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Sex Differences in Adult Cerebral Venous Sinus Thrombosis: A 10-Year Experience

Published online by Cambridge University Press:  02 December 2014

Claire Hinnell ,
Janel Nadeau ,
Vanessa Lam ,
Michael D. Hill  and
Shelagh B. Coutts
Claire Hinnell
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
Janel Nadeau
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
Vanessa Lam
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
Michael D. Hill
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada Department of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Department of Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Shelagh B. Coutts*
Affiliation:
Department of Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
*
Foothills Medical Centre, 1403-29th Street NW, Calgary, Alberta, T2N 2T9, Canada.
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Abstract

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Background:

Sex differences in the risk factors, presentation and outcome of cerebral venous sinus thrombosis (CVST) are poorly defined, despite a discrepant prevalence between males and females. The proportion of patients on hormonal therapy who develop CVST varies widely. We describe the clinical features, risk factors and outcome by sex and by hormone-related risk factors among a large cohort of patients.

Methods:

We reviewed records of 108 consecutive patients with CVST at a tertiary hospital in Calgary between 1999 and 2009. Descriptive statistics were used for between group comparisons (men, women with hormone-related risk factors and women without hormone-related risk factors).

Results:

Females made up 62% of patients, half of whom were on systemic hormonal therapy. Men and women without hormonal risk factors were older at onset. Oral contraceptive use was the major risk factor in women (45%) while concurrent mastoiditis was the most common predisposing factor in men (27%). Complications were frequent and overall mortality was 6%. Persisting deficits at discharge were more common in men (54% vs. 35% and 32%, p = 0.036). There was a trend for women with hormone-related risk factors to have less residual focal neurologic deficit than the other groups (5% vs. 15% and 17%, p=0.051).

Conclusions:

There are differences between sexes in the presentation, risk factors and outcome of patients with CVST.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 1 , January 2012 , pp. 74 - 77
Copyright
Copyright © The Canadian Journal of Neurological 2012

References

1Coutinho, JM, Ferro, JM, Canhao, P, et al.Cerebral venous and sinus thrombosis in women. Stroke. 2009 Jul;40(7):2356–61.Google Scholar
2Kurth, T, Bousser, MG.Stroke in women: an evolving topic. Stroke. 2009 Apr;40(4):1027–8.Google Scholar
3Bousser, MG, Kittner, SJ.Oral contraceptives and stroke. Cephalalgia. 2000 Apr;20(3):183–9.CrossRefGoogle ScholarPubMed
4de Freitas, GR, Bogousslavsky, J.Risk factors of cerebral vein and sinus thrombosis. Front Neurol Neurosci. 2008;23:23–54.Google Scholar
5Dentali, F, Crowther, M, Ageno, W.Thrombophilic abnormalities, oral contraceptives, and risk of cerebral vein thrombosis: a meta-analysis. Blood. 2006 Apr 1;107(7):2766–73.CrossRefGoogle ScholarPubMed
6Ferro, JM, Canhao, P, Bousser, MG, Stam, J, Barinagarrementeria, F.Cerebral vein and dural sinus thrombosis in elderly patients. Stroke. 2005 Sep;36(9):1927–32.CrossRefGoogle ScholarPubMed
7Stam, J.Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005 Apr 28;352(17):1791–8.Google Scholar
8Wasay, M, Bakshi, R, Bobustuc, G, et al.Cerebral venous thrombosis: analysis of a multicenter cohort from the United States. J Stroke Cerebrovasc Dis. 2008 Mar-Apr;17(2):49–54.Google Scholar
9Rizzo, L, Crasto, SG, Ruda, R, et al.Cerebral venous thrombosis: role of CT, MRI and MRA in the emergency setting. Radiol Med. 2010 Mar;115(2):313–25.CrossRefGoogle ScholarPubMed
10Bousser, MG, Ferro, JM.Cerebral venous thrombosis: an update. Lancet Neurol. 2007 Feb;6(2):162–70.Google Scholar
11de Bruijn, SF, Stam, J, Koopman, MM, Vandenbroucke, JP.Case-control study of risk of cerebral sinus thrombosis in oral contraceptive users and in [correction of who are] carriers of hereditary prothrombotic conditions. The Cerebral Venous Sinus Thrombosis Study Group. BMJ. 1998 Feb 21;316(7131):589–92.CrossRefGoogle ScholarPubMed
12Coutinho, JM, Ferro, JM, Canhao, P, Barinagarrementeria, F, Bousser, MG, Stam, J.Unfractionated or low-molecular weight heparin for the treatment of cerebral venous thrombosis. Stroke. Nov;41 (11):2575–80.CrossRefGoogle Scholar
13de Bruijn, SF, Stam, J.Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke. 1999 Mar;30(3):484–8.Google Scholar
14Stam, J, De Bruijn, SF, DeVeber, G.Anticoagulation for cerebral sinus thrombosis. Cochrane Database Syst Rev. 2002 (4): CD002005.Google Scholar
15Wasay, M, Dai, AI, Ansari, M, Shaikh, Z, Roach, ES.Cerebral venous sinus thrombosis in children: a multicenter cohort from the United States. J Child Neurol. 2008 Jan;23(1):26–31.Google Scholar