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Sex Differences in Adult Cerebral Venous Sinus Thrombosis: A 10-Year Experience

Published online by Cambridge University Press:  02 December 2014

Claire Hinnell
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
Janel Nadeau
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
Vanessa Lam
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
Michael D. Hill
Affiliation:
Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada Department of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Department of Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Shelagh B. Coutts*
Affiliation:
Department of Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
*
Foothills Medical Centre, 1403-29th Street NW, Calgary, Alberta, T2N 2T9, Canada.
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Abstract

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Background:

Sex differences in the risk factors, presentation and outcome of cerebral venous sinus thrombosis (CVST) are poorly defined, despite a discrepant prevalence between males and females. The proportion of patients on hormonal therapy who develop CVST varies widely. We describe the clinical features, risk factors and outcome by sex and by hormone-related risk factors among a large cohort of patients.

Methods:

We reviewed records of 108 consecutive patients with CVST at a tertiary hospital in Calgary between 1999 and 2009. Descriptive statistics were used for between group comparisons (men, women with hormone-related risk factors and women without hormone-related risk factors).

Results:

Females made up 62% of patients, half of whom were on systemic hormonal therapy. Men and women without hormonal risk factors were older at onset. Oral contraceptive use was the major risk factor in women (45%) while concurrent mastoiditis was the most common predisposing factor in men (27%). Complications were frequent and overall mortality was 6%. Persisting deficits at discharge were more common in men (54% vs. 35% and 32%, p = 0.036). There was a trend for women with hormone-related risk factors to have less residual focal neurologic deficit than the other groups (5% vs. 15% and 17%, p=0.051).

Conclusions:

There are differences between sexes in the presentation, risk factors and outcome of patients with CVST.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2012

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