Cerebral venous thrombosis in women from Indian subcontinent

Background and Purpose: Cerebral venous thrombosis (CVT) is one of the common causes of stroke in women. The causes in pregnancy include acquired hypercoagulable state and are multifactorial in nonpregnant women. This study was conducted to evaluate clinical profile, risk factors, and outcome of cerebral venous sinus thrombosis in pregnant and nonpregnant women. Methods: Women with radiologically proven CVT admitted between 2001 and 2014 were included in the study. Data regarding demographic features, clinical profile, laboratory parameters, and follow-up at 1, 3, and 6 months were analyzed both prospectively and retrospectively. Results: During the study period, 150 women with CVT were admitted. Among them, 69 were related to pregnancy (antepartum 3 and postpartum 66). Eighty-one women had CVT unrelated to pregnancy. Patients with pregnancy-related CVT were younger (24.55 ± 4.16 years) with shorter duration of symptoms (4.97 ± 5.73 days), compared to nonpregnant women who were older (37.14 ± 12.85 years) with longer symptom duration (11.51 ± 18.96 days). There was no difference in the clinical presentation except for higher incidence of altered sensorium in pregnancy group and higher incidence of partial seizures in nonpregnant group. Pattern of venous sinus involvement and infarction was similar in the two groups. Nonpregnant patients had multiple risk factors, severe anemia being the most common followed by the use of oral contraceptives, hyperhomocysteinemia, protein C/S deficiency, malignancy, and psoriasis. Mortality and long-term outcome were similar. Conclusions: Our study reveals a higher proportion of nonpregnant women with CVT. Clinicoradiological profile and outcome did not differ between pregnant and nonpregnant states.