Cerebral Venous Thrombosis in a Mexican Multicenter Registry of Acute Cerebrovascular Disease: The RENAMEVASC Study

• Published in: Journal of stroke and cerebrovascular diseases Vol. 21; no. 5; pp. 395 - 400
• Main Authors: Ruiz-Sandoval, José L., MD, Chiquete, Erwin, MD, PhD, Bañuelos-Becerra, L. Jacqueline, MD, Torres-Anguiano, Carolina, MD, González-Padilla, Christian, MD, Arauz, Antonio, MD, León-Jiménez, Carolina, MD, Murillo-Bonilla, Luis M., MD, MSc, Villarreal-Careaga, Jorge, MD, Barinagarrementería, Fernando, MD, Cantú-Brito, Carlos, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2012
• Subjects: Adult; Age Factors; Cardiovascular; Cerebral Veins; cerebral venous thrombosis; cerebrovascular disease; Cerebrovascular Disorders; cranial sinuses; Female; Hospitalization; Humans; Kaplan-Meier Estimate; Length of Stay; Male; Mexico - epidemiology; Neuroimaging; Neurology; outcome; Pregnancy; Pregnancy Complications, Cardiovascular; Prognosis; Proportional Hazards Models; Prospective Studies; Registries; Risk Factors; stroke; Stroke - complications; Venous Thrombosis - complications; Venous Thrombosis - epidemiology; Young Adult; Mexico; cranial sinuses; Cerebral veins; cerebrovascular disease; cerebral venous thrombosis; stroke; outcome
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2011.01.001

Background Cerebral venous thrombosis (CVT) is a rare form of cerebrovascular disease that is usually not mentioned in multicenter registries on all-type acute stroke. We aimed to describe the experience on hospitalized patients with CVT in a Mexican multicenter registry on acute cerebrovascular disease. Methods CVT patients were selected from the RENAMEVASC registry, which was conducted between 2002 and 2004 in 25 Mexican hospitals. Risk factors, neuroimaging, and 30-day outcome as assessed by the modified Rankin scale (mRS) were analyzed. Results Among 2000 all-type acute stroke patients, 59 (3%; 95% CI, 2.3-3.8%) had CVT (50 women; female:male ratio, 5:1; median age, 31 years). Puerperium (42%), contraceptive use (18%), and pregnancy (12%) were the main risk factors in women. In 67% of men, CVT was registered as idiopathic, but thrombophilia assessment was suboptimal. Longitudinal superior sinus was the most frequent thrombosis location (78%). Extensive (>5 cm) venous infarction occurred in 36% of patients. Only 81% of patients received anticoagulation since the acute phase, and 3% needed decompressive craniectomy. Mechanical ventilation (13.6%), pneumonia (10.2%) and systemic thromboembolism (8.5%) were the main in-hospital complications. The 30-day case fatality rate was 3% (2 patients; 95% CI, 0.23-12.2%). In a Cox proportional hazards model, only age <40 years was associated with a mRS score of 0 to 2 (functional independence; rate ratio, 3.46; 95% CI, 1.34-8.92). Conclusions The relative frequency of CVT and the associated in-hospital complications were higher than in other registries. Thrombophilia assessment and acute treatment was suboptimal. Young age is the main determinant of a good short-term outcome.