title: Cerebral Venous Sinus Thrombosis Incidence Is Higher Than Previously Thought: A Retrospective Population-Based Study.
abstract: The incidence of cerebral venous thrombosis (CVT) varies between studies, but it is estimated to be between 2 and 5 per million per year. A recent study in the Netherlands with comprehensive ascertainment suggested a much higher incidence. It is uncertain whether these differing estimates reflect the quality of ascertainment or true variation. The purpose of this study was to determine the incidence of CVT in Adelaide, using a novel clinical and radiological methodology.
  
  
  
  We retrospectively identified CVT International Classification of Diseases-coded cases from all Adelaide public hospitals from 2005 to 2011. We also searched all neuroimaging studies (259 101) from these hospitals for text variations containing venous thromb. All potential cases were reviewed, and cases of incident CVT ascertained. Associations and outcomes were determined.
  
  
  
  Of 169 possible cases, 105 cases of CVT were confirmed (59 cases by both coding and neuroimaging, 40 from neuroimaging alone, and 6 from coding alone). In our population of 953 390 adults, this represented an incidence of 15.7 million per year (95% confidence interval, 12.9-19.0), the highest incidence reported. Of these cases, a possible procoagulant predisposition was identified in 48%. Fifty-five of 105 cases occurred in females. Relative risk of CVT in females of reproductive age was insignificantly higher than in males (1.18 [95% confidence interval, 0.94-1.48]).
  
  
  
  Cerebral venous sinus thrombosis in our study was more common than previously reported, perhaps because of more complete ascertainment. Future CVT incidence studies should include comprehensive capture and review of neuroimaging.
authors.affiliation: From the Intensive Care Department, Royal Adelaide Hospital, Adelaide, SA, Australia (S.D.); Emergency Department, Flinders Medical Centre, Bedford Park, SA, Australia (B.W.); Neurology Department, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia (J.L.); Neurology Department, Royal Adelaide, Lyell MCEwin Hospitals (T.K.); and Department of Medicine, University of Adelaide, Adelaide, SA, Australia (T.K.).
authors.forename: Sharon
authors.initials: S
authors.lastname: Devasagayam
authors.affiliation: From the Intensive Care Department, Royal Adelaide Hospital, Adelaide, SA, Australia (S.D.); Emergency Department, Flinders Medical Centre, Bedford Park, SA, Australia (B.W.); Neurology Department, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia (J.L.); Neurology Department, Royal Adelaide, Lyell MCEwin Hospitals (T.K.); and Department of Medicine, University of Adelaide, Adelaide, SA, Australia (T.K.).
authors.forename: Ben
authors.initials: B
authors.lastname: Wyatt
authors.affiliation: From the Intensive Care Department, Royal Adelaide Hospital, Adelaide, SA, Australia (S.D.); Emergency Department, Flinders Medical Centre, Bedford Park, SA, Australia (B.W.); Neurology Department, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia (J.L.); Neurology Department, Royal Adelaide, Lyell MCEwin Hospitals (T.K.); and Department of Medicine, University of Adelaide, Adelaide, SA, Australia (T.K.).
authors.forename: James
authors.initials: J
authors.lastname: Leyden
authors.affiliation: From the Intensive Care Department, Royal Adelaide Hospital, Adelaide, SA, Australia (S.D.); Emergency Department, Flinders Medical Centre, Bedford Park, SA, Australia (B.W.); Neurology Department, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia (J.L.); Neurology Department, Royal Adelaide, Lyell MCEwin Hospitals (T.K.); and Department of Medicine, University of Adelaide, Adelaide, SA, Australia (T.K.). Timothy.Kleinig@sa.gov.au.
authors.forename: Timothy
authors.initials: T
authors.lastname: Kleinig
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D012189:Retrospective Studies; D012737:Sex Factors; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013021:South Australia / Q000453:epidemiology
keywords: cerebral veins; incidence; neuroimaging; stroke; venous thrombosis