Clinical Profiles, Risk Factors, and Radiological Findings of Cerebral Venous and Dural Sinus Thrombosis: A 10-Year Retrospective Review

Clinical Profiles, Risk Factors, and Radiological Findings of Cerebral Venous and Dural Sinus Thrombosis: A 10-Year Retrospective Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Profiles, Risk Factors, and Radiological Findings of Cerebral Venous and Dural Sinus Thrombosis: A 10-Year Retrospective Review Bereket Sinshaw, Koricho Simie, Guta Zenebe, Mehila Zebenigus, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7643666/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Cerebral venous thrombosis (CVT) accounts for 0.5% of all strokes, predominantly affecting young women due to pregnancy, puerperium, and oral contraceptive use. Clinical presentations include intracranial hypertension, focal deficits, seizures, and encephalopathy. Data on CVT in Ethiopia remain scarce. This study aimed to describe the clinical profiles, risk factors, and radiological findings of CVT at a tertiary center in Addis Ababa, Ethiopia. Methods and Analysis : We conducted a retrospective cross-sectional review of 105 cases of cerebral venous and dural sinus thrombosis at Yehuleshet Specialized Clinic, Ethiopia, between January 1, 2010, and December 30, 2019. Demographic, clinical, laboratory, and imaging data were extracted and analyzed using SPSS version 27. Results The mean age of the study participants was 34.8 + 14.3 years. Females accounted for the majority (61.9%) with a female-to-male ratio of 1:0.6. Infections (21%) were the most common risk factors identified, while pregnancy and puerperium were the most common gender-specific risk factors. Headache was the most common complaint, reported in 90.5%, followed by visual disturbances in 41.9% and seizures in 25.7% of patients. All patients had brain magnetic resonance imaging and magnetic resonance venography studies, and considering both single and multiple vessel thrombosis, the left transverse sinus (42.9%) and left sigmoid sinus (39%) were the most frequently involved. The majority of patients (72.4%) were treated with heparin, of whom 72% received unfractionated heparin, followed by warfarin. Conclusions In this retrospective review, CVT predominantly affected young women, with infections, pregnancy, and puerperium as main risk factors. Headache was the most common symptom, the left transverse and sigmoid sinuses were most frequently involved, and heparin was the primary treatment. These findings highlight the importance of timely diagnosis and management of CVT. Cerebral venous thrombosis dural sinus thrombosis clinical profiles Ethiopia radiological findings risk factors Figures Figure 1 Figure 2 Introduction Cerebral vein thrombosis (CVT), defined as thrombosis of the dural sinuses and/or cerebral veins, is an uncommon but important cause of stroke, accounting for approximately 0.5% of all stroke cases [ 1 ]. It has an estimated annual incidence of 3–4 cases per million in the general population and up to 7 cases per million among younger individuals [ 1 , 2 ]. According to the largest cohort study, the International Study on Cerebral Venous and Dural Sinuses Thrombosis (ISCVT), 487 (78%) of 624 patients were younger than 50 years, indicating that CVT predominantly affects young adults [ 3 ]. Women of reproductive age are disproportionately affected, which is largely attributed to hormonal and pregnancy-related risk factors, particularly pregnancy, the puerperium, and the use of oral contraceptives [ 2 ]. The major risk factors for CVT in adults can be broadly categorized as transient or permanent. The most common risk factors include prothrombotic conditions, use of oral contraceptives, vasculitis and other systemic inflammatory disorders, pregnancy and the puerperium, as well as several local causes such as brain tumors, arteriovenous malformations, head trauma, and infections involving the central nervous system, ear, paranasal sinuses, mouth, face, or neck [ 1 , 3 ]. The clinical manifestations of CVT are diverse, as they depend on the location and extent of venous obstruction. The onset of symptoms may be acute, subacute, or chronic. Four principal clinical patterns are recognized: isolated intracranial hypertension, focal neurological deficits, seizures, and encephalopathy. These patterns may appear alone or in combination, reflecting the heterogeneity of the underlying venous involvement [ 4 ]. Structural neuroimaging, including head computed tomography (CT) and routine brain magnetic resonance imaging (MRI), plays an essential role in evaluating parenchymal lesions secondary to venous thrombosis and may demonstrate direct evidence of intraluminal thrombus [ 5 ]. Magnetic resonance venography (MRV) is regarded as the gold standard for the diagnosis and follow-up of CVT. However, MRI can be superior in some cases, as it allows direct visualization of the thrombus rather than the absence of signal observed on MRV. Diffusion-weighted imaging (DWI) is highly sensitive for detecting acute ischemic changes, and contrast angiography should be strongly considered when isolated cortical vein thrombosis is suspected [ 5 , 6 ]. Management of CVT involves addressing the underlying cause when identifiable, controlling seizures and intracranial hypertension, initiating anticoagulation therapy, and, in severe cases, performing decompressive surgery to prevent fatal brain herniation [ 7 ]. Although the epidemiology and clinical features of CVT are well established in high-income countries, studies from low- and middle-income regions are scarce. In Africa, the risk factors, diagnosis, management, prognosis, and outcomes of CVT remain largely unexplored. To date, no research has focused on CVT in Ethiopia. This study therefore aims to characterize the epidemiology, clinical patterns, risk factors, imaging findings, and outcomes of CVT patients at Yehuleshet Specialized Clinic in Addis Ababa, Ethiopia. Methods Study setting and period This study was conducted at Yehuleshet Specialized Clinic, a private health facility established 20 years back by Dr. Guta Zenebe, a pioneer internist and neurologist in Ethiopia, with a vision of creating a center of excellence in neurology clinical care and neuroscience research in Ethiopia. It is the nation’s only neurology specialty center located in its capital city, Addis Ababa. The center provides patient care in both inpatient and outpatient departments. The study was conducted between January 1, 2010, and December, 2019. Study design and sampling This was a retrospective single-centre chart review of patients with cerebral venous and dural sinus thrombosis done at Yehuleshet Specialized Clinic, Ethiopia. The study included all cerebral venous and dural sinus thrombosis patients from January 1, 2010, to December 30, 2019. Study participants and material All patients with image-confirmed cerebral venous and dural sinus thrombosis at Yehuleshet Specialized Clinic from the period January 2010 to July 2020 were included in the study. A total of 105 charts were reviewed. Procedure for data collection A retrospective review of all CT and MRI scans performed over the past ten years was conducted to identify eligible CVT cases, and the corresponding patient files were retrieved for analysis. Imaging reports were obtained from the radiology database, while demographic, clinical, and laboratory data were extracted from patient charts and electronic records. Data collection was guided by a structured questionnaire, adapted from previously published CVT studies [ 1 , 3 , 8 ], and is provided as Supplementary