title: Cerebral venous thrombosis: influence of risk factors and imaging findings on prognosis.
abstract: OBJECTIVE
  To investigate imaging findings, risk factors and outcome in patients with cerebral venous thrombosis (CVT).
  
  
  METHODS
  Records of all patients with diagnosis of CVT between 1992 and 2002 were reviewed. Patients with CNS infection and with CVT secondary to invasive procedures were excluded. Inherited and acquired thrombophilia were searched in all patients.
  
  
  RESULTS
  Twenty-four patients (18 women, 6 men) with mean age of 29.5 years (range 3-48 years) were identified. Mean follow-up was 44 months (range 11-145 months). The most common symptoms were headache (75%), vomiting (33%) and impairment of consciousness (21%). Probable causes of CVT could be determined in 21 (88%) patients: pregnancy or puerperium in six (25%), oral contraceptive use in four (17%), head trauma in two (8%), mastoiditis in one (4%), nephrotic syndrome in one (4%), systemic disease in three (13%), and inherited thrombotic risk factors in four (17%) patients. CVT associated with pregnancy, puerperium and use of oral contraceptives had a significant better outcome than CVT caused by inherited thrombophilia or systemic disease (OR=14.4; p=0.02). CT scans were abnormal in 15 (62.5%) patients and MRI with gadolinium was abnormal in all. Those with parenchymal involvement had neurological sequelae during follow-up. All were treated with heparin followed by oral anticoagulants, and none had new or worsening of pre-existing intracerebral hemorrhage.
  
  
  CONCLUSIONS
  MRI is superior to conventional CT for diagnosing CVT. Patients with parenchymal lesions, thrombophilia and antiphospholipid syndrome had greater risk to be left with neurological sequelae. Anticoagulant therapy did not predispose to further intracerebral hemorrhage.
authors: Department of Internal Medicine, Rheumatology Unit, State University of Campinas, UNICAMP, Brazil.
authors: Simone
authors: S
authors: Appenzeller
authors: Carlos Borelli
authors: CB
authors: Zeller
authors: Joyce M
authors: JM
authors: Annichino-Bizzachi
authors: Lilian T L
authors: LT
authors: Costallat
authors: Leonardo
authors: L
authors: Deus-Silva
authors: Barbara
authors: B
authors: Voetsch
authors: Andreia V
authors: AV
authors: Faria
authors: Verônica A
authors: VA
authors: Zanardi
authors: Benito P
authors: BP
authors: Damasceno
authors: Fernando
authors: F
authors: Cendes
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy