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Cerebral venous sinus thrombosis: gender differences in ten years experience Objective: Cerebral venous sinus thrombosis (CVST) is an uncommon subtype of stroke. CVST is much more common in women than men with a ratio of three to one. This women preponderance is attributed to gender-specific risk factors (GSRF). In many patients, symptoms develop o...
Context in source publication
Context 1
... patients who had seizures during hospitalization (n=6), all had transverse sinus thrombosis; in two of them it was affected alone, in four of them it was occluded together with sigmoid sinus. Risk factors for CVST are shown in Table 2 (Table 2). We could not find any risk factors in 20.6% (n=7) of the patients. ...
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Increased intracranial pressure in cerebral venous sinus thrombosis or metabolic disease has been reported. We present a case of new-onset chronic headache and bilateral papilledema in the setting of elevated intracranial pressure in strong temporal association to vaccination against COVID-19 with AstraZeneca. After repeated drainage of cerebrospin...
Rationale
Venous sinus thrombosis is a special type of cerebrovascular disease. Its incidence is low and its symptoms are lack of specificity. And its early diagnosis and treatment are very difficult.
Patient concerns
This paper reported a rare case of a 43-year-old female who presented with cerebral venous thrombosis (CVT) complicated with cerebr...
This study presents the characteristics that distinguish between idiopathic intracranial hypertension (ICH) and ICH caused by intracranial vascular damage. Twenty-one patients with ICH were included in this study. The analysis of the symptomatology correlated with the values of intracranial pressure, and the imaging findings revealed significant di...
Background:
Diagnosing cerebral sinus venous thrombosis (CSVT) manifested as a spontaneous subdural hematoma (SDH) is challenging due to variability of its clinical features. The neuroradiological investigation is crucial to confirm the diagnosis. The management of SDH secondary to CVST is controversial and not well established.
Case description:...
Cerebral dural sinuses contain different types of chordae willisii (CW). The transvenous endovascular approach, which has become an optimal method for the treatment of cerebrovascular diseases, such as malformation, fistula, and chronic intracranial hypertension, due to sinus thromboses, frequently uses retrograde navigation through dural sinuses....
Citations
... CVST is less common than most strokes; however, it presents diagnostic challenges [10]. Previous studies identified significant gender-based variations in the presentation, course, and risk factors of CVST [11]. Although the age and sex distribution of CVST patients varies, women often make up a sizable majority of those with this ailment [12]. ...
Objective
Cerebral Venous Sinus Thrombosis (CVST), a complex and infrequent cerebrovascular disorder characterized by the formation of clots within the cerebral venous sinuses, occurs as a result of multiple risk factors and casualties, and its epidemiological picture should be investigated.
Methods
This descriptive study was conducted retrospectively on patients with a final diagnosis of cerebral vein thrombosis, who were referred to the emergency room of Ghaem Hospital (Mashhad, Iran) between 2009 and 2019. The study included all patients with cerebral vein thrombosis who were older than 18 years. Clinical symptoms and causes were documented and contrasted according to demographics.
Results
During the 10 years of this study, 749 cases of cerebral vein thrombosis were observed, with women accounting for the majority (72.8%). The most prevalent symptom was headache (554 cases; 74.0%), followed by seizures (23.1%), blurred vision (16.0%), nausea (7.5%), vomiting (6.9%), double nose (4.9%), and dizziness (3.3%). There was no significant difference in the frequency of symptoms between the two genders (p<0.05). The most commonly identified risk factors were OCP (110 cases; 14.7%), followed by infection (103 cases; 13.8%), malignancies (78 cases; 10.4%), and fasting (15 cases; 2.0%). There was no significant difference in risk factors between the two genders, with the exception that all cases of fasting were in women, and the differences were significant (p=0.015). The most common site of involvement according to Magnetic Resonance Venography (MRV) was the upper sagittal sinus (427 cases; 57.0%). There was no significant difference in terms of the site of the conflict between the two genders (p<0.05).
Conclusion
The findings of the present study showed that deep vein thrombosis occurred mainly in women and manifested itself mostly as a headache. Moreover, the upper sagittal sinus was the most common site of involvement.