File 1. Study variables The outcome variables were clinical profiles and radiological findings of cerebral venous and dural sinus thrombosis. Independent variables were classified as sociodemographic (age, sex, occupation) and clinical (infection, pregnancy and puerperium, mechanical precipitants, drugs, malignancy, hematologic condition, inflammatory diseases, and central nervous system disorders). Data quality assurance The adequacy of the questionnaire was tested using a pilot study on ten selected patients with different data collectors, and the feedback from the pilot study was used to amend the questionnaire and adjust it accordingly. The completeness of both patients’ charts and questionnaires was checked. Statistical analysis Data was analyzed using IBM SPSS Statistics Version 27. Descriptive data was summarized using standard univariate techniques and reported as proportions with odds ratios (OR) with 95% confidence intervals (CI), means with standard deviation (SD), or medians with interquartile range (IQR) depending on the variable type and probability distribution. Categorical data was analyzed using the chi-square test or Fisher’s exact test. All tests were two-sided, and a p-valve less than 0.05 was used to define statistical significance. Results Baseline characteristics of study participants Between January 2010 and July 2020, 105 patients with confirmed cerebral venous sinus thrombosis visited the study site. Females accounted for 61.9% (n = 65) with a female-to-male ratio of 1:0.6. The proportion of female patients in the study was statistically significantly higher than that of male patients (p = 0.015). The mean age (SD) of the study participants was 34.8 ± 14.3 years. The majority of participants (81%) were between the ages of 20 and 49 (Fig. 1 ). Of the 105 patients, 90.5% (n = 95) were urban residents. Risk factors of CVT in study participants Infections (21%) were the most common risk factors identified in the study participants, while pregnancy and puerperium were the most common gender-specific risk factors (27.7%). Other risk factors were the use of oral contraceptives (10.5%), head trauma (5.7%), hematologic disorders (5.7%), thyroid disorder (4.8%), and brain tumors (0.95%). Of the infections, otitis, mastoiditis, and sinusitis occurred in nine, meningitis in four, and systemic infection in three patients. Of the common gender-specific risk factors, the postpartum period was related in 16 patients, and oral contraceptive pill use was associated in 10 patients. Among the hematologic disorders, anemia was seen in four patients, and polycythemia and protein C deficiency in one patient each (Table 1 ). Comorbid conditions that were found in our patients were hypertension (13.3%), dyslipidemia (n = 4.76%), diabetes mellitus (4.76%), chronic kidney disease (2.85%), human immunodeficiency virus-1 infection (1.9%), polycystic ovary syndrome (0.95%), and tuberculous pericarditis (n = 1). Table 1 Risk Factors identified in included patients. Risk factors Frequency (%) Infection 22 (20.95%) Otitis, mastoiditis, sinusitis 9 (8.57%) Meningitis 4 (3.8%) Systemic infection 3 (2.85%) Pregnancy and puerperium 18 (27.7%) Pregnancy 2 (3%) Puerperium 16 (24.6%) Drug use 11 (10.47%) Oral contraceptive pills 10 (16.9%) Glucocorticoid 1 (0.95%) Hematologic disorders 6 (5.7%) Anemia 4 (3.8%) Polycythemia vera 1 (0.95%) Protein C deficiency 1 (0.95%) Head trauma 6 (5.7%) Thyroid disorder 5 (4.76%) Malignancy 1 (0.95%) Central nervous system 1 (0.95%) Outside central nervous system - Clinical Characteristics Headache was the most common clinical manifestation in 90.5% (n = 95) of patients. It was the only complaint in 31 (29.5%) patients. Visual disturbances, including blurring of vision and diplopia, were reported in 41.9% of patients. 25.7% (n = 27) of the patients had seizures, 14.3% had decreased levels of consciousness, 9.5% had a decline in cognition, and 21.9% (n = 23) had extremity weakness. Five (4.8%) of the patients had aphasia; unilateral hearing loss occurred in three cases (2.9%), while four (3.8%) cases had tinnitus. Vomiting was present in 23 patients (21.9%), paresthesia in 12 patients (11.4%), neck pain in 23 patients (21.9%), and four (3.8%) patients had ear discharge, while five (5.8%) patients had pain in the ear and mastoid region (Fig. 2 ). Neuroimaging pattern of CVT in study participants Nine patients had a brain CT scan done with a repeated brain MRI later. All patients had brain MRI and MRV studies. MRV cerebral venous sinus anatomic distribution The most commonly affected sites with thrombosis were the left transverse sinus, left sigmoid sinus, right sigmoid sinus, right transverse sinus, and superior sagittal sinus in 45 (42.9%), 41 (39%), 30 (28.6%), 29 (27.6%), and 25 (23.8%), respectively. The inferior sagittal sinus and internal cerebral vein of Galen were involved in one patient each. Treatment and outcome of CVT Most of our patients (72.4%) received heparin therapy: unfractionated heparin (UFH) in 52.4% or low-molecular-weight heparin in 20% during early anticoagulation, which was followed by warfarin for long-term anticoagulation. The duration of anticoagulant therapy was individualized according to patient prothrombotic risks. A small number of patients received additional antiplatelet medication, mainly aspirin. Twenty-one (20%) were on antiepileptic medication. The treatment of elevated intracranial pressure was by acetazolamide in 21 patients, mannitol in four patients in combination with therapeutic lumbar puncture. Optic nerve sheath fenestration was done in one patient due to deterioration in vision despite acetazolamide and therapeutic lumbar puncture. Discussion Cerebral venous and sinus thrombosis can occur at any age but predominantly affects young adults, particularly women of reproductive age, due to risk factors such as pregnancy, the puerperium, and oral contraceptive use. In the ISCVT cohort, 75% of patients were women [ 3 ]. In our retrospective review of 105 patients seen over a 10-year period at our center, 61.9% were women, with a female-to-male ratio of 1:0.6. The overall mean age was 34.8 ± 14.3 years. CVT is typically multifactorial, and identifying one risk factor or cause should not prevent clinicians from investigating additional contributing factors, particularly congenital thrombophilia. In the ISCVT cohort, 44% of patients had more than one predisposing factor, with congenital or genetic thrombophilia present in 22% of cases [ 3 ]. In our study, the most common etiological factors were infections, consistent with findings from other African countries [ 8 – 10 ]. This reflects a greater contribution of infectious causes in developing countries, while pregnancy, the puerperium, and oral contraceptive use remain important gender-specific risk factors in women. In our study, pregnancy and the puerperium accounted for 18 patients (27.7%), while oral contraceptive use was identified in 11 patients (16.9%). Although these risk factors are well established, the prevalence of oral contraceptive use in our cohort was lower than reported in other studies [ 11 , 12 ]. Protein C deficiency was detected in only one patient, reflecting the limited investigation of genetic thrombophilia at our center due to the lack of available diagnostic facilities. In this study, the most common presenting symptom of CVT was headache, consistent with reports from other settings [ 1 , 3 , 13 – 15 ]. Visual disturbances were the second most frequent complaint, differing from many studies where seizures are reported as the second most common presentation (seizures