Proceedings of Réanimation 2017, the French Intensive Care Society International Congress
Bibliographic record
Abstract
Introduction Head injury is a rare but possible etiology of cerebral thrombophlebitis.The diagnosis should be considered especially in front of open head injuries extended to venous sinuses.The MR angiography is the gold standard for early diagnosis.Patients and methods This is a descriptive prospective study of all trauma patients hospitalized in the intensive care unit of the University Hospital Habib Bourguiba Sfax over a period of 6 years between January 2010 and June 2016 and in whom the diagnosis of cerebral venous thrombophlebitis has been confirmed by angiography CT or MR angiography. ResultsDuring the period study, 15 patients were included.The median age of patients was 29 [17-49] years.All patients were male, victims of poly trauma following an accident of traffic.In admission, SAPSII was 31 [24-52] and SOFA was 4 [2-8].We have noted the presence of a serious head injury in 15 patients, extended open skull fractures of the venous sinus in 9 patients.A related chest trauma was present in 12 patients and abdominal trauma in 4 patients, trauma of the pelvis and/or members were present in 7 patients.All patients underwent mechanical ventilation.The diagnosis of cerebral venous thrombosis was confirmed by cerebral angiography CT in 9 patients and cerebral MR angiography in 6 patients.7 patients have presented secondary pulmonary embolism.All patients did not show a contraindication against anticoagulation at diagnosis of thrombophlebitis.The thrombophilia (antithrombin III, protein C and S, homocysteine, and antiphospholipid, gene mutation factors II and V) as well as for antineutrophil cytoplasmic antibodies were negative in all patients.The outcome was favorable in 13 patients.Two patients were died due to a state of refractory septic shock.Discussion Post traumatic cerebral thrombophlebitis is a rare thrombotic vascular disease.It must be mentioned especially with presence of extensive skull fractures in open sinuses.Venous MR angiography is the gold standard.The treatment is based on anticoagulation curative dose.Its prescription can be complicated in these cases associated with traumatic intracranial hemorrhage.Conclusion Head injury is a rare but possible etiology of cerebral thrombophlebitis.Other prospective studies are needed to better understand the path physiology and the prognosis of these thromboses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.074 | 0.016 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".