Long-Term Prognosis of Cerebral Vein and Dural Sinus Thrombosis

Abstract

The purpose of this study was to analyze the long-term mortality, functional recovery and long-term complications of cerebral vein and dural sinus thrombosis (CVDST) admitted to Portuguese hospitals. A follow-up of symptomatic CVDST admitted to Portuguese hospitals since 1980 was performed. Fifty-one patients (retrospective cases) were re-evaluated during 1996; 91 consecutively admitted patients from 6/1995 to 6/1998 were followed up to 1999. In 1996, 4 (8%) of the retrospective cases had died (3 patients died in the acute phase), 4 (8%) could not be reached, 33 (64%) had recovered completely (Rankin 0 or 1) and 3 (6%) were dependent. The prospective cases had a mean follow-up of 1 year: 6 (7%) patients died in the acute phase, one (1%) died during follow-up, 75 (82%) recovered completely, and only 1 (1%) was dependent. For the prospective cases, worsening after admission (OR = 18.2; 95% CI = 2.9–112.4) and encephalopathy as the presenting syndrome (OR = 7.1; 95% CI = 1.2–40.9) predicted death or dependency, while absence of aphasia (OR 6.7, 95% CI = 1.6–33) and no worsening after admission (OR = 5.9; 95% CI = 1.6–20) predicted total recovery. During follow-up of the prospective cases, 4 (5%) patients had thrombotic events, 8 (10%) patients experienced seizures, 9 (11%) complained of severe headaches and 1 patient suffered severe visual loss. The long-term functional prognosis of patients with CVDST was fairly good with complete recovery in the majority of cases. However, these patients had a moderate risk of further thrombotic events and seizures.

Magnetic Resonance Venography Proving its Utility and Standard over Clinical Findings in Diagnosing Cases of Cerebral Venous Thrombosis - A Case Series

“…Most of patients in this study were in the age groups of 14 years and 30-72 years. This agreed with similar literature reported that the most patients with this disease present in the young-to-middle-aged patients 9 . Other literature reported that it is most common in the third decade while it may occur in all age groups.…”

Role of magnetic resonance venogram, diffusion and susceptibility weighted imaging in diagnosis of cerebral venous thrombosis

“…This slight preponderance in females is probably due to specific causes such as oral contraceptives, pregnancy and puerperium. 7 This preponderance of females did not exist before the era of the oral contraceptive pills. Female predominance was also seen in our study where female to male ratio was 1.3: 1.…”

Two cases of venous sinus thrombosis in women taking the oral contraceptive pill, Yaz (dropirenone/ ethinyl estradiol), and review of the literature

“…Gosk-Bierska et al [54] found 13% recurrence of venous thromboembolism with a median time to recurrence of 10 months. Ferro et al [53] found a recurrence rate of 2%.…”

“…Mortality rates reported in the literature range from 2% -8% and 65% -90% of patients make a complete recovery with minimal neurologic deficit [1][2][3]13,14,16,22,34,53,54]. In multiple studies, poor prognosis correlated with male gender, older age, coma, malignnancy, CNS infection, and worsening exam after admission [44,53]. Pregnancy, peurperium, and oral contraceptive use are associated with a better outcome than those patients with systemic disease such as malignancy or inherited thrombophilia [4,16].…”