Clinical And Imaging Analysis Of Intracranial Venous Thrombosis In The Elderly

ObjectiveCerebral venous thrombosis(CVT)is a specific type of cerebrovascular disease with low incidence.Unlike arterial stroke,CVT is more common in young and middle-aged women,but is more rare in the elderly.Age is a risk factor for poor prognosis of CVT.Under the social background of aging population,proper understanding of risk factors,clinical and imaging features of elderly patients with CVT is of great clinical significance for timely and effective diagnosis and treatment of elderly patients with CVT and improvement of their prognosis.At present,there are few reports on elderly CVT.In this study,we retrospectively analyzed the clinical and imaging characteristics of 19 cases of elderly CVT admitted to our hospital,to improve clinicians’ understanding of elderly CVT and provide reference for clinical treatment.MethodsA retrospective study was conducted to consecutively collect clinical data of adult CVT cases in Linyi People’s Hospital from January 2010 to December 2020.We divided into young and middle-aged group(< 60 years old)and elderly group(≥ 60 years old)according to their age.By comparing the clinical and imaging data of the two groups,we analyzed the risk factors,clinical symptoms and signs,imaging characteristics,treatment and prognosis of elderly patients with CVT.Results215 adult CVT patients were collected,including 19 elderly CVT patients(8.8%),all with acute or subacute onset.We found that(1)Major clinical symptoms and signs:disturbance of consciousness and abnormal mental status(13 cases,68.4%);headache(12cases,63.2%);focal neurological deficits(9 cases,47.4%);seizures(5 cases,26.3%).Compared with the young and middle-aged group,the consciousness disorder and abnormal mental status were significantly higher in the elderly group(P= 0.001),and the headache was significantly lower(P=0.001),both differences were statistically significant.(2)Cranial MRI+MRV features: 18 cases(94.7%)of brain parenchymal lesions,including 18 cases of venous infarction,14 cases of combined with hemorrhagic transformation;3 cases of subdural hematoma;2 cases of subarachnoid hemorrhage in the convex surface of the cerebral hemisphere.14 cases(73.7%)had involvement of 2 or more venous sinuses,and the most common sites were: 14 cases of superior sagittal sinus,13 cases of transverse sinus,11 cases of sigmoid sinus and 7 cases of straight sinus.The brain parenchymal lesions were significantly higher in the elderly group compared with the young and middle-aged group(P=0.046),the difference was statistically significant.(3)All 19 patients were treated with anticoagulation,and 5 patients(26.3%)died in the acute stage,2 patients had a poor prognosis and 12 patients had a good prognosis after 3-6months of follow-up.The mortality was significantly higher in the elderly group compared with the young and middle-aged group(P=0.001),and the difference was statistically significant.ConclusionCVT is more rare in the elderly,disturbance of consciousness and abnormal mental status were common,and headache was uncommon relatively.Multiple venous sinus involvement and cerebral parenchymal lesions were common,with high incidence of venous infarction accompanied by multi-modal intracranial hemorrhage.The prognosis of CVT in the elderly were poor and had high mortality than in the younger.