ranked third in our cohort) [ 5 , 10 , 13 , 14 ]. A meta-analysis of South American studies similarly identified visual deficits as the second most frequent symptom [ 12 ], Atalu et al. reported similar frequencies for seizures and visual disturbances [ 11 ]. Seizures occurred in 25.7% of patients, comparable to other reports[ 8 , 14 , 16 ], while focal neurological deficits were observed in 21.9% of cases. The current gold standard for diagnosing CVT is the combined use of MRI and MRV to visualize thrombosed vessels [ 17 ]. In our study, all patients had brain MRI with MRV, and involvement of the left-sided transverse sinus and sigmoid sinus were the most common findings. Findings on the most commonly affected single vessel are inconsistent in the literature, with some studies reporting the transverse sinus [ 5 , 12 ] and others the superior sagittal sinus [ 8 , 9 , 11 , 14 ] as the predominant site of thrombosis. Parenteral anticoagulation, preferably with low molecular weight heparin rather than unfractionated heparin, is recommended by the AHA/ASA and the European Stroke Organization during the acute phase of CVT, followed by oral warfarin therapy [ 7 , 18 ]. In the present study, heparin therapy was administered to 72.4% of patients, with the majority receiving unfractionated heparin. The higher use of unfractionated heparin compared to low molecular weight heparin likely reflects its greater availability and lower cost. Our study has some limitations. The study was done at a single center and included patients from a privately owned health facility, limiting generalizability of the findings. The retrospective nature of the study has limited detailed characterization of patient profiles. Lack of setup to perform testing for inherited thrombophilia has compromised knowledge of the possible underlying causes of CVT. Conclusions In this retrospective review, CVT predominantly affected young women, with infections, pregnancy, and puerperium as main risk factors. Headache was the most common symptom, the left transverse and sigmoid sinuses were most frequently involved, and heparin was the primary treatment. These findings highlight the importance of timely diagnosis and management of CVT. Abbreviations CNS Central nervous system CSOM Chronic suppurative otitis media CT Computer tomography CVT Cerebral venous thrombosis CVST Cerebral venous and dural sinus thrombosis DWI Diffusion weighted imaging ISCVT International Study on Cerebral Venous and Dural Sinus Thrombosis MRI Magnetic resonance imaging MRN Medical record number MRS Modified Rankin Scale MRV Magnetic resonance venography Declarations Competing interests The authors would like to mention that there are no competing interests. Ethical approval and consent to participate Ethical approval was obtained from the Addis Ababa Regional Health Bureau Ethical Review Committee. The requirement for informed consent was waived, as only anonymized retrospective data were used. The study was conducted in accordance with the principles of the Declaration of Helsinki. Funding No funding was received. Author Contribution BS: conceptualization, design, acquisition of data, analysis, and interpretation of data; GZ: conceptualization, design, acquisition of data, and interpretation of data; MZ: conceptualization, design, acquisition of data, and interpretation of data; BG: design, acquisition of data, analysis, and interpretation of data; HT: design, acquisition of data, analysis, and interpretation of data; TG: design, acquisition of data, analysis, and interpretation of data; KS and GS: data curation and writing–review and editing. All authors read and approved the final manuscript. Acknowledgement The authors would like to express their deep and sincere gratitude to the study participants. Our gratitude extends to data collectors working at Yehuleshet Specialized Clinic. Their special thanks go to Prof. Guta Zenebe for providing the platform to conduct this study. Data Availability De-identified participant data that support the findings of this study are available from the corresponding author upon reasonable request. To maintain confidentiality, the data are not publicly available. References Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6(2):162–70. Thrombosis of the cerebral. veins and sinuses - PubMed [Internet]. [cited 2025 Sept 5]. Available from: https://pubmed.ncbi.nlm.nih.gov/15858188/ Canhão P, Ferro JM, Lindgren AG, Bousser MG, Stam J, Barinagarrementeria F. Causes and Predictors of Death in Cerebral Venous Thrombosis. Stroke. 2005;36(8):1720–5. Cerebral Venous Thrombosis. | Circulation [Internet]. [cited 2025 Sept 5]. Available from: https://www.ahajournals.org/doi/ 10.1161/circulationaha.111.067835 Zhou LX, Yao M, Cui LY, Li ML, Zhu YC, Ni J, et al. The Structural Imaging Characteristics and Its Clinical Relevance in Patients with Cerebral Venous Thrombosis-A Retrospective Analysis from One Single Center in China. Front Neurol. 2017;8:648. Wasay M, Azeemuddin M. Neuroimaging of cerebral venous thrombosis. J Neuroimaging. 2005;15(2):118–28. Ferro JM, Bousser MG, Canhão P, Coutinho JM, Crassard I, Dentali F, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology. Eur J Neurol. 2017;24(10):1203–13. Sidhom Y, Mansour M, Messelmani M, Derbali H, Fekih-Mrissa N, Zaouali J, et al. Cerebral venous thrombosis: clinical features, risk factors, and long-term outcome in a Tunisian cohort. J Stroke Cerebrovasc Dis. 2014 July;23(6):1291–5. Souirti Z, Messouak O, Belahsen F. Cerebral venous thrombosis in Morocco: retrospective study of 30 cases. The Pan African Medical Journal [Internet]. 2014 Apr 14 [cited 2025 Sept 5];17(281). Available from: https://www.panafrican-med-journal.com//content/article/17/281/full Onyambu CK, Amayo E, Kitonyi JM, CLINICAL FEATURES AND PATTERNS OF IMAGING, IN CEREBRAL VENOUS SINUS THROMBOSIS AT KENYATTA NATIONAL HOSPITAL. East Afr Med J. 2013 Sept;90(9):297–304. Risk Factors and Clinical Manifestations of Cerebral Venous Thrombosis (CVT). in Patients Admitted to Ardabil City Hospitals during 2012–2017 [Internet]. [cited 2025 Sept 5]. Available from: https://www.jscimedcentral.com/jounal-article-info/Journal-of-Neurological-Disorders-and-Stroke/Risk-Factors-and-Clinical--Manifestations-of-Cerebral--Venous-Thrombosis-%28CVT%29-in--Patients-Admitted-to-Ardabil--City-Hospitals-during -2012--2017-6855. Maali L, Khan S, Qeadan F, Ismail M, Ramaswamy D, Hedna VS. Cerebral venous thrombosis: continental disparities. Neurol Sci. 2017;38(11):1963–8. Ramrakhiani N, Sharma DK, Dubey R, Gupta P, Sharma A, Sharma KK. Clinical Profile, Risk Factors and Outcomes in Patients with Cerebral Venous Sinus Thrombosis: A Study from Western India. J Assoc Physicians India. 2019 Sept;67(9):49–53. Patil VC, Choraria K, Desai N, Agrawal S. Clinical profile and outcome of cerebral venous sinus thrombosis at tertiary care center. J Neurosci Rural Pract. 2014 July;5(3):218–24. Cerebral Venous Thrombosis. | Stroke [Internet]. [cited 2025 Sept 5]. Available from: https://www.ahajournals.org/doi/ 10.1161/strokeaha.107.512814 Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352(17):1791–8. Diagnosis and Management of Cerebral Venous Thrombosis. A Scientific Statement From the American Heart Association | Stroke [Internet]. [cited 2025 Sept 5]. Available from: https://www.ahajournals.org/doi/ 10.1161/STR.0000000000000456 Diagnosis and Management of Cerebral Venous. Thrombosis | Stroke [Internet]. [cited 2025 Sept 5]. Available from: https://www.ahajournals.org/doi/ 10.1161/str.0b013e31820a8364 Additional Declarations No competing interests reported. Supplementary Files SupplementaryFile1.