Cerebral Venous Thrombosis: 11 Years in a Stroke Unit

Abstract

Introduction: Cerebral venous thrombosis (CVT) is a rare type of stroke that is more frequent in young women. This condition presents generally with nonspecific signs and symptoms, and the diagnosis is based on imaging of the brain venous circulation. First-line treatment is anticoagulation Our objective was to characterization of the population diagnosed with CVT in stroke Unit of Setubal hospital.

Methods: Retrospective and descriptive study of CVT cases admitted to our Stroke Unit between 2008 and 2018. Data were collected from the hospital system records and registered in a database. We analyzed demographic, clinical and imaging characteristics and data from the etiological investigation and functional outcome (modified Rankin Scale).

Results: Of the 27 patients included, 21 (78%) were women and the mean age was 43.5 years. The most frequent presentation was headache (96.3%). An oral contraceptive was the most common risk factor identified (44.4%). The initial examination was made by head computed tomography (CT) scan in 23 (85.2%) patients, out of the 20 evocative characteristics of CVT. Diagnosis was confirmed by CT venography or magnetic resonance angiography (MRA). More than 50% of patients had involvement of more than one venous structure. A heparin-based treatment was administered to all patients and the clinical status for discharge was favourable in 25 cases.

Conclusion: CVT mainly affected young women, with oral contraception being a major risk factor. The clinical picture tended to be nonspecific, with headache as the most frequent manifestation. In case of clinical suspicion, a negative head CT does not exclude the diagnosis and the investigation should be continued with MR and MRA. It is important to recognize this pathology, which remains underdiagnosed.