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Clinical and prognostic characteristics of cerebral venous thrombosis at high altitude: a single-center retrospective study of Tibet

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Abstract

Objective

Data regarding diagnosis, management, and prognosis of patients with cerebral venous thrombosis (CVT) from high altitude are limited. The aim of the present study is to identify the clinical features, risk factors, and outcomes of cerebral venous thrombosis (CVT) in Tibet.

Methods

We retrospectively included patients with a diagnosis of CVT consecutively admitted to Tibet Autonomous Region People’s Hospital between July 2015, and September 2022. The risk factors, clinical and radiological presentations, treatment and outcomes were analyzed.

Results

A total of 38 patients with CVT were included in this study. The median age was 31 years, and females accounted for 63.2%. Patients of Tibetan nationality accounted for 71.1% (n = 27) and the median altitude of residence in Tibet was 3800 m (3657, 4054). Headache was the most common symptom (92.1%). The most common risk factors of CVT were infection in the past 4 weeks (34.2%) and pregnancy or puerperium (23.7%). Lateral sinus (transverse and/or sigmoid sinus) (68.4%) and superior sagittal sinus (55.3%) were the most commonly involved. The D-dimer increased in 31 patients (81.6%). All three patients who died in hospital and during follow-up had risk factor of recent infection. Favorable outcome at follow-up with a median length of 454 days (189, 1059) was observed in 85.3% of patients.

Conclusions

CVT at high altitude is more common in young patients and women, with various clinical manifestations and risk factors. Recent infection is the most common risk factor and may increase the mortality of CVT at high altitude. The long-term prognosis of CVT at high altitude is favorable.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding authors on reasonable request.

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Acknowledgements

The authors would like to thank all patients for participating in the project and all the staff for the time and effort they devoted.

Funding

This study was supported by grants from STI2030-Major Project #2021ZD0201100 Task 5 #2021ZD0201105 and National High Level Hospital Clinical Research Funding (2022-PUMCH-D-007).

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Authors and Affiliations

  1. Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 1, Shuaifuyuan, Dongdan, Dongcheng District, Beijing, 100730, China

    Yuhui Sha, Lixin Zhou & Jun Ni

  2. Department of Neurology, Tibet Autonomous Region People’s Hospital, Lhasa, China

    Yang Ci, Zhuoga Cidan & Yuhua Zhao

Authors
  1. Yuhui Sha
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  2. Yang Ci
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  3. Zhuoga Cidan
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  4. Yuhua Zhao
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  5. Lixin Zhou
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  6. Jun Ni
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Contributions

JN, LZ contributed to study concept and design. YC, YS, ZC, YZ made contributions to data collection and analysis. YS contributed to manuscript drafting. Critical revision of the manuscript for intellectual content was completed by JN and LZ.

Corresponding authors

Correspondence to Lixin Zhou or Jun Ni.

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Conflicts of interest

The authors declare that the research was conducted in the absence of any potential conflict of interest.

Ethical approval

The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. This study was approved by the ethical review board of Tibet Autonomous Region People’s Hospital.

Consent for publication

All authors agreed to the submission.

Additional information

Yuhui Sha and Yang Ci are co-first authors.

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Sha, Y., Ci, Y., Cidan, Z. et al. Clinical and prognostic characteristics of cerebral venous thrombosis at high altitude: a single-center retrospective study of Tibet. J Neurol 270, 2688–2692 (2023). https://doi.org/10.1007/s00415-023-11597-2

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  • DOI: https://doi.org/10.1007/s00415-023-11597-2

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