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7643666","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":546402790,"identity":"eb4013e3-d126-494e-aff5-f6a6d3e50f2c","order_by":0,"name":"Bereket Sinshaw","email":"","orcid":"","institution":"Yehuleshet Specialty Clinic","correspondingAuthor":false,"prefix":"","firstName":"Bereket","middleName":"","lastName":"Sinshaw","suffix":""},{"id":546402791,"identity":"3f6ea3f5-9075-49bf-851b-5185544dbc3a","order_by":1,"name":"Koricho Simie","email":"","orcid":"","institution":"Arsi University","correspondingAuthor":false,"prefix":"","firstName":"Koricho","middleName":"","lastName":"Simie","suffix":""},{"id":546402793,"identity":"4e1e9ad9-643b-4409-af7c-f14bd5d37283","order_by":2,"name":"Guta Zenebe","email":"","orcid":"","institution":"Yehuleshet Specialty Clinic","correspondingAuthor":false,"prefix":"","firstName":"Guta","middleName":"","lastName":"Zenebe","suffix":""},{"id":546402796,"identity":"620cb9c9-c8a0-4ede-812e-be0110013614","order_by":3,"name":"Mehila Zebenigus","email":"","orcid":"","institution":"Yehuleshet Specialty Clinic","correspondingAuthor":false,"prefix":"","firstName":"Mehila","middleName":"","lastName":"Zebenigus","suffix":""},{"id":546402799,"identity":"47b85448-3f66-442c-8234-3b3321ef18a1","order_by":4,"name":"Betesaida Guta","email":"","orcid":"","institution":"Yehuleshet Specialty Clinic","correspondingAuthor":false,"prefix":"","firstName":"Betesaida","middleName":"","lastName":"Guta","suffix":""},{"id":546402801,"identity":"1de61b03-b9b2-43a2-b92d-c4b617956fa0","order_by":5,"name":"Heera Tesfaye","email":"","orcid":"","institution":"Yehuleshet Specialty Clinic","correspondingAuthor":false,"prefix":"","firstName":"Heera","middleName":"","lastName":"Tesfaye","suffix":""},{"id":546402802,"identity":"b4a8157e-d682-4392-aa1a-490192a71410","order_by":6,"name":"Tsega Guta","email":"","orcid":"","institution":"Yehuleshet Specialty Clinic","correspondingAuthor":false,"prefix":"","firstName":"Tsega","middleName":"","lastName":"Guta","suffix":""},{"id":546402804,"identity":"69e5e93d-3a4b-4b80-9adc-59c34b217bff","order_by":7,"name":"Gashaw Solela","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2klEQVRIiWNgGAWjYHACNjDJx94AJA0sSNDCxnMApEWCFC0SCSCKCC3y7sefPfjZVifHJvn86oYfBRIM/O3dCXi1GJ7JMTfsbTtszCadU3azB+gwiTNnN+DX0pDDJsG77UBim3RO2g0eoBYDiVwCWvqfP5P8u60usU3yTNrNP8RokZdIMJPm3cac2CbBfuw2UbYYSLwxk5b9B/QLTw7bbRkDCR6CfpHvT38m+eZMnRw/+/FnN9/8sZHjb+8lYMsBOJPHAEziVQ62pQHOZH9AUPUoGAWjYBSMTAAAKLFDnkjueBUAAAAASUVORK5CYII=","orcid":"","institution":"Addis Ababa University","correspondingAuthor":true,"prefix":"","firstName":"Gashaw","middleName":"","lastName":"Solela","suffix":""}],"badges":[],"createdAt":"2025-09-17 22:08:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7643666/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7643666/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96330266,"identity":"80803ee2-6f91-4c87-9599-86bfde2d9b63","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":107636,"visible":true,"origin":"","legend":"","description":"","filename":"ClinicalProfilesRiskFactorsandRadiologicalFindingsofCerebralVenousandDuralSinusThrombosis.docx","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/58789fd065781dc3969884af.docx"},{"id":96330270,"identity":"8d5ad3af-7c35-4439-ba77-121517a76281","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":9963,"visible":true,"origin":"","legend":"","description":"","filename":"bf7fb766c547434396b6d869091b7389.json","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/bab69c9a17e71a3a7af50a18.json"},{"id":96367598,"identity":"7380ddf3-09d8-48f4-8196-fd929bfad9d6","added_by":"auto","created_at":"2025-11-20 10:13:28","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":23183,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/b2657b57b8ee3aa106cf861b.docx"},{"id":96365470,"identity":"ec9202d3-ac9a-4574-bc80-fc588568a553","added_by":"auto","created_at":"2025-11-20 10:10:23","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":58920,"visible":true,"origin":"","legend":"","description":"","filename":"bf7fb766c547434396b6d869091b73891enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/5f93b77954510e5555381827.xml"},{"id":96330274,"identity":"51b58b25-1e58-4aa9-9421-99fcfaab5a17","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":3450,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/9ebdd1e7f06857806af83028.png"},{"id":96330271,"identity":"62737341-2e18-4be4-9278-5eccfd77fee8","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"png","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7956,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/459a0146fb77cf8243515b3e.png"},{"id":96330272,"identity":"85918808-93ed-4cc2-b639-3b4e6e5a1ed0","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"xml","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":57122,"visible":true,"origin":"","legend":"","description":"","filename":"bf7fb766c547434396b6d869091b73891structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/f2f9e6723e8c433ef08624a1.xml"},{"id":96330273,"identity":"c07cacdc-8183-4ca9-852c-20783cf60772","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"html","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":64399,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/5b4b0cdd0fb49c0f78bcc7bd.html"},{"id":96365696,"identity":"14892179-ed7d-411c-8d60-31f33da774a7","added_by":"auto","created_at":"2025-11-20 10:10:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":11653,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA bar graph showing the age distribution of CVT patients seen at Yehuleshet Specialty Clinic between January 2010 and July 2020.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/5a6008a0da999fd3b866bb29.png"},{"id":96330269,"identity":"9f67837e-1b1c-433d-8024-3205c600d1ae","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":30596,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA bar graph showing frequency distribution of presenting features of CVT seen at Yehuleshet Specialty Clinic between January 1, 2010, and December 30, 2019.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/df70263a0d4dcad7cd6f7eaf.png"},{"id":105366665,"identity":"ae944369-a158-4947-8d4e-5e0ab2520599","added_by":"auto","created_at":"2026-03-25 08:43:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":853079,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/bf401639-34c4-4b2a-ab39-e89e6b68ec1d.pdf"},{"id":96330264,"identity":"3e6d5816-c2ba-40d2-be3d-8c37cfad35e3","added_by":"auto","created_at":"2025-11-20 00:48:08","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":23183,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7643666/v1/faf97edef4410e63a2b72d91.