Original ArticleCerebral Venous Thrombosis: Analysis of a Multicenter Cohort From the United States
Section snippets
Methods
Patients with diagnosis of CVT were identified by International Classification of Diseases, Ninth Revision coding system (325, phlebitis and thrombophlebitis of intracranial venous sinuses; 671.5, CVT in pregnancy and puerperium; and 437.6, nonpyogenic thrombosis of intracranial venous sinus) at 10 centers in the United States during a 10-year period by retrospective chart review (1991-1997) or prospective enrollment (1997-2001). The investigators screened 232 patients for study inclusion by
Results
The study included 182 patients. The age range was 13 to 82 years (mean 38 years). In all, 109 individuals (60%) were women. In 103 patients (57%), one or more predisposing factors were identified (Table 1). A homocysteine level was checked in 89 patients (49%) and was elevated (>20 μmol/L) in 9 patients (10%). The range of homocysteine level was 20 to 37 μmol/L (median 25 μmol/L) in this 10% of patients. Two or more risk factors were identified in 19 patients (10%).
Headache (76%) was the most
Discussion
This study represents the second largest registry of patients with CVT after the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)6 and the largest cohort of these patients from the United States. Clinical and radiologic features, predisposing factors, outcome, and predictors of outcome are not much different from ISCVT or other European studies. The major strength of the study is it being the largest US-based multicenter cohort with the largest number (n = 27; 15% of all
Acknowledgment
The authors are grateful to Dr Steve Roach, Ohio State University, for manuscript review and valuable suggestions.
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Supported in part by a seed money grant from Aga Khan University.
Presented in preliminary form at World Congress of Neurology December 2005 in Sydney, Australia, and at the American Academy of Neurology Meeting, in Toronto, Ontario, Canada, in April 1999.