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Published on: June 2, 2015
Clinical presentation domains and venous anatomical patterns in cerebral venous thrombosis: a retrospective cohort
Amirreza Radfar1, Etrat Hooshmandi1, Vahid Reza Ostovan1
1Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Background:
Cerebral venous thrombosis (CVT) presents with heterogeneous clinical manifestations that may partly reflect differences in venous anatomical involvement. However, systematic evaluation of structured clinical presentation domains in relation to distinct venous involvement patterns remains limited.
Methods:
We conducted a retrospective observational cohort study of consecutive adult patients with radiologically confirmed CVT at a tertiary referral center between 2017 and 2025. Presenting symptoms were categorized into predefined, non-mutually exclusive clinical presentation domains, and venous anatomical involvement was classified as isolated superficial thrombosis, isolated parenchymal thrombosis, or combined superficial and parenchymal thrombosis. Domain distributions and overall presentation burden were compared across anatomical patterns, and associations between clinical domains and venous involvement were examined using multinomial logistic regression.
Results:
Among 325 patients (median age 39.4 years; 68% female), superficial venous involvement was observed in 68.9%, combined involvement in 22.5%, and isolated parenchymal thrombosis in 8.6%. Intracranial hypertension-related presentation was independently associated with combined thrombosis compared with isolated superficial involvement (adjusted OR 3.30, 95% CI 1.07-10.14). Visual presentation was inversely associated with isolated parenchymal thrombosis (adjusted OR 0.20, 95% CI 0.04-0.94). Other clinical domains, including cortical irritation-related presentation and deep cerebral dysfunction, were not independently associated with venous anatomical patterns. Overall presentation burden did not differ significantly across anatomical groups.
Conclusion:
Predefined clinical presentation domains show selective but limited associations with venous anatomical patterns in CVT. Intracranial hypertension-related presentation was associated with combined venous involvement, whereas the inverse association between visual presentation and isolated parenchymal thrombosis should be interpreted cautiously. Substantial clinical overlap across anatomical groups underscores the complex and multifactorial nature of clinical-anatomical relationships in CVT.
Clinical Trial Registration:
Not applicable. This study was an observational retrospective cohort study and was not registered as a clinical trial.
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