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Published on: April 23, 2021
Cerebral Venous Thrombosis in Older Patients
Susanna M Zuurbier1, Sini Hiltunen1, Erik Lindgren1
1From the Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands (S.M.Z., S.M.S, J.M.C.); Department of Neurology, Helsinki University Central Hospital, Finland (S.H., J.P., T.T); Department of Intensive Care, Royal Adelaide Hospital, South Australia, Australia (S.D.); Department of Neurology, Royal Adelaide, Lyell McEwin Hospitals (T.K.) and Department of Medicine (T.K.), University of Adelaide, South Australia, Australia; Department of Clinical Neuroscience/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden (E.L., K.J., T.T); Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (E.L., K.J., T.T.); the Divisions of Neuroradiology (D.M.M.) and Neurology (F.L.S.), University Health Network and the University of Toronto, Canada.
Background And Purpose:
Cerebral venous thrombosis (CVT) is rare in older patients. We investigated whether clinical features and outcomes differ in older and younger patients.
Methods:
We used data from a multicenter observational registry of consecutive adult patients with CVT admitted between 1987 and 2016. We compared demographics, clinical manifestations, and outcomes between older (upper quartile of the age distribution) and younger (lower 3 quartiles of the age distribution) patients.
Results:
Data for 843 patients with CVT were available. The median age was 43 years (interquartile range, 30-55 years). Older patients (≥55 years; n=222) were less often women than younger patients (48% versus 71%; P<0.001) and less often reported headache (63% versus 87%; P<0.001). Cancer was more common in older patients (24% versus 9%; P<0.001), especially solid malignancies (19% versus 5%; P<0.001). Outcome at follow-up was worse in older patients (modified Rankin Scale, 3-6; adjusted odds ratio, 2.68; 95% confidence interval, 1.78-4.03; mortality, adjusted odds ratio, 2.13; 95% confidence interval, 1.09-4.19).
Conclusions:
The sex ratio of CVT is evenly distributed in older patients, probably because of the dissipation of hormonal influences. Malignancy should be considered as a potential precipitant in older patients with CVT.
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