Clinical Spectrum, Risk Factors and Management Outcomes in Cerebral Venous Thrombosis: A Retrospective Cohort Analysis
Vijaya Pamidimukkala1, Ramachandra Prasad Yelamanchi2, Usha Kiran Behera2, Naren Polavarapu2, Uppala Veeramma1, Bhargavi Devi Mandarapu2, Sudheer B.V3, Srinivasa Reddy Sanivarapu3
1Neurology, Lalitha Super Specialities Hospital, 2Neurology, Lalitha super Specialities Hospital, 3Lalitha super Specialities Hospital
Objective:
This study aimed to analyze clinical presentations, risk factors, imaging findings, and treatment outcomes in patients with cerebral venous thrombosis (CVT) to better understand variability in severity and management strategies.
Background:
Cerebral venous thrombosis (CVT) is a rare condition with variable presentations and outcomes.
Design/Methods:
A retrospective analysis was conducted on 40 CVT patients. Data were collected on demographics, clinical presentation, risk factors, imaging findings, and treatments. Descriptive statistics summarized cohort characteristics and outcomes.
Results:

The cohort included 40 patients aged 13 to 65, with a female-to-male ratio of 2:3, with a mean symptom duration of 8.1 days. Most (82.5%) presented acutely. Seizures (92.5%) and headaches (82.5%) were the most frequent symptoms, while 52.5% had focal deficits or papilledema. The mean GCS was 13, and the median NIHSS score was 3. Severe disability (mRS 5) was seen in 39.5% of patients. Anemia was present in 27.5%, alcohol use in 30%, and hemoconcentration in 42.5%. Multiple risk factors were noted in 12.5%, while 10% had no identifiable risk factors. Thrombosis most commonly involved the superior sagittal sinus (75%), followed by right transverse sinus (57.5%). Deep venous sinus involvement was noted in 10%, and most(39)patients had more than one sinus affected. All patients received initial anticoagulation with LMWH or UFH, followed by oral anticoagulants (Acitrom in 50%, Dabigatran in 35%). Nine patients required blood transfusions, and all received antiseizure medications. Three patients underwent decompressive craniotomy, and one succumbed to mass effect.

Conclusions:

Acute CVT presentation was common, with significant morbidity in 39.5%. Hemoconcentration, anemia and Alcoholism were the most common risk factors. Timely anticoagulation proved effective for most patients, highlighting the need for early diagnosis and tailored management based on individual risk profiles.

10.1212/WNL.0000000000212052
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