Title of article :
Characteristics and Manifestations of Patients with Cerebral Venous Sinus Thrombosis and Factors Associated with Unfavorable Functional Outcomes
Author/Authors :
Ilkhani ، Saba Department of Surgery and Vascular Surgery - Shohada Tajrish Hospital - Shahid Beheshti University of Medical Science , Fakhredin ، Hanieh School of Medicine - Shahid Beheshti University of Medical Sciences , Jameie ، Melika Neuroscience Research Center - Iran University of Medical Sciences , Hosseini ، Meghdad Department of Neurology - Imam Hossein Medical and Educational Center - Shahid Beheshti University of Medical Sciences , Amini Harandi ، Ali Brain Mapping Research Center - Shahid Beheshti University of Medical Sciences , Jameie ، Mana Department of Cardiovascular Diseases Research - Tehran Heart Center - Tehran University of Medical Sciences , Sakhaei ، Delaram School of Medicine - Mazandaran University of Medical Sciences , Assarzadegan ، Farhad Department of Neurology - Imam Hossein Medical and Educational Center - Shahid Beheshti University of Medical Sciences , Alijanpour ، Shayan Students Scientific Research Center, School of Nursing and Midwifery - Tehran University of Medical Sciences
Abstract :
Background: Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disease that typically affects young females. Objectives: To describe the clinical, laboratory, and neuroimaging characteristics of CVST and evaluate the differences in characteristics of patients with unfavorable versus favorable outcomes. Methods: This retrospective study (2007 - 2018) reviewed all consecutive patients with CVST, assessing their demographic, clinical, laboratory, neuroimaging characteristics, and clinical outcomes. The modified Rankin Scale (mRS) was used to assess the functional outcomes of patients after a three-month follow-up. Factors affecting patients’ outcomes (favorable [mRS ≤ 2] vs. unfavorable [mRS 2]) were examined using the Independent t-test and chi-squared test. Results: A total of 141 patients (mean age: 38.15 ± 13.71; female-to-male ratio of 2.28) with CVST were included. Most of the admissions (42.6%) were in the summer. Most patients had a subacute disease onset (66.0%), with headaches being the most frequent manifestation (66.0%). Regular oral contraceptive pill use and fasting were the most frequent clinical risk factors (52.0% and 22.7%, respectively). Different types of inherited thrombophilia (deficiency in protein C, protein S, or antithrombin III) were recorded in nearly 13 to 16% of patients. The lateral transverse sinus (61.7%) and the superior sagittal sinus (45.4%) were the most frequently involved. The mortality rates at discharge and after three months were 4.3% and 8.0%, respectively. In the follow-up assessment, 81.3% of patients showed a favorable outcome [mRS ≤ 2], while 18.7% had an unfavorable outcome. Patients with unfavorable outcomes were significantly older compared to those with favorable outcomes (52 ± 5.81 vs. 35.95 ± 1.42, P = 0.017). Significant associations were observed between admission season (P = 0.020), chief complaint (P = 0.028), course of the disease (P = 0.021), previous thromboembolic events (P = 0.001), and antiphospholipid IgG (P = 0.032). Conclusions: The most prevalent risk factors among patients with CVST were being female, a history of using oral contraceptives, and fasting. Older patients with reduced consciousness, an acute disease course, a history of thromboembolic events, and positive antiphospholipid IgG are more likely to have an unfavorable outcome.
Keywords :
Sinus Thrombosis , Intracranial” , Lateral Sinus Thrombosis , Sagittal Sinus Thrombosis , Cerebral Venous Sinus Thrombosis , Prognosis
Journal title :
Thrita Student Journal of Medical Sciences
Journal title :
Thrita Student Journal of Medical Sciences