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Research ArticleOriginal Article
Open Access

Clinical and epidemiological profile of cerebral venous thrombosis

Mohammed S. Alqahtani, Adel A. Alhazzani, Ibrahim Alnaami, Saeed A. Alqahtani, Tariq M. Alahmari, Abdulaziz M. Alqarni, Ibrahim A. Alburaidi, Mohammed A. Alqahtani, Saleh M. Alqahtani, Moayad A. Zarbh, Yasser wassel, Jaber Alfaifi and Ahmed Elhadad
Neurosciences Journal October 2020, 25 (5) 380-385; DOI: https://doi.org/10.17712/nsj.2020.5.20200028
Mohammed S. Alqahtani
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MBBS
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  • For correspondence: [email protected]
Adel A. Alhazzani
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MD, FRCPC, FAAN
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Ibrahim Alnaami
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MD, MSc, FRCSC
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Saeed A. Alqahtani
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MD
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Tariq M. Alahmari
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MBBS
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Abdulaziz M. Alqarni
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MBBS
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Ibrahim A. Alburaidi
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MBBS
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Mohammed A. Alqahtani
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MBBS
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Saleh M. Alqahtani
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MBBS
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Moayad A. Zarbh
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MBBS
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Yasser wassel
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MD
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Jaber Alfaifi
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
MD
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Ahmed Elhadad
From the Neurology Unit (Alqahtani MS, alfaifi, wassel), Department of Internal Medicine, Department of Radiology (Alahmari, Elhaddad), Armed Forces Hospital Southern Region, from the Department of Neurology (Alqahtani, Alnaami), Aseer Central Hospital, from the Department of Neurology (Alqarni), King Khalid University, and from the Department of Medical (Alburaidi, Alqahtani MA, Alqahtani SM, zarbah), Section of Neurology (Alqahtani SA), Department of Medicine, College of Medicine, Section of Neurosurgery (Alnaami), Department of Surgery, College of Medicine, King Khalid University, Abha, and from the Neurology Unit (Alhazzani), Department of Medicine, College of Medicine, King Saud university, Riyadh, Kingdom of Saudi Arabia
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  • Figure 1
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    Figure 1

    Clinical presentation of patients with Cerebral Venous Thrombosis, Aseer Region-Southern of Saudi Arabia.

Tables

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    Table 1

    Personal data of patients with Cerebral Venous Thrombosis, Aseer Region-Southern of Saudi Arabia.

    Personal datan(%)
    Gender
    Male22(18.5)
    Female97(81.5)
    Age in years
    <30 years42(35.3)
    30-3942(35.3)
    40+35(29.4)
    Marital status
    Single34(28.6)
    Married85(71.4)
    Nationality
    Saudi107(89.9)
    Non-Saudi12(10.1)
    Educational level
    Illiterate18(15.1)
    Basic27(22.7)
    Secondary44(37.0)
    Bachelor30(25.2)
    Work
    Working43(36.1)
    Not working63(52.9)
    Student13(10.9)
    Area
    High altitude78(65.5)
    Sea level41(34.5)
    • View popup
    Table 2

    Pattern of CVT among affected patients, Aseer Region-Southern of Saudi Arabia.

    Pattern of CVTNo(%)
    The duration of the symptoms before presentation (days)
    1-250(42)
    3-638(31.9)
    7+31(26.1)
    Diagnostic imaging
    CTV63(52.9)
    MRV56(47.1)
    Imaging done
    CT24(20.2)
    MRI26(21.8)
    Both69(58.0)
    Time to do CT (hours)
    1-221(22.6)
    3-536(38.7)
    6-1016(17.2)
    >1020(21.5)
    Initial image findings
    Normal27(29.0)
    Hemorrhage ICH39(41.9)
    Edema or infarct27(29.0)
    Time to do MRI
    <6 hours21(22.1)
    6-1224(25.3)
    13-2423(24.2)
    After 24 hours27(28.4)
    Average time of diagnosis (days)
    1-2101(84.9)
    3-718(15.1)
    Location
    Superior Sagittal Sinus26(21.8)
    Transverse Sinus21(17.6)
    Sigmoid sinus12(10.1)
    Superior Sagittal + transverse16(13.4)
    Transverse + sigmoid32(26.9)
    Multiple sinuses12(10.1)
    Right50(42.0)
    Left69(58.0)
    • CVT - Cerebral venous thrombosis

    • MRV - Megnetic resonance venography

    • ICH - intracerebral hemorrhage

    • CT - computerized tomography scan

    • View popup
    Table 3

    Risk factors of CVT among affected patients, Aseer Region-Southern of Saudi Arabia.

