Background and Purpose
Cerebral venous sinuses thrombosis (CVST) is an uncommon type of stroke with an incidence
of 3-4 cases per million. There have been reports of higher incidence of this disease
in Iran. Our objective is to describe the incidence, clinical presentation, predisposing
factors, and outcomes of CVST at Sina Hospital in Hamadan, west of Iran.
Methods
This is a prospective, single-center, longitudinal study of all patients referred
to Sina Hospital in Hamadan, west of Iran, between May 2009 to May 2015 who were diagnosed
with CVST.
Results
In this study, 151 patients were included. There were 118 women and 33 men. The mean
age was 37.48 years. The mean incidence rate of CVST in the duration of our study
was 13.49 per 1 million. Oral contraceptives, the most common risk factor, were used
by 55.1% of women and half of these patients had fasting simultaneously. Fifty-eight
patients had more than 1 risk factor. After 12 months' follow-up, 73.1% of the patients
were functionally independent (mRS score 0-1). Ten percent were dependent. The overall
mortality was 16.9%.
Conclusions
The incidence of CVST in Hamadan is higher than the world's average, and overall outcome
is worse. It seems that fasting and subsequent dehydration in women with recent use
of oral contraceptives make them more susceptible to CVST.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Thrombosis of the cerebral veins and sinuses.NEJM. 2005; 352: 1791-1798
- Cerebral venous thrombosis.in: Major problems in neurology. WB Saunders, London1997: 385-389
- Cerebral vein and sinus thrombosis in Isfahan-Iran: a changing profile.Can J Neurol Sci. 2004; 31: 474-477
- Diagnosis and management of cerebral venous thrombosis a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2011; 42: 1158-1192
- The incidence of cerebral venous thrombosis: a cross-sectional study.Stroke. 2012; 43: 3375-3377
- Incidence of cerebral venous thrombosis in Iranian women: a longitudinal two-year study in Zanjan Province of Iran.J Pioneer Med Sci. 2014; 4: 28-31
- Prognosis of cerebral vein and dural sinus thrombosis results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT).Stroke. 2004; 35: 664-670
- Cerebral venous thrombosis in Saudi Arabia. Clinical variables, response to treatment, and outcome.Neurosciences (Riyadh). 2009; 14: 349-354
- Cerebral venous sinus thrombosis in Iran: cumulative data, shortcomings and future directions.Iran Red Crescent Med J. 2012; 14: 805-810
- Cerebral venous sinus thrombosis presentation in emergency department in Van, Turkey.J Pak Med Assoc. 2014; 64: 370-374
- The clinical rationale for menses-free contraception.J Womens Health (Larchmt). 2007; 16: 1171-1180
- Oral contraceptive pill for primary dysmenorrhoea.Cochrane Database Syst Rev. 2009; (CD002120)
- Benefits and risks of oral contraceptives.Am J Obstet Gynecol. 1999; 180: S343-S348
- Sawm: fasting.([updated 2009]; Available at) (Accessed January 4, 2015)
- Ramadan.([updated 2011 2011-07-05]; Available at) (Accessed January 4, 2015)
- High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives.NEJM. 1998; 338: 1793-1797
- Estimates of the risk of cardiovascular death attributable to low-dose oral contraceptives in the United States.Am J Obstet Gynecol. 1999; 180: 241-249
- prevalence of diabetes and impaired fasting glucose in the adult population of Iran national survey of risk factors for non-communicable diseases of Iran.Diabetes Care. 2008; 31: 96-98
- Third National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) in Iran: methods and results on prevalence of diabetes, hypertension, obesity, central obesity, and dyslipidemia.BMC Public Health. 2009; 9: 167
- Behçet syndrome.Curr Opin Rheumatol. 2004; 16: 38-42
- Behçet's syndrome: disease manifestations, management, and advances in treatment.Nat Clin Pract Rheumatol. 2007; 3: 148-155
- Aseptic cerebral venous thrombosis associated with abdominal tuberculosis.Neurol India. 2003; 51: 128
- Tuberculosis, an uncommon cause of cerebral venous thrombosis.Arq Neuropsiquiatr. 2005; 63: 852-854
- Extensive sino-orbital zygomycosis after heart transplantation: a case report.Transplant Proc. 2009; 41: 2927-2929
Article info
Publication history
Published online: March 14, 2016
Accepted:
February 13,
2016
Received in revised form:
February 7,
2016
Received:
December 5,
2015
Footnotes
Source of funding: This study was partially supported by Hamadan University of Medical Sciences.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.022
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
