1   2   3 , Ran Meng  1   2   3
Affiliations
Case Reports

Cyclosporine-A-Induced Intracranial Thrombotic Complications: Systematic Review and Cases Report

Si-Ying Song et al. Front Neurol. .

Abstract

This study reported two cases of intracranial thrombotic events of aplastic anemia (AA) under therapy with cyclosporine-A (CsA) and reviewed both drug-induced cerebral venous thrombosis (CVT) and CsA-related thrombotic events systematically. We searched PubMed Central (PMC) and EMBASE up to Sep 2019 for publications on drug-induced CVT and Cs-A-induced thrombotic events. Medical subject headings and Emtree headings were used with the following keywords: "cyclosporine-A" and "cerebral venous thrombosis OR cerebral vein thrombosis" and "stroke OR Brain Ischemia OR Brain Infarction OR cerebral infarction OR intracerebral hemorrhage OR intracranial hemorrhage." We found that CsA might be a significant risk factor in inducing not only CVT but also cerebral arterial thrombosis in patients with AA.

Keywords: case report; cerebral arterial infarction; cerebral venous sinus thrombosis; cyclosporine-A; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Magnetic resonance venography images of head in Case 1. The red arrow indicates the focal stenosis of cerebral venous sinus and venous collateral circulation.
Figure 2
Figure 2
Non-contrast enhanced (A,C,E) and contrast-enhanced (B,D,F) black-blood thrombus images of the head in Case 1. The red arrow indicates the focal stenosis of the internal jugular vein and cerebral vein sinus.
Figure 3
Figure 3
(A) Magnetic resonance images of the head in Case 2. The red arrow indicates the focal ischemic infarction in left occipital lobe [(a) T1 sequence; (b–d) T1 sequence with contrast-enhancing; (e) T2 sequence; (f) T2 FLAIR sequence; (g) DWI sequence; (h) ADC sequence]. (B) Magnetic resonance images of the head in Case 2. The red arrow indicates the focal ischemic infarction in cerebellum [(a) T1 sequence; (b) T2 sequence; (c) T2 FLAIR sequence; (d) DWI sequence].
Figure 4
Figure 4
(A–D) Magnetic resonance arthrography images of the head in Case 2. The red arrow indicates partial filling defects.
Figure 5
Figure 5
Magnetic resonance venography images of the head (A–C) and neck (D–F) in Case 2.
Figure 6
Figure 6
Flow diagram of the study selection process on drug-induced cerebral venous sinus thrombosis (CVST).
Figure 7
Figure 7
Flow diagram of the study selection process on cyclosporine-A (CsA)-induced thrombosis.
See this image and copyright information in PMC

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