Work

Clinical characterization and predictors of poor outcome in patients with cerebral venous thrombosis: Experience from a Latin American cohort

Year: 2025

Type: article

Abstract: BACKGROUND: Cerebral venous thrombosis (CVT) is a rare but potentially reversible cause of stroke that disproportionately affects women and younger adults. Data from Latin America are scarce, and regional risk patterns remain underexplored. OBJECTIVE: To describe the clinical, imaging, and laboratory features of CVT in a Latin American cohort and identify predictors of poor in-hospital outcomes. METHODS: We conducted a retrospective cohort study of 147 adult patients with neuroimaging-confirmed CVT at a tertiary academic hospital in Bogotá, Colombia (2017-2024). Patients were stratified by sex and age (<50 vs. ≥50 years). The primary outcome was a composite of in-hospital death, severe complications, or modified Rankin Scale ≥3 at discharge. Multivariable logistic regression was used to identify independent predictors. RESULTS: Median age was 40 years, and 64.6 % were female. Common risk factors included oral contraceptive use (19.0 %), smoking (15.0 %), and active malignancy (12.2 %). Headache was the predominant symptom (55.1 %), with a migraine-like phenotype in most cases. Venous infarction occurred in 42.2 %, and 17.8 % had poor outcomes. In multivariable analysis, encephalopathy, aphasia, hemiparesis, venous infarction, subarachnoid hemorrhage, anemia, and a moderate CVT Risk Score were independently associated with poor outcomes. The model showed good calibration (Hosmer-Lemeshow p = 0.82). CONCLUSIONS: This study provides regionally relevant data on CVT and identifies clinical and imaging predictors of poor outcomes. Anemia emerged as a novel prognostic factor. These findings support context-adapted strategies for risk stratification and clinical management in low- and middle-income settings.

Source: Journal of Stroke and Cerebrovascular Diseases

DOI: 10.1016/j.jstrokecerebrovasdis.2025.108471