2026 American Academy of Neurology Abstract Website

Objective:

To investigate the clinical characteristics, management and outcomes of cerebral venous thrombosis (CVT) patients with antiphospholipid syndrome (APS) in a Chinese cohort. This work seeks to provide a foundation for the development of diagnostic strategies in APS-associated CVT.

Background:

CVT is a relatively rare but severe subtype of stroke. The diagnosis of CVT is difficult. The risk factors for CVT are diverse and complex. Early diagnosis and appropriate treatment are essential for reducing complications.

APS is a systemic autoimmune disorder. CVT is a relatively rare and historically underrecognized manifestation of APS. And APS is a significant risk factor for CVT. APS associated CVT patients may present with atypical features, differing from non-APS-CVT. The clinical and neuroimaging characteristics, and prognosis of APS-CVT patients remain inadequately understood.

Design/Methods:

A retrospective cohort study was conducted on 121 consecutive CVT patients admitted to Peking Union Medical College Hospital from 2015 to 2023. Data on demographics, clinical manifestations, imaging findings, laboratory tests, treatment, and outcomes at discharge were analyzed.

Results:

APS was identified in 16.5% of CVT patients(median age 34.5, 60.0% female). 75% had no prior other thrombotic/obstetric events. For APS-CVT, 50% had a chronic onset , with a median diagnostic delay of 20 days. Headache was the most common. 85.0% APS-CVT patients had additional risk factors. All patients received anticoagulation therapy. APS-CVT involved fewer transverse/multi-sinus thromboses, lower hemoglobin, and more extracranial thrombosis. Favorable outcomes were achieved in 80.0%.

Conclusions:

APS represents a significant risk factor for CVT. APS-CVT primarily affects young individuals and women, often presents insidiously, and is frequently accompanied extracranial venous thrombosis. Its diagnosis is challenging, so screening for APS should be considered in CVT patients in such clinical contexts. The distinct venous sinus involvement in APS-CVT may reveal unique pathogenesis. Most patients were treated with warfarin, which may be associated with a favorable outcome.