Clinical features, common characteristics, and outcomes of cerebral venous sinus thrombosis in Northwest Iran: A retrospective descriptive cohort study

Abstract

Background: Cerebral venous sinus thrombosis (CVST) is an uncommon but increasingly recognized cause of stroke. Despite a higher prevalence in developing regions, comprehensive data from these areas remain scarce. This study aims to describe the clinical features, common exposures, and outcomes of patients with CVST in Northwest Iran.

Methods: A retrospective descriptive study was conducted between September 2018 and September 2020 in Tabriz City, Iran. Data on demographics, common characteristics, clinical presentations, imaging findings, and outcomes were collected from Tabriz Stroke Registry. The modified Rankin Scale (mRS) was used to assess outcomes at 1, 6, and 12 months. Statistical analysis was performed, employing descriptive statistics and normality tests.

Results: A total of 128 patients were included, predominantly women (76.6%) with a median age of 36.5 years. Common characteristics included contraceptive use (37.5%), infections (5.5%), and fasting (9.4%). Headache was the most frequent symptom (91.7%), followed by papilledema (53.3%) and seizures (43.3%). At one month, 86.7% of patients achieved a favorable outcome (mRS < 3), with mortality rates of 2.5%, 3.7%, and 4.5% at one, six, and twelve months, respectively. Imaging data indicated that the transverse/sigmoid sinuses (66.7%) and superior sagittal sinus (62.2%) were the most commonly affected. sinuses (66.7%) and superior sagittal sinus (62.2%) were the most commonly affected.

Conclusion: Among hospitalized patients with stroke in our tertiary centers, the proportion of CVST appears higher than those reported in many Western hospital-based series. Headache was the most common presentation; oral contraceptive use and fasting were frequently observed exposures. Population-based and controlled studies are needed to estimate true incidence and evaluate causal risk factors.