This Article Full Text Full Text (PDF) All Versions of this Article: 39/10/2707    most recent STROKEAHA.107.512814v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Khealani, B. A. Articles by Kamal, A. K. Search for Related Content PubMed PubMed Citation Articles by Khealani, B. A. Articles by Kamal, A. K. Pubmed/NCBI databases Medline Plus Health Information Deep Vein Thrombosis Related Collections Cerebral Venous Thrombosis Anticoagulants

(Stroke. 2008;39:2707.)
© 2008 American Heart Association, Inc.

Original Contributions

Cerebral Venous Thrombosis

A Descriptive Multicenter Study of Patients in Pakistan and Middle East

Bhojo A. Khealani, FCPS; Mohammad Wasay, MBBS, FRCP; Mohammed Saadah, MRCP (UK), FRCPE; Erum Sultana, MBBS; Shahid Mustafa, MD; Farrukh Shohab Khan, MD Ayeesha K. Kamal, MD, FAHA

From Aga Khan University Hospital (B.A.K., M.W., S.M., A.K.K.), Karachi, Pakistan; Department of Neurology (M.S.), Rashid Hospital, Dubai, United Arab Eremites; and Liaquat National Hospital (E.S., F.S.K.).

Correspondence to Mohammad Wasay, MD, FRCP, FAAN, Department of Medicine, Division of Neurology, Aga Khan University, Karachi 74800, Pakistan. E-mail mohammad.wasay{at}aku.edu or mohammadwasay@hotmail.com

Background and Purpose— The natural history, causative factors, and outcomes of patients with cerebral venous thrombosis from Asia and Middle East have not been well described. This descriptive multicenter study describes the results for cerebral venous thrombosis patients in South Asia and the Middle East.

Methods— The retrospective and prospective data of patients with radiologically confirmed cerebral venous thrombosis were collected from 4 centers located in Pakistan and United Arab Emirates. The demographic, clinical, radiological, and outcome data were recorded and analyzed. Primary outcome was death or dependency (modified Rankin score >2) at the time of hospital discharge.

Results— This study included 109 patients with cerebral venous thrombosis; the presenting features most commonly being observed were headache (81%), focal motor deficits (45%), seizures (39%), and mental status changes (37%). Important predisposing factors included systemic and central nervous system infection (18%), postpartum state (17%), hyperhomocystinemia (9%), genetic thrombophilia (5%), and oral contraceptive pill use (3%). Ninety-six (67%) patients received therapeutic anticoagulation. Seven patients died and 43 had poor outcome at discharge. Focal motor deficits (OR, 2.93; 95% CI, 1.2–7.5; P=0.018) and hemorrhagic infarctions (OR, 2.81; 95% CI, 1.04–7.85; P=0.041) were independent predictors of unfavorable outcome at discharge. Hemorrhagic infarction was the most significant factor of long-term unfavorable outcome (OR, 5.87; 95% CI, 1.49–23.02; P=0.011).

Conclusions— Infections and postpartum state were the most common predisposing factors for cerebral venous thrombosis in this cohort. Most patients (67%) were treated with anticoagulation therapy. Almost 50% of patients were dead or disabled at discharge.

Key Words: cerebral venous thrombosis

This article has been cited by other articles:

				J. M. Coutinho, J. M. Ferro, P. Canhao, F. Barinagarrementeria, C. Cantu, M.-G. Bousser, and J. Stam Cerebral Venous and Sinus Thrombosis in Women Stroke, July 1, 2009; 40(7): 2356 - 2361. [Abstract] [Full Text] [PDF]