Cerebral vein and dural sinus thrombosis in Portugal: 1980-1998

There is insufficient information on the prognosis and safety of anticoagul ation in acute cerebral vein and dural sinus thrombosis (CVDST). To describ e the clinical aspects and medical management of CVDST in Portuguese hospit als, to evaluate the safety of anticoagulation in this setting, and to iden tify subgroups of CVDST patients with different prognoses, we registered sy mptomatic CVDST patients admitted to Portuguese hospitals since 1980, Cases were collected from file review up to 6/95 and from consecutively admitted patients from 6/95 to 6/98, One hundred and forty-two patients were includ ed from 20 centers (51 retrospectively and 91 prospectively). One hundred a nd twelve patients (79%) were anticoagulated. There were only 6 new intracr anial hemorrhages (4 in anticoagulated patients) and 2 systemic hemorrhages , Nine (6%) patients died. At discharge, 96 [68%), had recovered completely and only 6 (4%) were dependent (Rankin greater than or equal to 3). Signif icant multivariate predictors of death/dependency were central nervous syst em infection as a predisposing cause (odds ratio, OR = 15.4; 95% confidence interval Cl = 111-1.1), encephalopathy on admission (OR = 5.2; 95% Cl = 18 .7-1.5) and hemorrhage on admission CT/MR (OR = 3.6; 95% Cl = 12.9-1). Sign ificant predictors of complete recovery were no encephalopathy on admission (OR = 5; 95% Cl = 12.5-2.1), age <45 years (OR = 3.8; 95% Cl = 9.2-1.6) an d anticoagulation (OR = 3.8; 95% Cl = 9.6-1.5). It is possible to identify CVDST patients with potential bad or good prognosis in the acute phase. Ant icoagulation was safe and a predictor of complete recovery in acute CVDST, Copyright <(c)> 2001 S. KargerAG, Basel.