| Objective:To analyze the clinical characteristics and prognosis of patients with intracranial venous sinus thrombosis(C VST),especially to explore the differences of clinical characteristics among different gender subgroups and the related factors affecting short-term prognosis,so as to provide reference for clinicians to diagnose and treat CVST and optimize clinical decision-making.Methods:Through the First Hospital of Shanxi Medical University electronic medical record system and data center of informatization,collected and recorded on January 1,2018 to February 18,2022 in our hospital and doctor first diagnosed CVST the clinical data of115 patients,were retrospectively analyzed the clinical presentation,risk factors,laboratory and imaging findings,treatment and prognosis,etc.,The clinical characteristics were also discussed based on relevant literature.This method was approved by the ethics Committee of the First Hospital of Shanxi Medical University.Results:A total of 115 patients were included in this study,and the ratio of male to female patients was 1:1.25.The median age was 36 years old,and the mean BMI was 24.59.Except for pregnant women,50% of patients had BMI ≥ 24,and there was no statistical significance between male and female(P = 0.083).The common symptoms of CVST were headache(62.61%),epilepsy(27.83%),limb weakness(21.74%),nausea and vomiting(20.87%),and ocular symptoms(20.87%).More women than men had seizures(men vs.women,21.57% vs.32.81%,P = 0.08)and NIHSS score ≥6 at admission(men vs.women,11.76% vs.32.81%,P < 0.001).Laboratory tests lacked specificity,and42.61% of patients with d-dimer elevation(i.e.≥0.5ug/m L)showed no significant difference between gender subgroups(P = 0.50).29.67% of patients had intracranial pressure over 330 mm H2 O,and there were more females in the range of 180-330 mm H2O(P = 0.016).Imaging examination is the main basis for diagnosis.In this study,more male patients were involved in multiple venous sinusas(male vs female,86.00%vs74.19%,P = 0.034),and more female patients had brain parenchymal injury(male vs female,34.00% VS56.45%,P = 0.02)and multiple lobes(male vs female,12.00%vs45.16%,P < 0.001).83.48% of the patients had one or more clear or possible risk factors for C VST.In this study,the top three risk factors were obesity(56.25%),hematological diseases(55.21%)and Hyper homocysteine(46.88%),among which Hyperhomocysteine was more common in male patients(71.79%).Blood system diseases were more common in female patients(61.40%),mainly thrombocytopenia(43.48%)and anemia(42.10%).No statistical difference was found in other possible risk factors between different gender subgroups.After standardized anticoagulant therapy,86.96% of the patients had a good prognosis(m RS score ≤ 2),and multifactor regression analysis was performed to confirm the disorder of consciousness(OR = 5.21,95%CI,1.93-14.00,P = 0.001),cerebral hemorrhage(OR = 3.15,95%CI,1.21-8.50,P = 0.025)were independent predictors of poor short-term prognosis in CVST patients.Conclusion:CVST tends to occur in young people,with more female patients than male patients.The clinical symptoms are non-specific,headache is the most common,and female patients are more likely to have early seizures,more severe admission,and more brain parenchymal damage.Most patients can identify at least one risk factor that obesity may increase CVST risk,especially in women who use oral contraceptives.The main risk factors for CVST in Taiyuan and its surrounding areas may be thrombocytopenia and anemia in females and Hyperhomocysteine in males.After active anticoagulant therapy,most patients had a good short-term prognosis,while disturbance of consciousness and intracerebral hemorrhage were independent predictors of poor short-term prognosis. |
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