title: Head trauma is the major risk factor for cerebral sinus-vein thrombosis.
abstract: BACKGROUND
  Cerebral sinus vein thrombosis (CSVT) is a rare disease with significant neurological sequelae and high mortality rate. Incidence of CSVT diagnosis in the western world has increased despite the reduced occurrence of infections.
  
  
  OBJECTIVE
  To identify risk factors that may explain the predisposition to site specific thrombosis.
  
  
  METHODS
  Ninety consecutive patients diagnosed with acute CSVT in tertiary hospital. As a control group we used the data extracted from the National Trauma Registry and Healthcare Services.
  
  
  RESULTS
  Trauma history up to one month prior to diagnosis of CVST was found in 13 (14%) patients. Six patients had skull fractures, the others had blunt trauma. The overall SMR was 941 (p<0.0001); the separate results for men and women were 1206 and 543, respectively. Infections confined to the head and neck in 7% of the cases and brain tumor were observed in 8%. At the time of CVST, 23 of 50 (46%) women had a hormonal risk factor. The SMR for OC use was 1.63 (p=0.0298). Prothrombotic polymorphisms were detected in 16 of 63 (25.4%) patients who were tested for factor V Leiden and prothrombin G20210A mutation (OR=3.47, p=0.002) in comparison to 49% in DVT patients (OR=9.95, p<0.0001).
  
  
  CONCLUSIONS
  Assessment for CVST in patients with recent trauma and headache even after intact head CT is required. The other risk factors, such as hormone related and prothrombotic polymorphisms, were not specific just for CVST and the latter play a lesser role in CVST than in DVT.
authors.affiliation: Department of Internal Medicine "D", Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Ornit
authors.initials: O
authors.lastname: Giladi
authors.affiliation: Department of Statistics and Operations Research, Faculty of Exact Sciences, Tel Aviv University, Israel.
authors.forename: David M
authors.initials: DM
authors.lastname: Steinberg
authors.affiliation: National Center of Trauma and Emergency Medicine Research, Gertner Institute for Health Policy & Epidemiology Head, Israel; Disaster Medicine and School of Public Health, Tel-Aviv University, Israel.
authors.forename: Kobi
authors.initials: K
authors.lastname: Peleg
authors.affiliation: Stroke Center, Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Tanne
authors.affiliation: National Center of Trauma and Emergency Medicine Research, Gertner Institute for Health Policy & Epidemiology Head, Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Givon
authors.affiliation: Department of Internal Medicine "D", Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Grossman
authors.affiliation: Trauma Unit, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Klein
authors.affiliation: Trauma Unit, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Shirli
authors.initials: S
authors.lastname: Avigdori
authors.affiliation: Diagnostic Imaging of Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Gahl
authors.initials: G
authors.lastname: Greenberg
authors.affiliation: School of Public Health, Tel-Aviv University, Israel.
authors.forename: Rachel
authors.initials: R
authors.lastname: Katz
authors.affiliation: School of Public Health, Tel-Aviv University, Israel.
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
authors.affiliation: The Institute of Thrombosis and Hemostasis, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel. Electronic address: ophiras@sheba.health.gov.il.
authors.forename: Ophira
authors.initials: O
authors.lastname: Salomon
mesh_terms: D000328:Adult; D017677:Age Distribution; D001779:Blood Coagulation Factors / Q000235:genetics; D015984:Causality; D015897:Comorbidity; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000453:epidemiology* / Q000235:genetics*; D012307:Risk Factors; D017678:Sex Distribution; D012851:Sinus Thrombosis, Intracranial / Q000453:epidemiology* / Q000235:genetics*
chemical_list: D001779:Blood Coagulation Factors
keywords: Cerebral sinus veins; Thrombophilia; Thrombosis; Trauma