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Profiles, Risk Factors, and Radiological Findings of Cerebral Venous and Dural Sinus Thrombosis: A 10-Year Retrospective Review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCerebral vein thrombosis (CVT), defined as thrombosis of the dural sinuses and/or cerebral veins, is an uncommon but important cause of stroke, accounting for approximately 0.5% of all stroke cases [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It has an estimated annual incidence of 3\u0026ndash;4 cases per million in the general population and up to 7 cases per million among younger individuals [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. According to the largest cohort study, the International Study on Cerebral Venous and Dural Sinuses Thrombosis (ISCVT), 487 (78%) of 624 patients were younger than 50 years, indicating that CVT predominantly affects young adults [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Women of reproductive age are disproportionately affected, which is largely attributed to hormonal and pregnancy-related risk factors, particularly pregnancy, the puerperium, and the use of oral contraceptives [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe major risk factors for CVT in adults can be broadly categorized as transient or permanent. The most common risk factors include prothrombotic conditions, use of oral contraceptives, vasculitis and other systemic inflammatory disorders, pregnancy and the puerperium, as well as several local causes such as brain tumors, arteriovenous malformations, head trauma, and infections involving the central nervous system, ear, paranasal sinuses, mouth, face, or neck [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe clinical manifestations of CVT are diverse, as they depend on the location and extent of venous obstruction. The onset of symptoms may be acute, subacute, or chronic. Four principal clinical patterns are recognized: isolated intracranial hypertension, focal neurological deficits, seizures, and encephalopathy. These patterns may appear alone or in combination, reflecting the heterogeneity of the underlying venous involvement [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eStructural neuroimaging, including head computed tomography (CT) and routine brain magnetic resonance imaging (MRI), plays an essential role in evaluating parenchymal lesions secondary to venous thrombosis and may demonstrate direct evidence of intraluminal thrombus [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Magnetic resonance venography (MRV) is regarded as the gold standard for the diagnosis and follow-up of CVT. However, MRI can be superior in some cases, as it allows direct visualization of the thrombus rather than the absence of signal observed on MRV. Diffusion-weighted imaging (DWI) is highly sensitive for detecting acute ischemic changes, and contrast angiography should be strongly considered when isolated cortical vein thrombosis is suspected [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eManagement of CVT involves addressing the underlying cause when identifiable, controlling seizures and intracranial hypertension, initiating anticoagulation therapy, and, in severe cases, performing decompressive surgery to prevent fatal brain herniation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAlthough the epidemiology and clinical features of CVT are well established in high-income countries, studies from low- and middle-income regions are scarce. In Africa, the risk factors, diagnosis, management, prognosis, and outcomes of CVT remain largely unexplored. To date, no research has focused on CVT in Ethiopia. This study therefore aims to characterize the epidemiology, clinical patterns, risk factors, imaging findings, and outcomes of CVT patients at Yehuleshet Specialized Clinic in Addis Ababa, Ethiopia.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy setting and period\u003c/h2\u003e\u003cp\u003e This study was conducted at Yehuleshet Specialized Clinic, a private health facility established 20 years back by Dr. Guta Zenebe, a pioneer internist and neurologist in Ethiopia, with a vision of creating a center of excellence in neurology clinical care and neuroscience research in Ethiopia. It is the nation\u0026rsquo;s only neurology specialty center located in its capital city, Addis Ababa. The center provides patient care in both inpatient and outpatient departments. The study was conducted between January 1, 2010, and December, 2019.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy design and sampling\u003c/h3\u003e\n\u003cp\u003eThis was a retrospective single-centre chart review of patients with cerebral venous and dural sinus thrombosis done at Yehuleshet Specialized Clinic, Ethiopia. The study included all cerebral venous and dural sinus thrombosis patients from January 1, 2010, to December 30, 2019.\u003c/p\u003e\n\u003ch3\u003eStudy participants and material\u003c/h3\u003e\n\u003cp\u003eAll patients with image-confirmed cerebral venous and dural sinus thrombosis at Yehuleshet Specialized Clinic from the period January 2010 to July 2020 were included in the study. A total of 105 charts were reviewed.\u003c/p\u003e\n\u003ch3\u003eProcedure for data collection\u003c/h3\u003e\n\u003cp\u003eA retrospective review of all CT and MRI scans performed over the past ten years was conducted to identify eligible CVT cases, and the corresponding patient files were retrieved for analysis. Imaging reports were obtained from the radiology database, while demographic, clinical, and laboratory data were extracted from patient charts and electronic records. Data collection was guided by a structured questionnaire, adapted from previously published CVT studies [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], and is provided as Supplementary File 1.\u003c/p\u003e\n\u003ch3\u003eStudy variables\u003c/h3\u003e\n\u003cp\u003eThe outcome variables were clinical profiles and radiological findings of cerebral venous and dural sinus thrombosis. Independent variables were classified as sociodemographic (age, sex, occupation) and clinical (infection, pregnancy and puerperium, mechanical precipitants, drugs, malignancy, hematologic condition, inflammatory diseases, and central nervous system disorders).\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eData quality assurance\u003c/h2\u003e\u003cp\u003eThe adequacy of the questionnaire was tested using a pilot study on ten selected patients with different data collectors, and the feedback from the pilot study was used to amend the questionnaire and adjust it accordingly. The completeness of both patients\u0026rsquo; charts and questionnaires was checked.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eData was analyzed using IBM SPSS Statistics Version 27. Descriptive data was summarized using standard univariate techniques and reported as proportions with odds ratios (OR) with 95% confidence intervals (CI), means with standard deviation (SD), or medians with interquartile range (IQR) depending on the variable type and probability distribution. Categorical data was analyzed using the chi-square test or Fisher\u0026rsquo;s exact test. All tests were two-sided, and a p-valve less than 0.05 was used to define statistical significance.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eBaseline characteristics of study participants\u003c/h2\u003e\u003cp\u003eBetween January 2010 and July 2020, 105 patients with confirmed cerebral venous sinus thrombosis visited the study site. Females accounted for 61.9% (n\u0026thinsp;=\u0026thinsp;65) with a female-to-male ratio of 1:0.6. The proportion of female patients in the study was statistically significantly higher than that of male patients (p\u0026thinsp;=\u0026thinsp;0.015). The mean age (SD) of the study participants was 34.8\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;14.3 years. The majority of participants (81%) were between the ages of 20 and 49 (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Of the 105 patients, 90.5% (n\u0026thinsp;=\u0026thinsp;95) were urban residents.