Epidemiology of Cerebral Venous Sinus Thrombosis: 2021-2023

Cerebral venous sinus thrombosis (CVST) is a high-risk, low-prevalence disease. Presentations can be variable, and diagnosis often requires magnetic resonance venography, making diagnosis challenging. To date, no studies have focused on patients presenting to the emergency department (ED) who were ultimately diagnosed with CVST. We conducted a cross-sectional study using Cosmos (Epic Systems Corporation), a large de-identified electronic health record database. Our objective was to describe the ED encounter rate, demographic characteristics, clinical features, medications, and outcomes of adult patients with CVST between 2021 and 2023. Our age distribution indicates that CVST occurs more frequently in older adults than previously thought. Headache was the most common chief complaint. Co-presentation with head injury and malignancy was also frequent. Most patients underwent some form of neuroimaging and received anticoagulation. In this large, nationally representative ED cohort, CVST was rare; however, prospective studies are needed to better understand the risk factors, diagnostic approaches, and medical management of CVST in patients presenting to the ED.