Ten years of cerebral venous thrombosis (CVT) in Northeast Melbourne, Australia: male gender and presence of myeloproliferative neoplasm is associated with thrombotic recurrence in unprovoked events

Research output: Contribution to conferenceAbstract

Abstract

Background: Cerebral venous thrombosis (CVT) is a rare venous
thrombotic event associated with significant morbidity and mortality.
Aims: We review our local experience in the management of CVT compared
to other venous thromboembolism (VTE).
Methods: Retrospective evaluation of CVT presentations, from January
2005 to December 2014, at Austin and Northern Health, Melbourne.
Results: 52 patients (30 female, 22 male) with a median age of 40 (18–
83) years, presented with 53 episodes of CVT. 17 patients (32%) failed
to be diagnosed on initial presentation with a false negative rate of
35% on initial CT brain; all of which were subsequently diagnosed on
MRI or CT angiography/venography. 29 episodes (55%) were associated
with an underlying risk factor, particularly in females (RR 2.10;
p=0.02) compared to men, with hormonal risk factors being most common.
The median duration of anticoagulation was 6 months with 11
receiving life-long anticoagulation. 81% had residual thrombosis on
repeat imaging, which was not associated with recurrence at the same
or distant site. At last follow-up, 2 patients (5%) had a deterioration
of modified Rankin score of ≥ 2 from baseline, however, 15 (37%) continued
to report ongoing symptoms. Nine (17%) had CVT-related
haemorrhagic transformation with 2 resultant CVT-related deaths
(RR 22.5; p=0.04). No patients with clearly provoking factors had
recurrent VTE. Males with unprovoked events had a higher risk of
VTE recurrence (RR 18.2, p=0.05) with all three men who had recurrent
VTE being subsequently diagnosed with myeloproliferative neoplasm
(MPN). Compared to the VTE population, CVT patients weryounger, had similar rate of provoked events and VTE recurrence,
although with significantly higher rate of MPN diagnosis (RR 8.57
(2.11–34.89); p=0.003).
Conclusions: CVT is a rare condition with heterogenous presentations.
All recurrences occurred in male patients with subsequent MPN diagnoses,
suggesting the need for further evaluation and investigation in
males with unprovoked events.
Original languageEnglish
Pages125-126
Number of pages2
Publication statusPublished - 2016

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