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Published on: May 23, 2025
Prevalence of Inherited Procoagulant States in Cerebral Venous Thrombosis and its Correlation with Severity and
Shaman Gill1, Pawan Dhull1, Madhukar Bhardwaj2
1Department of Neurology, Command Hospital (Central Command), Lucknow, Uttar Pradesh, India.
Insights
Inherited procoagulant states are a risk factor in 12% of cerebral venous thrombosis (CVT) cases. However, these inherited states do not correlate with CVT severity or patient outcomes.
Area of Science:
- Neurology
- Hematology
- Genetics
Background:
- Cerebral venous thrombosis (CVT) is a significant cause of stroke in young adults.
- CVT results from thrombotic occlusion of cerebral veins or sinuses.
- Risk factors include oral contraceptives, thrombophilias, infections, malignancy, and pregnancy.
Purpose of the Study:
- To determine the prevalence of inherited procoagulant states in CVT patients.
- To correlate these states with disease severity and patient outcomes.
Main Methods:
- Prospective observational study of 75 CVT patients (18-50 years) over 2 years.
- Procoagulant testing performed 3 months post-CVT onset after stopping anticoagulants.
- Severity assessed by Glasgow Coma Scale (GCS); functional outcome by modified Rankin Scale (mRS).
Main Results:
- 12% (9/75) of CVT patients had an inherited procoagulant state.
- No significant correlation found between procoagulant states and GCS-assessed severity.
- Thrombophilia presence did not impact mRS-assessed outcomes at 7 days, 6 weeks, or 3 months.
Conclusions:
- Inherited procoagulant states are an important risk factor for CVT.
- The presence of inherited procoagulant states does not influence CVT severity or long-term outcomes.
Abstract:
Background Cerebral venous thrombosis (CVT) is one of the important causes of stroke in young adults. It is caused by complete or partial thrombotic occlusion of the cerebral venous sinuses or cortical veins. There are many risk factors associated with this condition, out of which common ones are oral contraceptives use, genetic, or acquired thrombophilias, infections, malignancy, pregnancy, and puerperium. We aimed to study the prevalence of inherited procoagulant states in patients with CVT and correlate these states with the severity and outcome. Materials and Methods It was a prospective observational study of 2 years duration in which 75 patients, 18 to 50 years old, with confirmed CVT were included. The baseline data, imaging findings were recorded for all the patients. After 3 months of the onset of CVT, anticoagulants were stopped and a procoagulant test was done for all patients. Severity was assessed by Glasgow Coma Score (GCS) at the onset of illness. Functional assessments were done using the modified Rankin Scale (mRS) at presentation, at 7 days, 6 weeks, and 3 months. Results In the present study, any procoagulant state was seen in 9 out of 75 patients with CVT that accounted for 12% of the total population. There was no significant correlation between the presence of procoagulant states and severity of illness as assessed by GCS at presentation. The presence of any thrombophilia did not affect the final outcome at 7 days, 6 weeks or 3 months ( p = 0.532, p = 0.944 and p = 0.965 respectively) as assessed by modified Rankin Scale (mRS). Conclusion Inherited procoagulant states are an important risk factor for CVT. The presence of an inherited procoagulant state does not have any correlation with the disease severity and outcome.
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