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[Thrombosis of the cerebral veins and sinuses in 62 patients]
H P Bienfait1, J Stam, A W Lensing
1Academisch Medisch Centrum, afd. Neurologie, Amsterdam.
Objective:
Analysis of signs, symptoms, course and treatment of patients with cerebral venous and sinus thrombosis (CVST).
Design:
Retrospective study.
Setting:
Neurological departments of Dutch teaching hospitals.
Method:
Analysis of data of patients admitted to the neurological wards of nine teaching hospitals, diagnosed from 1970 to 1990. All patients with a clinical diagnosis of CVST, confirmed by X-ray angiography, magnetic resonance imaging, surgery or autopsy were included. Patients with cavernous sinus thrombosis were excluded. The clinical condition of patients after 3 months was scored on a 4-point scale.
Results:
Of 93 patients 62 fulfilled the inclusion criteria. Three months after the diagnosis 41 patients (66%) had recovered, 10 patients (16%) were seriously disabled, 11 patients (18%) had died. Factors associated with a poor outcome were coma (relative risk 3.5) and hemiparesis (relative risk 2.3) at the time of diagnosis. Signs of cerebral haemorrhage or infarction (by computed X-ray tomography) were associated with disability or death. Anticoagulant treatment was not significantly associated with a better or poorer outcome in these patients.
Conclusion:
This study confirms the variations in causes, clinical presentation, natural history, and treatment of CVST. No conclusion could be drawn about the effect of anticoagulant treatment.