    Risk factorsNo(%)
    Family history of DVT/ stroke
    No85(71.4)
    Yes34(28.6)
    History of hypercoagulopathy state
    Yes43(44.3)
    No54(55.7)
    Co-morbidity
    No80(67.2)
    DM14(11.8)
    HTN9(7.6)
    Others16(13.4)
    Past history of
    CVT6(5.0)
    PE8(6.7)
    DVT10(8.4)
    Other risk factors
    OCP37(31.1)
    Pregnancy2(1.7)
    Surgery8(6.7)
    Post-partum13(10.9)
    • View popup
    Table 4

    Admission data of patients with Cerebral Venous Thrombosis, Aseer Region-Southern of Saudi Arabia.

    Admission datan(%)
    Modified Rankin Scale (mRs)
    mRs 5–62(1.7)
    mRs 3–43(2.5)
    mRs 0–2114(95.8)
    Admission days
    1-646(38.7)
    7-1450(42.0)
    15+23(19.3)
    Initial management
    IV heparin85(71.4)
    SC heparin34(28.6)
    Discharge medication
    Warfarin102(85.7)
    NOAC15(12.6)
    Still on medication
    Yes87(73.1)
    No32(26.9)
    • View popup
    Table 5

    Predictors of recanalization among patientswith Cerebral Venous Thrombosis, Aseer Region-Southern of Saudi Arabia.

    PredictorFinding on CT follow upP-value
    Still thrombusRecanalization
    n(%)n(%)
    Gender
    Male1(5.9)16(94.1).881
    Female4(5.0)76(95.0)
    Age in years
    < 30 years0(0.0)32(100).272
    30-393(7.9)35(92.1)
    40+2(7.4)25(92.6)
    Area
    High altitude3(4.9)58(95.1).891
    Sea level2(5.6)34(94.4)
    The duration of the symptoms before presentation (days)
    1-20(0.0)44(100).048*
    3-63(11.1)24(88.9)
    7+2(7.7)24(92.3)
    Location
    Superior Sagittal Sinus2(9.5)19(90.5).139
    Transverse Sinus0(0.0)17(100)
    Sigmoid sinus2(18.2)9(81.8)
    Superior Sagittal + Transverse0(0.0)14(100)
    Transverse + Sigmoid0(0.0)25(100)
    Superior Sagittal + Transverse + Sigmoid1(11.1)8(88.9)
    Site
    Right2(4.9)39(95.1).916
    Left3(5.4)53(94.6)
    Initial management
    IV heparin5(7.2)64(92.8).144
    SC heparin0(0.0)28(100)
    Discharge medication
    Warfarin5(5.3)89(94.7).682
    NOAC0(0.0)3(100.0)
    Average time of diagnosis (days)
    1-25(6.0)78(94.0).346
    3-70(0.0)14(100)
    Still on medication
    Yes4(5.6)68(94.4).762
    No1(4.0)24(96.0)
    Complications
    Yes4(13.8)25(86.2).012*
    No1(1.5)67(98.5)
    • P - Exact probability test

    • ↵* p<0.05 (significant)

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Neurosciences Journal: 25 (5)
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Clinical and epidemiological profile of cerebral venous thrombosis
Mohammed S. Alqahtani, Adel A. Alhazzani, Ibrahim Alnaami, Saeed A. Alqahtani, Tariq M. Alahmari, Abdulaziz M. Alqarni, Ibrahim A. Alburaidi, Mohammed A. Alqahtani, Saleh M. Alqahtani, Moayad A. Zarbh, Yasser wassel, Jaber Alfaifi, Ahmed Elhadad
Neurosciences Journal Oct 2020, 25 (5) 380-385; DOI: 10.17712/nsj.2020.5.20200028

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Clinical and epidemiological profile of cerebral venous thrombosis
Mohammed S. Alqahtani, Adel A. Alhazzani, Ibrahim Alnaami, Saeed A. Alqahtani, Tariq M. Alahmari, Abdulaziz M. Alqarni, Ibrahim A. Alburaidi, Mohammed A. Alqahtani, Saleh M. Alqahtani, Moayad A. Zarbh, Yasser wassel, Jaber Alfaifi, Ahmed Elhadad
Neurosciences Journal Oct 2020, 25 (5) 380-385; DOI: 10.17712/nsj.2020.5.20200028
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