Clinical features of cerebral venous thrombosis based on a series of 50 cases

Abstract

Background: Cerebral venous thrombosis (CVT) is responsible for approximately 1% of all strokes. Diagnosis is often delayed due to nonspecific clinical features and the subacute course of the disease. We aimed to analyze the clinical pattern of patients with CVTs in a tertiary neurological hospital. Material and methods: The study included patients with CVTs, admitted to the Institute of Neurology and Neurosurgery between 2008 and 2021. The diagnosis was confirmed by MRI and/or CT-angiography images. Results: Totally 50 patients with CVTs were included, with a median age of 45.3 years, 27 females. The venous infarct was noticed in 13, subarachnoid hemorrhage – in 7, and no cerebral parenchymal lesion was seen in 25 cases. The thrombus occluded superior sagittal sinus (23), transvers sinus (18), cavernous sinus (16), cerebral veins (3). In 16 patients there were multiple venous sinus involvement. Risk factors were present in 34 cases: infections (22), prothrombotic states (6), puerperium (4), cancer (4), oral contraceptives (3), head injury (3), autoimmune disease (1). In 7 cases multiple risk factors were noticed. The most common clinical features were: the abrupt onset (34), intracranial hypertension (33), headache (29), focal deficit (18), visual loss (13), epileptic seizures (8). 5 patients (10%) died. 27 patients were prescribed anticoagulants and 5 patients received modified Rankin score 0 at discharge. Conclusions: Young adults with new onset headache, visual loss or other focal lesions should be evaluated for CVT in order to avoid severe consequences and long-term disability.