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eRisk factors of CVT in study participants\u003c/h2\u003e\u003cp\u003eInfections (21%) were the most common risk factors identified in the study participants, while pregnancy and puerperium were the most common gender-specific risk factors (27.7%). Other risk factors were the use of oral contraceptives (10.5%), head trauma (5.7%), hematologic disorders (5.7%), thyroid disorder (4.8%), and brain tumors (0.95%). Of the infections, otitis, mastoiditis, and sinusitis occurred in nine, meningitis in four, and systemic infection in three patients. Of the common gender-specific risk factors, the postpartum period was related in 16 patients, and oral contraceptive pill use was associated in 10 patients. Among the hematologic disorders, anemia was seen in four patients, and polycythemia and protein C deficiency in one patient each (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Comorbid conditions that were found in our patients were hypertension (13.3%), dyslipidemia (n\u0026thinsp;=\u0026thinsp;4.76%), diabetes mellitus (4.76%), chronic kidney disease (2.85%), human immunodeficiency virus-1 infection (1.9%), polycystic ovary syndrome (0.95%), and tuberculous pericarditis (n\u0026thinsp;=\u0026thinsp;1).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eRisk Factors identified in included patients.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRisk factors\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eInfection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22 (20.95%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOtitis, mastoiditis, sinusitis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9 (8.57%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMeningitis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (3.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSystemic infection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (2.85%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003ePregnancy and puerperium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (27.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePregnancy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePuerperium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (24.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eDrug use\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (10.47%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOral contraceptive pills\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (16.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGlucocorticoid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.95%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eHematologic disorders\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (5.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAnemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (3.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePolycythemia vera\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.95%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProtein C deficiency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.95%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHead trauma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (5.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThyroid disorder\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (4.76%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eMalignancy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.95%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCentral nervous system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.95%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOutside central nervous system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eClinical Characteristics\u003c/h2\u003e\u003cp\u003eHeadache was the most common clinical manifestation in 90.5% (n\u0026thinsp;=\u0026thinsp;95) of patients. It was the only complaint in 31 (29.5%) patients. Visual disturbances, including blurring of vision and diplopia, were reported in 41.9% of patients. 25.7% (n\u0026thinsp;=\u0026thinsp;27) of the patients had seizures, 14.3% had decreased levels of consciousness, 9.5% had a decline in cognition, and 21.9% (n\u0026thinsp;=\u0026thinsp;23) had extremity weakness. Five (4.8%) of the patients had aphasia; unilateral hearing loss occurred in three cases (2.9%), while four (3.8%) cases had tinnitus. Vomiting was present in 23 patients (21.9%), paresthesia in 12 patients (11.4%), neck pain in 23 patients (21.9%), and four (3.8%) patients had ear discharge, while five (5.8%) patients had pain in the ear and mastoid region (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eNeuroimaging pattern of CVT in study participants\u003c/h2\u003e\u003cp\u003eNine patients had a brain CT scan done with a repeated brain MRI later. All patients had brain MRI and MRV studies.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eMRV cerebral venous sinus anatomic distribution\u003c/h2\u003e\u003cp\u003eThe most commonly affected sites with thrombosis were the left transverse sinus, left sigmoid sinus, right sigmoid sinus, right transverse sinus, and superior sagittal sinus in 45 (42.9%), 41 (39%), 30 (28.6%), 29 (27.6%), and 25 (23.8%), respectively. The inferior sagittal sinus and internal cerebral vein of Galen were involved in one patient each.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eTreatment and outcome of CVT\u003c/h2\u003e\u003cp\u003eMost of our patients (72.4%) received heparin therapy: unfractionated heparin (UFH) in 52.4% or low-molecular-weight heparin in 20% during early anticoagulation, which was followed by warfarin for long-term anticoagulation. The duration of anticoagulant therapy was individualized according to patient prothrombotic risks. A small number of patients received additional antiplatelet medication, mainly aspirin. Twenty-one (20%) were on antiepileptic medication. The treatment of elevated intracranial pressure was by acetazolamide in 21 patients, mannitol in four patients in combination with therapeutic lumbar puncture. Optic nerve sheath fenestration was done in one patient due to deterioration in vision despite acetazolamide and therapeutic lumbar puncture.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eCerebral venous and sinus thrombosis can occur at any age but predominantly affects young adults, particularly women of reproductive age, due to risk factors such as pregnancy, the puerperium, and oral contraceptive use. In the ISCVT cohort, 75% of patients were women [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In our retrospective review of 105 patients seen over a 10-year period at our center, 61.9% were women, with a female-to-male ratio of 1:0.6. The overall mean age was 34.8\u0026thinsp;\u0026plusmn;\u0026thinsp;14.3 years.\u003c/p\u003e\u003cp\u003eCVT is typically multifactorial, and identifying one risk factor or cause should not prevent clinicians from investigating additional contributing factors, particularly congenital thrombophilia. In the ISCVT cohort, 44% of patients had more than one predisposing factor, with congenital or genetic thrombophilia present in 22% of cases [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In our study, the most common etiological factors were infections, consistent with findings from other African countries [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This reflects a greater contribution of infectious causes in developing countries, while pregnancy, the puerperium, and oral contraceptive use remain important gender-specific risk factors in women.\u003c/p\u003e\u003cp\u003eIn our study, pregnancy and the puerperium accounted for 18 patients (27.7%), while oral contraceptive use was identified in 11 patients (16.9%). Although these risk factors are well established, the prevalence of oral contraceptive use in our cohort was lower than reported in other studies [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Protein C deficiency was detected in only one patient, reflecting the limited investigation of genetic thrombophilia at our center due to the lack of available diagnostic facilities.