Cerebral venous thrombosis: a retrospective unicentric analysis of clinical and neuroimaging characteristics

Neurol Sci. 2022 Mar;43(3):1839-1847. doi: 10.1007/s10072-021-05514-6. Epub 2021 Aug 4.

Abstract

Thrombosis of dural sinuses and/or cerebral veins (CVT) is an uncommon form of stroke, usually affecting young individuals. It has a variable clinical presentation ranging from mild cases presenting only headaches, to severe cases featuring encephalopathy, coma or status epilepticus. A retrospective cross-sectional study of patients treated in the outpatient department and in-hospital during the period from 2014 to 2020 at the Neurology Clinic-University Clinical Centre of Serbia was conducted. Forty-nine patients (24 men; 25 women) were included in the study. Twenty-three patients (46.9%) suffered a subacute form of CVT (48 h-4 weeks), 19 (38.8%) presented with an acute form (< 48 h) and 7 (14.3%) with a chronic form (> 4 weeks). Around 75% of patients reported headaches during disease course. Focal neurological deficit (FND) was observed in 27 (55.1%) patients. Patients who did not report headaches (22.4%) presented with more severe symptoms (seizures and coma). More than 70% of patients had no radiologically evident brain parenchymal lesion. The most frequent locations of CVT were transverse sinus (79.6%), sigmoid sinus (44.9%) and superior sagittal sinus (36.7%). Thrombosis of more than one sinus/vein occurred in 33 (67.3%) patients. Hereditary thrombophilia was observed in 9 (18.4%) patients, 11 (22.4%) patients had some type of infection and 20% of women reported OCT usage. As much as 25% of cases remained without evident risk factors. The most common symptom in our cohort was acute unilateral throbbing headache of high intensity, while patients without headaches had more severe symptoms.

Keywords: Cerebral venous thrombosis; Clinical presentation; Headache; Neuroimaging; Risk factors.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Humans
  • Intracranial Thrombosis* / complications
  • Intracranial Thrombosis* / diagnostic imaging
  • Intracranial Thrombosis* / epidemiology
  • Male
  • Neuroimaging
  • Retrospective Studies
  • Sinus Thrombosis, Intracranial* / complications
  • Sinus Thrombosis, Intracranial* / diagnostic imaging
  • Sinus Thrombosis, Intracranial* / epidemiology
  • Venous Thrombosis* / diagnostic imaging
  • Venous Thrombosis* / epidemiology