Dagný Ásgeirsdóttir¹

Ingvar H. Ólafsson²

Ólafur Árni Sveinsson^1,3

¹University Iceland, Faculty of Medicine, ²Department of Neurosurgery, University Hospital of Iceland, Reykjavik, Iceland, ³Department of Neurology, University Hospital of Iceland, Reykjavik, Iceland.

Correspondence: Olafur Sveinsson, olafursv@landspitali.is

Key words: cerebral sinus thrombosis, incidence, cerebral infarction, intracranial hemorrhage, anitcoagulation

BACKGROUND: Cerebral venous sinus thrombosis (CSVT) is the cause of 0.5%-1% of all strokes. CSVT can cause haemorrhage, cerebral infarction and increased intracranial pressure. Due to a variety of symptoms, CSVT can be difficult to diagnose. The purpose of this study was to examine the incidence of CSVT in Iceland 2008-2020, risk factors, symptoms, treatment and outcome.

METHODS: A retrospective reviewing of medical records of those diagnosed with CSVT from 1. January 2008 to 31. December 2020, was performed. Sex, age at diagnosis, symptoms, known risk factors, imaging results, treatment and outcome were studied. Statistical processing was performed with Excel and Rstudio.

RESULTS: Overall, 31 patients were diagnosed with CSVT (22 women). The mean incidence was 0.72/100.00 per year. The mean age was 34.3 years (14-63 years). The most common symptom was headache (87%), other symptoms included focal symptoms and seizures. The most common risk factor was the use of oral contraceptives (73%). Four patients had no risk factor. The most commonly affected sinus was the transverse-sinus (74%). All patients were treated with anticoagulants. Most received heparin or low-molecular-weight heparin then succeeded by warfarin or NOACs. Three months after diagnosis, 87% of the patients scored 0-2 on the modified Rankin Scale. One patient died as a result of CSVT.

DISCUSSION: The incidence of CSVT in Iceland is in accordance with other studies. Headache was the most common symptom and oral contraceptives the most common risk factor among women. Most patients made a good recovery, which suggests a timely diagnosis and appropriate treatment for CSVT in Iceland.