\u003c/p\u003e\u003cp\u003eIn this study, the most common presenting symptom of CVT was headache, consistent with reports from other settings [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Visual disturbances were the second most frequent complaint, differing from many studies where seizures are reported as the second most common presentation (seizures ranked third in our cohort) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. A meta-analysis of South American studies similarly identified visual deficits as the second most frequent symptom [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], Atalu et al. reported similar frequencies for seizures and visual disturbances [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Seizures occurred in 25.7% of patients, comparable to other reports[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], while focal neurological deficits were observed in 21.9% of cases.\u003c/p\u003e\u003cp\u003eThe current gold standard for diagnosing CVT is the combined use of MRI and MRV to visualize thrombosed vessels [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. In our study, all patients had brain MRI with MRV, and involvement of the left-sided transverse sinus and sigmoid sinus were the most common findings. Findings on the most commonly affected single vessel are inconsistent in the literature, with some studies reporting the transverse sinus [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] and others the superior sagittal sinus [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] as the predominant site of thrombosis.\u003c/p\u003e\u003cp\u003eParenteral anticoagulation, preferably with low molecular weight heparin rather than unfractionated heparin, is recommended by the AHA/ASA and the European Stroke Organization during the acute phase of CVT, followed by oral warfarin therapy [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In the present study, heparin therapy was administered to 72.4% of patients, with the majority receiving unfractionated heparin. The higher use of unfractionated heparin compared to low molecular weight heparin likely reflects its greater availability and lower cost.\u003c/p\u003e\u003cp\u003eOur study has some limitations. The study was done at a single center and included patients from a privately owned health facility, limiting generalizability of the findings. The retrospective nature of the study has limited detailed characterization of patient profiles. Lack of setup to perform testing for inherited thrombophilia has compromised knowledge of the possible underlying causes of CVT.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn this retrospective review, CVT predominantly affected young women, with infections, pregnancy, and puerperium as main risk factors. Headache was the most common symptom, the left transverse and sigmoid sinuses were most frequently involved, and heparin was the primary treatment. These findings highlight the importance of timely diagnosis and management of CVT.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCNS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCentral nervous system\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCSOM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eChronic suppurative otitis media\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eComputer tomography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCVT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCerebral venous thrombosis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCVST\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCerebral venous and dural sinus thrombosis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDWI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eDiffusion weighted imaging\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eISCVT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInternational Study on Cerebral Venous and Dural Sinus Thrombosis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMRI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMagnetic resonance imaging\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMRN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMedical record number\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMRS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eModified Rankin Scale\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMRV\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMagnetic resonance venography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors would like to mention that there are no competing interests.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003cp\u003e Ethical approval was obtained from the Addis Ababa Regional Health Bureau Ethical Review Committee. The requirement for informed consent was waived, as only anonymized retrospective data were used. The study was conducted in accordance with the principles of the Declaration of Helsinki.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eNo funding was received.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eBS: conceptualization, design, acquisition of data, analysis, and interpretation of data; GZ: conceptualization, design, acquisition of data, and interpretation of data; MZ: conceptualization, design, acquisition of data, and interpretation of data; BG: design, acquisition of data, analysis, and interpretation of data; HT: design, acquisition of data, analysis, and interpretation of data; TG: design, acquisition of data, analysis, and interpretation of data; KS and GS: data curation and writing\u0026ndash;review and editing. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to express their deep and sincere gratitude to the study participants. Our gratitude extends to data collectors working at Yehuleshet Specialized Clinic. Their special thanks go to Prof. Guta Zenebe for providing the platform to conduct this study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eDe-identified participant data that support the findings of this study are available from the corresponding author upon reasonable request. To maintain confidentiality, the data are not publicly available.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6(2):162\u0026ndash;70.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eThrombosis of the cerebral. veins and sinuses - PubMed [Internet]. [cited 2025 Sept 5]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/15858188/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/15858188/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCanh\u0026atilde;o P, Ferro JM, Lindgren AG, Bousser MG, Stam J, Barinagarrementeria F. Causes and Predictors of Death in Cerebral Venous Thrombosis. Stroke. 2005;36(8):1720\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCerebral Venous Thrombosis. | Circulation [Internet]. [cited 2025 Sept 5]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ahajournals.org/doi/\u003c/span\u003e\u003cspan address=\"https://www.ahajournals.org/doi/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/circulationaha.111.067835\u003c/span\u003e\u003cspan address=\"10.1161/circulationaha.111.067835\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhou LX, Yao M, Cui LY, Li ML, Zhu YC, Ni J, et al. The Structural Imaging Characteristics and Its Clinical Relevance in Patients with Cerebral Venous Thrombosis-A Retrospective Analysis from One Single Center in China. Front Neurol. 