Long-term sequelae after cerebral venous thrombosis in functionally independent patients.
BACKGROUND
The majority of survivors of cerebral venous thrombosis (CVT) regain functional independence, but it is unclear whether these patients experience long-term sequelae. The aim of this case-control study was to assess: (1) frequency of headache, fatigue, depression, and concentration impairment; and (2) impact of these sequelae on daily life and employment in patients with CVT who are functionally independent.


METHODS
We included 44 patients with CVT older than 15 years diagnosed between January 1997 and July 2006 who were functionally independent (modified Rankin scale score <or= 2) at least 12 months after CVT. Healthy control subjects were matched for age and sex. Headache was assessed by the Headache Impact Test, fatigue with the Fatigue Severity Scale, depression by the Center for Epidemiological Studies Depression Scale, and concentration impairment with the cognition dimension of the 6-dimensional EuroQol. We studied the psychosocial impact (based on the Severity Impact Profile 68) and the impact on employment status.


RESULTS
Median follow-up was 63 months (range 12-124). In all, 33 patients (75%) reported concentration impairment, 19 (43%) had headache, 13 (30%) were depressive, and 13 (30%) experienced fatigue. All sequelae were more reported by patients than control subjects. The sequelae were correlated with each other, and with a higher psychosocial impact. Working was impossible for 8 (21%) and difficult for 13 (34%) of previously employed patients.


CONCLUSIONS
In this case-control study, patients with CVT classified as having a good (independent) outcome often experience long-term symptoms that have a negative impact on their psychosocial and employment status.
Department of Neurology, University Medical Center Groningen, University of Groningen, the Netherlands. k.koopman@neuro.umcg.nl
Karen
K
Koopman
Maarten
M
Uyttenboogaart
Patrick C
PC
Vroomen
Jan
J
van der Meer
Jacques
J
De Keyser
Gert-Jan
GJ
Luijckx
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology; D016208:Databases, Factual; D003863:Depression / Q000209:etiology; D004651:Employment; D005221:Fatigue / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D020767:Intracranial Thrombosis / Q000150:complications* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012919:Social Behavior; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications* / Q000523:psychology; D055815:Young Adult