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Head trauma is the major risk factor for cerebral sinus-vein thrombosis

Ornit Giladi1, David M Steinberg2, Kobi Peleg3

  • 1Department of Internal Medicine "D", Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.

Thrombosis Research
|December 15, 2015
PubMed

Insights

Recent trauma is a key risk factor for cerebral sinus vein thrombosis (CSVT), even with a normal head CT. Hormonal factors and prothrombotic polymorphisms are less specific to CSVT compared to deep vein thrombosis.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Thrombosis Research

Background:

  • Cerebral sinus vein thrombosis (CSVT) is a rare condition with high mortality and neurological impact.
  • Increasing incidence of CSVT diagnosis noted in Western countries, despite declining infection rates.

Purpose of the Study:

  • To identify specific risk factors contributing to the predisposition of site-specific thrombosis in CSVT.
  • Investigate potential links between trauma, hormonal influences, and genetic predispositions in CSVT development.

Main Methods:

  • Study involved ninety consecutive patients diagnosed with acute CSVT at a tertiary hospital.
  • Control data was sourced from the National Trauma Registry and Healthcare Services for comparison.

Main Results:

  • 14% of CSVT patients had a history of trauma (including skull fractures or blunt trauma) within one month prior to diagnosis.
  • Hormonal risk factors were present in 46% of women, with oral contraceptive (OC) use showing a significant SMR (1.63, p=0.0298).
  • Prothrombotic polymorphisms (Factor V Leiden, prothrombin G20210A) were found in 25.4% of tested patients, with a lower association (OR=3.47) compared to deep vein thrombosis (DVT) (OR=9.95).

Conclusions:

  • Clinical suspicion for CSVT is warranted in patients presenting with headache and recent trauma, even with a normal head CT scan.
  • Hormonal factors and prothrombotic polymorphisms are not exclusive to CSVT, with genetic factors playing a less significant role than in DVT.
Abstract

Keywords:
Cerebral sinus veinsThrombophiliaThrombosisTrauma

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