Thromboembolic events, bleeding, and mortality in patients with cerebral venous thrombosis: a nationwide cohort study

Area of Science:

• Neurology
• Vascular Medicine
• Epidemiology

Background:

• Cerebral venous thrombosis (CVT) primarily affects young to middle-aged women.
• Long-term prognosis data for CVT patients are limited.
• Understanding prognostic variations is crucial for patient management.

Purpose of the Study:

• To investigate the long-term clinical course and prognosis of patients diagnosed with cerebral venous thrombosis (CVT).
• To analyze how age and sex influence the risks of adverse outcomes following CVT.
• To identify specific risk profiles for different demographic groups within the CVT patient population.

Main Methods:

• Utilized Danish national registries to identify all first-time primary inpatient CVT diagnoses between 1996 and 2018.
• Included 653 CVT patients (median age 41, 67% women) and a matched general population cohort (N=65,300).
• Compared risks of venous thromboembolism (VTE), ischemic stroke, major bleeding, and mortality between CVT patients and controls, stratified by age and sex.

Main Results:

• CVT patients exhibited elevated risks for VTE at other sites, ischemic stroke, major bleeding, and mortality compared to the general population.
• Younger patients (18-54 years) with CVT showed the most prominent increased risk for VTE at other sites.
• Older patients (≥55 years) with CVT faced the highest risks for ischemic stroke, major bleeding, and all-cause mortality, particularly evident in older women.
• No elevated risk of myocardial infarction was observed in CVT patients.

Conclusions:

• Prognosis following cerebral venous thrombosis (CVT) is significantly heterogeneous and depends critically on patient age and sex.
• Clinicians must consider age and sex-specific risk factors when managing CVT patients.
• Targeted monitoring and preventative strategies may be warranted based on these identified prognostic differences.