title: Long-term evaluation of the risk of recurrence after cerebral sinus-venous thrombosis.
abstract: BACKGROUND
  The clinical course of cerebral sinus-venous thrombosis (CSVT) is largely unknown because prospective studies with a long follow-up and with the goal to assess thrombosis recurrence rate and predisposing factors for recurrence are lacking.
  
  
  RESULTS
  One hundred forty-five patients with a first CSVT were followed up for a median of 6 years after discontinuation of anticoagulant treatment. End points were recurrent CSVT or other clinical manifestations of venous thromboembolism. CSVT recurred in 5 patients (3%) and other manifestations of venous thromboembolism (deep vein thrombosis of the lower limbs or pulmonary embolism) were seen in 10 additional patients (7%), for a recurrence rate of 2.03 per 100 person-years (95% confidence interval, 1.16 to 3.14) for all manifestations of venous thromboembolism and 0.53 per 100 person-years (95% confidence interval, 0.16 to 1.10) for CSVT. Nearly half of the recurrences occurred within the first year after discontinuation of anticoagulant therapy. Risk factors for recurrent venous thrombosis were male sex (adjusted hazard ratio, 9.66; 95% confidence interval, 2.86 to 32.7) and, for thromboses other than CSVT, severe thrombophilia resulting from antithrombin, protein C, protein S deficiency, anti-phospholipid antibodies, or combined abnormalities (adjusted hazard ratio, 4.71; 95% confidence interval, 1.34 to 16.5).
  
  
  CONCLUSIONS
  The risk of recurrent CSVT is low and is higher in the first year after discontinuation of anticoagulant treatment and among men. Mild thrombophilia abnormalities are not associated with recurrent CSVT, but severe thrombophilia entails an increased risk of deep vein thrombosis of the lower limbs or pulmonary embolism.
authors.affiliation: A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine and Medical Specialties, Fondazione IRCCS Ca'Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. martin@policlinico.mi.it
authors.forename: Ida
authors.initials: I
authors.lastname: Martinelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Bucciarelli
authors.forename: Serena M
authors.initials: SM
authors.lastname: Passamonti
authors.forename: Tullia
authors.initials: T
authors.lastname: Battaglioli
authors.forename: Emanuele
authors.initials: E
authors.lastname: Previtali
authors.forename: Pier Mannuccio
authors.initials: PM
authors.lastname: Mannucci
mesh_terms: D000925:Anticoagulants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity; D008297:Male; D011379:Prognosis; D011655:Pulmonary Embolism; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D019851:Thrombophilia; D020246:Venous Thrombosis
chemical_list: D000925:Anticoagulants