Cerebral vein and sinus thrombosis in Isfahan-Iran: A changing profile

Objectives: This study was performed to investigate the clinical presentation and predisposing factors for cerebral vein and sinus thrombosis (CYST) in Isfahan, Iran. Methods: Data from the records of all patients with CVST referred to the largest tertiary-care hospital of Isfahan during a five-year period (1997 to 2001) were extracted and reviewed. Results: The number of cases with CVST diagnosed annually was 6, 9, 11, 14 and 15 patients, respectively. Thirteen men and 42 women were diagnosed to have CVST with the mean age of 35.1+/-3.8 and 28.7+/-1.3 years, respectively. Headache was the most frequent complaint (95%) and 63% of patients had focal neurological symptoms, including seizure (58%). Among possible predisposing factors, oral contraceptive pill was the most prevalent one, which was used by 38.1% of affected women for a period of as short as 1-3 months. Anticardiolipin antibodies were detected in 14% of patients. Conclusions: It seems that the annual incidence of CYST is increasing in Isfahan, perhaps due to more extensive intake of oral contraceptive pills and usage of more accurate modern diagnostic tools. The use of oral contraceptive pills was the most frequent predisposing factor; infections and postpartum factors were infrequently observed. Despite other reports from the Middle East, Behcet's disease is not a principal risk factor for CVST in Isfahani patients.