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J Neurol. 2016 Mar;263(3):477-84. doi: 10.1007/s00415-015-7996-9. Epub 2016 Jan 2.

Long-term outcome after cerebral venous thrombosis: analysis of functional and vocational outcome, residual symptoms, and adverse events in 161 patients.

Author information

1
Department of Neurology, Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland. sini.hiltunen@helsinki.fi.
2
National School of Clinical Investigation, Helsinki, Finland. sini.hiltunen@helsinki.fi.
3
Department of Neurology, Helsinki University Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.
4
Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
5
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.

Abstract

Cerebral venous thrombosis (CVT) affects mainly working-aged individuals. Functional recovery after CVT is generally considered good with about 3/4 of patients achieving short-term independence. However, vascular events, long-term functional outcome, and employment after CVT remain poorly investigated. We identified consecutive adult CVT patients treated at the Helsinki University Hospital (1987-2013) and invited them to a follow-up visit. Each clinical examination was combined with interview. We also recorded recurrent venous thromboembolism (VTE) and hemorrhagic events during follow-up and antithrombotic medication use. A modified Rankin Scale (mRS) served to assess functional outcome. Logistic regression served to identify independent factors associated with unemployment and functional recovery. Of the 195 patients identified, 21 died, 9 declined to participate, and 4 were excluded from the study. Thus, 161 patients (106 women) underwent an examination after a median of 39 months (interquartile range 14-95). VTE (one of which was CVT) occurred in 9 (6%) patients, and severe hemorrhagic events in 10 (6%). Functional outcome was good, with 84% scoring 0-1 on the mRS; 42% reported residual symptoms. Altogether, 91 (57%) patients were employed. After adjusting for age and sex, a National Institutes of Health Stroke Scale score>2 at admission and low education level, associated with both unfavorable functional outcome and unemployment. Long-term functional outcome after CVT may appear good if measured with mRS, but patients often have residual symptoms and are frequently unable to return to their previous work.

KEYWORDS:

Anticoagulation; Cerebral venous thrombosis; Follow-up; Long-term outcome; Sinus thrombosis; Vocational status

PMID:
26725090
DOI:
10.1007/s00415-015-7996-9
[Indexed for MEDLINE]
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