2017;8:648.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWasay M, Azeemuddin M. Neuroimaging of cerebral venous thrombosis. J Neuroimaging. 2005;15(2):118\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFerro JM, Bousser MG, Canh\u0026atilde;o P, Coutinho JM, Crassard I, Dentali F, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology. Eur J Neurol. 2017;24(10):1203\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSidhom Y, Mansour M, Messelmani M, Derbali H, Fekih-Mrissa N, Zaouali J, et al. Cerebral venous thrombosis: clinical features, risk factors, and long-term outcome in a Tunisian cohort. J Stroke Cerebrovasc Dis. 2014 July;23(6):1291\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSouirti Z, Messouak O, Belahsen F. Cerebral venous thrombosis in Morocco: retrospective study of 30 cases. The Pan African Medical Journal [Internet]. 2014 Apr 14 [cited 2025 Sept 5];17(281). Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.panafrican-med-journal.com//content/article/17/281/full\u003c/span\u003e\u003cspan address=\"https://www.panafrican-med-journal.com//content/article/17/281/full\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOnyambu CK, Amayo E, Kitonyi JM, CLINICAL FEATURES AND PATTERNS OF IMAGING, IN CEREBRAL VENOUS SINUS THROMBOSIS AT KENYATTA NATIONAL HOSPITAL. East Afr Med J. 2013 Sept;90(9):297\u0026ndash;304.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRisk Factors and Clinical Manifestations of Cerebral Venous Thrombosis (CVT). in Patients Admitted to Ardabil City Hospitals during 2012\u0026ndash;2017 [Internet]. [cited 2025 Sept 5]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.jscimedcentral.com/jounal-article-info/Journal-of-Neurological-Disorders-and-Stroke/Risk-Factors-and-Clinical--Manifestations-of-Cerebral--Venous-Thrombosis-%28CVT%29-in--Patients-Admitted-to-Ardabil--City-Hospitals-during\u003c/span\u003e\u003cspan address=\"https://www.jscimedcentral.com/jounal-article-info/Journal-of-Neurological-Disorders-and-Stroke/Risk-Factors-and-Clinical--Manifestations-of-Cerebral--Venous-Thrombosis-%28CVT%29-in--Patients-Admitted-to-Ardabil--City-Hospitals-during\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e-2012--2017-6855.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMaali L, Khan S, Qeadan F, Ismail M, Ramaswamy D, Hedna VS. Cerebral venous thrombosis: continental disparities. Neurol Sci. 2017;38(11):1963\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRamrakhiani N, Sharma DK, Dubey R, Gupta P, Sharma A, Sharma KK. Clinical Profile, Risk Factors and Outcomes in Patients with Cerebral Venous Sinus Thrombosis: A Study from Western India. J Assoc Physicians India. 2019 Sept;67(9):49\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePatil VC, Choraria K, Desai N, Agrawal S. Clinical profile and outcome of cerebral venous sinus thrombosis at tertiary care center. J Neurosci Rural Pract. 2014 July;5(3):218\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCerebral Venous Thrombosis. | Stroke [Internet]. [cited 2025 Sept 5]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ahajournals.org/doi/\u003c/span\u003e\u003cspan address=\"https://www.ahajournals.org/doi/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/strokeaha.107.512814\u003c/span\u003e\u003cspan address=\"10.1161/strokeaha.107.512814\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352(17):1791\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDiagnosis and Management of Cerebral Venous Thrombosis. A Scientific Statement From the American Heart Association | Stroke [Internet]. [cited 2025 Sept 5]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ahajournals.org/doi/\u003c/span\u003e\u003cspan address=\"https://www.ahajournals.org/doi/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/STR.0000000000000456\u003c/span\u003e\u003cspan address=\"10.1161/STR.0000000000000456\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDiagnosis and Management of Cerebral Venous. Thrombosis | Stroke [Internet]. [cited 2025 Sept 5]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ahajournals.org/doi/\u003c/span\u003e\u003cspan address=\"https://www.ahajournals.org/doi/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/str.0b013e31820a8364\u003c/span\u003e\u003cspan address=\"10.1161/str.0b013e31820a8364\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cerebral venous thrombosis, dural sinus thrombosis, clinical profiles, Ethiopia, radiological findings, risk factors","lastPublishedDoi":"10.21203/rs.3.rs-7643666/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7643666/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eCerebral venous thrombosis (CVT) accounts for 0.5% of all strokes, predominantly affecting young women due to pregnancy, puerperium, and oral contraceptive use. Clinical presentations include intracranial hypertension, focal deficits, seizures, and encephalopathy. Data on CVT in Ethiopia remain scarce. This study aimed to describe the clinical profiles, risk factors, and radiological findings of CVT at a tertiary center in Addis Ababa, Ethiopia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003e\u003cb\u003eand Analysis\u003c/b\u003e: We conducted a retrospective cross-sectional review of 105 cases of cerebral venous and dural sinus thrombosis at Yehuleshet Specialized Clinic, Ethiopia, between January 1, 2010, and December 30, 2019. Demographic, clinical, laboratory, and imaging data were extracted and analyzed using SPSS version 27.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe mean age of the study participants was 34.8\u0026thinsp;+\u0026thinsp;14.3 years. Females accounted for the majority (61.9%) with a female-to-male ratio of 1:0.6. Infections (21%) were the most common risk factors identified, while pregnancy and puerperium were the most common gender-specific risk factors. Headache was the most common complaint, reported in 90.5%, followed by visual disturbances in 41.9% and seizures in 25.7% of patients. All patients had brain magnetic resonance imaging and magnetic resonance venography studies, and considering both single and multiple vessel thrombosis, the left transverse sinus (42.9%) and left sigmoid sinus (39%) were the most frequently involved. The majority of patients (72.4%) were treated with heparin, of whom 72% received unfractionated heparin, followed by warfarin.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eIn this retrospective review, CVT predominantly affected young women, with infections, pregnancy, and puerperium as main risk factors. Headache was the most common symptom, the left transverse and sigmoid sinuses were most frequently involved, and heparin was the primary treatment. These findings highlight the importance of timely diagnosis and management of CVT.\u003c/p\u003e","manuscriptTitle":"Clinical Profiles, Risk Factors, and Radiological Findings of Cerebral Venous and Dural Sinus Thrombosis: A 10-Year Retrospective Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-20 00:48:03","doi":"10.21203/rs.3.rs-7643666/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e80204c9-913e-4ada-8aeb-d5427a285e8e","owner":[],"postedDate":"November 20th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-25T08:41:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-20 00:48:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7643666","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7643666","identity":"rs-7643666","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}