title: Cerebral venous sinus thrombosis in iran: cumulative data, shortcomings and future directions.
abstract: BACKGROUND
  Cerebral venous sinus thrombosis (CVST) is a frequent cause of cerebrovascular disease in Iran.
  
  
  OBJECTIVE
  In this study, we report cumulative data of published Iranian studies in a systematic manner with critically appraisal and presenting future directions.
  
  
  METHODS
  The authors systematically searched the ISI web of knowledge, Pubmed, Scopus, EBESCO and iranmedex for keywords attributed to cerebral venous sinus thrombosis. The methodological and demographic characteristics, etiology, site of involvement and clinical manifestations of the patients with CVST were investigated.
  
  
  RESULTS
  Seven eligible series with 465 patients were found. Age of the patients were between 29.5-43.8 in these series. The ratio of Female to male was 2.79. The Mortality rate was 11.4%. Oral contraceptive pills the single most common risk factor in the all series(40-71% of female patients). Headache(80-97%), sensori/motor deficits(39-64%) and seizure(20-62%) were the most common clinical presentations. Hemorrhagic transformation was seen in 11-58% of the patients. All included studies have substantial shortcomings. Majority of the studies were retrospective and only one study was population based. Despite the ethnic heterogeneity in Iran, none of these studies reported ethnic information. Detailed methodology was missing in all studies. The extent of investigation for hematologicalor neoplastic disorders was not clear methods. Only one study reported a subgroup with multifactorialetiology. Neither Barthel index nor modified Rankin scale were reported in any studies. The mortality was reported only in the three studies. The analysis of prognostic factors was not done in any study.
  
  
  CONCLUSIONS
  To overcome theses hortcomings, more well-structured epidemiologic studies should be conducted in Iran as a CVST-raising country.
authors.affiliation: Research Center for Stem Cell and Transgenic Technology, Shiraz University of Medical Sciences, Shiraz, IR Iran ; Department of Neurology, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Borhani Haghighi
authors.forename: Nahid
authors.initials: N
authors.lastname: Ashjazadeh
authors.forename: Anahid
authors.initials: A
authors.lastname: Safari
authors.forename: Salvador
authors.initials: S
authors.lastname: Cruz-Flores
keywords: Causality; Clinical Manifestations; Epidemiology; Iran; Mortality; Sinus Thrombosis, Intracranial