Trends in Cerebral Venous Thrombosis: Incidence, Clinical, and Angiographic Features

Background: Cerebral venous thrombosis (CVT), thrombosis of the dural sinus, cerebral veins, or both, is a rare cerebrovascular disease. Although mortality rates after CVT have declined over time, this condition can result in devastating neurologic outcomes. CVT is estimated to account for <1% of all strokes. Unlike arterial strokes, CVT tends to affect young patients with a female predominance, is often nonapoplectic in onset, and has a wide spectrum of clinical presentations. These and other features make CVT a challenging disease to diagnose without an understanding of its evolving epidemiology, clinical features, associated conditions, and the neuroimaging findings typically needed to confirm the diagnosis. Methods: This descriptive study retrospectively collected 39 CVT cases in Dr. Wahidin Sudirohusodo General Hospital Makassar. Data were taken from patients’ medical records, radiological records, and catheter lab data records. The clinical manifestation and angiographic findings variables of consecutive CVT cases that had digital subtraction angiography (DSA) between January 2017 and December 2023 were analyzed. Results: This study was conducted on a total of 39 CVT patients with a mean age of 42.26 ± 12.98 years, mostly female 53.84%. The most clinical manifestation was vascular headache (87.2%). Presentation of hemiparesis was 30.8%, diplopia was 20.5%, and seizure 10.3%. Based on angiographic findings, most thrombosis is located in the cavernous sinus, as many as 41%, followed by superior sinus sagitalis (SSS), as many as 30.8%, and tranversus sinus (25.6%). The patient with the manifestation of vascular headache was female and located in the cavernous sinus. All patients presented with diplopia were located in the cavernous sinus. Conclusion: Most of CVT’s patients were female and of productive age, with the most clinical presentation was vascular headache followed by focal neurological deficits like hemiparesis and diplopia. Based on angiographic findings, mostly thrombosis is located in the cavernous sinus, followed with the superior sagitalis sinus (SSS). The characteristics of patient CVT with vascular headaches mostly were female with thrombosis located in the cavernous sinus.