Cerebral Venous Sinus Thrombosis: Current Updates in the Asian Context

Background:Cerebral venous sinus thrombosis (CVT) is a life-threatening cause of stroke in Asian countries. South Asia,comprising of India, Pakistan, and Bangladesh, contributed to40% of strokes in women. Major CVT registries are from theWestern nations, which differs from the Asian countries withrespect to epidemiology, gender biases, and risk factors. Thisreview focuses on the various aspects of relevance in eval-uation and management of patients with CVT in the Asiancontext.Summary:The incidence of CVT is higher in Asia thanin Western nations. Young age, female gender, especially inpregnancy and puerperal period, and dehydration appear tobe the critical risk factors. Tropical infections like malaria,scrub typhus, andflaviviral encephalitis predispose to CVT.There is a higher prevalence of inherited thrombophilia in theAsian cohorts, contributing to prothrombotic states. Anti-coagulation and supportive management offer excellentoutcomes. Newer anticoagulants are safe and efficacious. Inmedically refractory cases, endovascular treatment offersmodest benefits. Decompressive hemicraniectomy, whendone early, offers mortality benefits in patients with largehemorrhagic venous infarctions.KeyMessages:CVT is animportant cause of stroke with a high burden in South Asiancountries. Establishment of robust registries is the need of thehour to study the natural history, course, and outcomes andto develop management algorithms tailored to the availableresources.(c) 2024 The Author(s).Published by S. Karger AG, Basel