Screening for thrombophilic risk factors among 25 German patients with cerebral venous thrombosis

Objectives - In this study the frequency of inherited thrombophilic risk fa ctors in a population of German CVT patients and their influence on clinica l outcome were evaluated. Material and methods - Twenty-five patients (age 37.1 +/- 16.3 years) with CVT were screened for inherited coagulation disor ders. All participants received a full clinical follow-up (mean follow-up p eriod 4.8 +/- 6.4 years). Results - Inherited thrombophilic risk factors we re identified in 9 (36%) of the 25 patients studied. Four were found positi ve for the heterozygous factor V Leiden mutation, 2 were heterozygous carri ers of the prothrombin-G20210A-polymorphism. APC resistance proved to be a reliable screening method for factor V Leiden mutation, whereas genetic eva luation for protein S and C deficiencies failed to demonstrate any mutation s despite the identification of 1 patient with a protein C and protein S de ficiency each. One patient suffered from a familial plasminogen deficiency. These 9 patients had a less favorable outcome (P < 0.05). Conclusion - Our results demonstrate that screening for inherited thrombophilia should be a n integral part in the diagnostic work up of CVT patients. Patients with in herited coagulopathies tended to have a less favorable outcome, corroborati ng recommendations for a longer period of oral anticoagulation.