... As females tend to have higher prevalence of autoimmune reactions compared to males (Klein & Flanagan, 2016), it is possible that such side effects affect females more often than males. It should also be noted that females, especially those using oral contraceptives, have been shown to be more at risk of CVST than males in the general population (Coutinho et al., 2009;Hinnell et al., 2012;Ozcan et al., 2013). However, a detailed analysis by sex including a comparison in prevalence of CVST in the general young female population versus the vaccinated female young population is currently lacking, but is much needed. ...
The development of SARS-CoV-2 vaccines represents a significant breakthrough for managing the COVID-19 pandemic, however their approval process has exposed a crucial limitation in clinical trial reports—that is, a disregard for sex differences in response to vaccines. Historically, males and females have shown different reactions to vaccines of many kinds, which have become apparent with the arrival of COVID-19 vaccines in late-2020. In this article, we review both regulatory data from Phase III vaccine trials as well as peer-reviewed reports from vaccines administered to the general population, many of which failed to stratify results by sex. We also discuss the exclusion of pregnant and lactating women in drug development and the regulatory guidelines for use of COVID-19 vaccines in such populations. We conclude by proposing some questions to stimulate discussion with the intent to advance the field toward one of precision medicine.
... In some of the patients the clinical symptoms develop slowly whereas in a few the symptoms are non-specific requiring a high index of clinical suspicion to pick up the diagnosis. Therefore, it is not too unjustified that there does not exist a definite clinical syndrome [4]. ...
Cerebral venous sinus thrombosis (CVST) is a neuromuscular disorder with protean manifestation requiring a high index of suspicion. Early diagnosis is sometimes lifesaving. It is particularly challenging is to establish an accurate etiology as it guides the clinician for long term thrombo-prophylaxis. We report a young female with no conventional risk factors for CVST, who presented with headache, generalised seizures and prolonged loss of consciousness. Her work-up revealed an elevated serum homocysteine level which might be a possible causative association in the etiopathogenesis of this neuromuscular condition.
... It is reported in the literature that CVST is much more common in women than men with a ratio of 3:1, and that this female preponderance is attributed to gender-specific risk factors such as pregnancy and puerperium. 18 Despite this female predilection, our results showed that in the normal setting, men have a significantly higher baseline of cerebral venous sinus attenuation on NCCT than women (Table 1). ...
Background and purpose:
Noncontrasted computed tomography (NCCT) is used as the initial neuroimaging test of choice for patients who present with new-onset neurological symptoms. An apparently hyperattenuated venous sinus may lead to the suspicion of cerebral venous sinus thrombosis (CVST). Improved understanding of all factors that can affect attenuation of dural sinuses can guide triage of patients to or from further investigations of suspected CVST. The purpose of this retrospective study was to assess the effect of different factors including hematocrit (HCT), hemoglobin (Hb), age, BUN/Cr ratio (blood urea nitrogen-to-creatinine ratio), and gender on the attenuation of dural sinuses on brain NCCT.
Methods:
A total of 1293 patients with neurological symptoms who presented to the emergency department were included in this study. For each patient, clinical assessment, laboratory investigations, and brain NCCT were reviewed. For each brain NCCT, the average attenuation of superior sagittal sinus and both right and left sigmoid sinuses was measured.
Results:
Positive significant correlations were found between average attenuation of dural sinuses on one hand and each of age, Hb, and HCT on the other hand. No significant correlation was found between average attenuation and BUN/Cr ratio. Gender discrepancy was also significant as higher attenuation was found in men.
Conclusion:
Age, gender, and Hb levels are the main factors that should be taken into account upon the assessment of dural sinuses on brain NCCT. The highest normal attenuation is predicted in an elderly polycythemic man and the lowest is predicted in a young anemic woman.
... In some patients, clinical presentations are nonspecific. Therefore, there is not a defined clinical syndrome [10]. ...
Abstract Cerebral venous sinus thrombosis is an uncommon condition and can be precipitated by various conditions. Here we report a case of cerebral venous sinus thrombosis in a young man in whom the serum homocysteine level was found to be elevated. A 36-year-old man was admitted with sudden severe headache, vomiting and visual obscuration. Investigations revealed widespread cerebral venous sinus thrombosis. All investigations to find out the etiology came out normal except the serum homocysteine level which was found to be elevated. Further studies are required to evaluate the importance of estimation of serum homocysteine level in cases of CVST, especially where a clear risk factor has not been identified and where other investigations failed to find out any known etiological factor.
