Cerebral Venous-Sinus Thrombosis: Risk Factors, Clinical Report, and Outcome. A Prospective Study in the North East of Iran

Introduction: Cerebral venous-sinus thrombosis (CVST) is a life threatening condition that needs rapid diagnosis and treatment. It appears comparatively more common in Middle East and South Asia. Objectives: To determine the demographic, clinical patterns, etiologies and prognostic factors of CVST in the North East of Iran. Materials and Methods: All adult patients admitted with a documented diagnosis of CVST from January 2011 to March 2012 in an academic hospital in the North East of Iran, entered this prospective descriptive study. The patients' demographic characteristics, clinical presentations, laboratory and brain imaging findings, treatment options were also studied. Follow-up visits were performed at month 1, 6, and then at month 12 using modified Rankin Scale (mRS). Findings were analyzed using descriptive tests and Chi square test in SPSS software version 21. Results: Sixty patients (13.3% men, 86.7% women) with mean age of 38.11±11.30 years were identified. Fifty one cases (85%) had a clinical picture of increased intracranial pressure. Causes included positive antiphospholipid antibodies in 3.3%, protein C, S and anti thrombin III deficiency in 5%, 1.7% and 3.3%, polycythemia in 1.7%, infections in 1.7%, postpartum in 9.6% of women, and using Oral Contraceptive Pills (OCPs) in 65.38%. We found 10% mortality rate on discharge and 11.9% within 30 days and 42.7% rate of death or dependency at month 12. Conclusion: The findings of the study indicate that the use of OCPs was a main factor associated with CVST especially in association with inherited hypercoagulable state.