title: Long-term outcome after cerebral venous thrombosis: analysis of functional and vocational outcome, residual symptoms, and adverse events in 161 patients.
abstract: Cerebral venous thrombosis (CVT) affects mainly working-aged individuals. Functional recovery after CVT is generally considered good with about 3/4 of patients achieving short-term independence. However, vascular events, long-term functional outcome, and employment after CVT remain poorly investigated. We identified consecutive adult CVT patients treated at the Helsinki University Hospital (1987-2013) and invited them to a follow-up visit. Each clinical examination was combined with interview. We also recorded recurrent venous thromboembolism (VTE) and hemorrhagic events during follow-up and antithrombotic medication use. A modified Rankin Scale (mRS) served to assess functional outcome. Logistic regression served to identify independent factors associated with unemployment and functional recovery. Of the 195 patients identified, 21 died, 9 declined to participate, and 4 were excluded from the study. Thus, 161 patients (106 women) underwent an examination after a median of 39 months (interquartile range 14-95). VTE (one of which was CVT) occurred in 9 (6%) patients, and severe hemorrhagic events in 10 (6%). Functional outcome was good, with 84% scoring 0-1 on the mRS; 42% reported residual symptoms. Altogether, 91 (57%) patients were employed. After adjusting for age and sex, a National Institutes of Health Stroke Scale score>2 at admission and low education level, associated with both unfavorable functional outcome and unemployment. Long-term functional outcome after CVT may appear good if measured with mRS, but patients often have residual symptoms and are frequently unable to return to their previous work.
authors.affiliation: Department of Neurology, Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland. sini.hiltunen@helsinki.fi.|National School of Clinical Investigation, Helsinki, Finland. sini.hiltunen@helsinki.fi.
authors.forename: Sini
authors.initials: S
authors.lastname: Hiltunen
authors.affiliation: Department of Neurology, Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Putaala
authors.affiliation: Department of Neurology, Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.
authors.forename: Elena
authors.initials: E
authors.lastname: Haapaniemi
authors.affiliation: Department of Neurology, Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.|Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.|Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Turgut
authors.initials: T
authors.lastname: Tatlisumak
mesh_terms: D000328:Adult; D000368:Aged; D004651:Employment; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D020767:Intracranial Thrombosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology*; D012008:Recurrence; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology
chemical_list: D005343:Fibrinolytic Agents
keywords: Anticoagulation; Cerebral venous thrombosis; Follow-up; Long-term outcome; Sinus thrombosis; Vocational status