Thrombosis of the Cerebral Veins and Sinuses in Hamadan, West of Iran

J Stroke Cerebrovasc Dis. 2016 Jun;25(6):1313-9. doi: 10.1016/j.jstrokecerebrovasdis.2016.02.022. Epub 2016 Mar 14.


Background and purpose: Cerebral venous sinuses thrombosis (CVST) is an uncommon type of stroke with an incidence of 3-4 cases per million. There have been reports of higher incidence of this disease in Iran. Our objective is to describe the incidence, clinical presentation, predisposing factors, and outcomes of CVST at Sina Hospital in Hamadan, west of Iran.

Methods: This is a prospective, single-center, longitudinal study of all patients referred to Sina Hospital in Hamadan, west of Iran, between May 2009 to May 2015 who were diagnosed with CVST.

Results: In this study, 151 patients were included. There were 118 women and 33 men. The mean age was 37.48 years. The mean incidence rate of CVST in the duration of our study was 13.49 per 1 million. Oral contraceptives, the most common risk factor, were used by 55.1% of women and half of these patients had fasting simultaneously. Fifty-eight patients had more than 1 risk factor. After 12 months' follow-up, 73.1% of the patients were functionally independent (mRS score 0-1). Ten percent were dependent. The overall mortality was 16.9%.

Conclusions: The incidence of CVST in Hamadan is higher than the world's average, and overall outcome is worse. It seems that fasting and subsequent dehydration in women with recent use of oral contraceptives make them more susceptible to CVST.

Keywords: Cerebral venous thrombosis; Iran; incidence; risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cerebral Veins* / diagnostic imaging
  • Contraceptives, Oral / adverse effects
  • Cranial Sinuses* / diagnostic imaging
  • Dehydration / complications
  • Disability Evaluation
  • Fasting / adverse effects
  • Female
  • Humans
  • Incidence
  • Iran / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Sinus Thrombosis, Intracranial / diagnostic imaging
  • Sinus Thrombosis, Intracranial / epidemiology*
  • Sinus Thrombosis, Intracranial / mortality
  • Sinus Thrombosis, Intracranial / physiopathology
  • Time Factors
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / epidemiology*
  • Venous Thrombosis / mortality
  • Venous Thrombosis / physiopathology
  • Young Adult


  • Contraceptives, Oral