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(Stroke. 2005;36:1716.)
© 2005 American Heart Association, Inc.

Original Contributions

A Negative D-Dimer Assay Does Not Rule Out Cerebral Venous Thrombosis

A Series of Seventy-Three Patients

Isabelle Crassard, MD; Claudine Soria, MD, PhD; Christophe Tzourio, MD, PhD; France Woimant, MD; Ludovic Drouet, MD, PhD; Anne Ducros, MD, PhD Marie-Germaine Bousser, MD

From the Neurology Department (I.C., C.T., F.W., M.-G.B.) and Angio-Haematology Department (C.S., L.D.), Lariboisière Hospital; Inserm U708 (C.T.); and the Emergency Headache Center (A.D.), Lariboisière Hospital, Paris, France.

Correspondence to Isabelle Crassard, Neurology Department, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France. E-mail: isabelle.crassard{at}lrb.aphp.fr

Background and Purpose— Cerebral venous thrombosis (CVT) is an infrequent variety of cerebrovascular disease with a wide spectrum of clinical presentations and a notoriously difficult diagnosis. Previous reports have emphasized the potential clinical utility of D-dimer assay in CVT diagnosis.

Methods— A rapid sensitive D-dimer assay was performed at entry in 73 patients with CVT <30 days duration, examined in our institution between 1999 and 2003.

Results— The mean value of D-dimer levels was 1521 ng/mL; 7 patients (10% of all patients and 26% of those presenting with isolated headache) had values <500 ng/mL. In a multivariate analysis, isolated headache was the only variable associated with a negative D-dimer assay.

Conclusion— A negative D-Dimer assay does not confidently rule out CVT, particularly in the setting of recent isolated headache.

Key Words: cerebral thrombosis • headache • sinus thrombosis