title: Cerebral vein and dural sinus thrombosis in elderly patients.
abstract: OBJECTIVE
  The clinical features and prognosis of cerebral vein and dural sinus thrombosis (CVT) in elderly patients have not been previously described.
  
  
  METHODS
  In a multicenter prospective observational study, we compared clinical and imaging features, risk factors, and outcome of adult patients aged <65 (young and middle-aged patients) and > or =65 years (elderly patients).
  
  
  RESULTS
  A total of 624 adult patients with CVT were registered and followed-up for a median of 16 months. Fifty-one (8.2%) were aged > or =65 years. Presentation as an isolated intracranial hypertension syndrome was less frequent in elderly patients (4/51 versus 139/573, P=0.008), whereas depressed consciousness (17 versus 97, P=0.005), and mental status changes (22 versus 115, P=0.001) were more frequent in the elderly. The prognosis of elderly patients was considerably worse than that of younger patients, as only 49% of elderly patients made a complete recovery (versus 82% in younger patients), whereas 27% died and 22% were dependent at the end of follow-up (versus 7 and 2% respectively in younger patients). Carcinoma (5 cases) was more frequent as a risk factor for CVT in elderly patients (P=0.017). During follow-up, elderly patients were more likely to experience thrombotic events (HR=4.8, 95% CI=1.9 to 11.9) and were less likely to experience severe headaches (HR=0.2, 95% CI=0.02, 0.97).
  
  
  CONCLUSIONS
  Elderly patients with CVT have a distinctive clinical presentation: isolated intracranial hypertension is uncommon, whereas mental status and alertness disturbances are common. The prognosis of CVT is worse in elderly patients.
authors.affiliation: Department of Neurosciences and Mental Health, Hospital Santa Maria, 1649-035 Lisbon, Portugal. jmferro@fm.ul.pt
authors.forename: José M
authors.initials: JM
authors.lastname: Ferro
authors.forename: Patrícia
authors.initials: P
authors.lastname: Canhão
authors.forename: Marie-Germaine
authors.initials: MG
authors.lastname: Bousser
authors.forename: Jan
authors.initials: J
authors.lastname: Stam
authors.forename: Fernando
authors.initials: F
authors.lastname: Barinagarrementeria
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002550:Cerebral Veins / Q000473:pathology*; D003244:Consciousness Disorders; D003693:Delirium / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis; D020767:Intracranial Thrombosis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012851:Sinus Thrombosis, Intracranial / Q000473:pathology*; D013927:Thrombosis / Q000473:pathology; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis