{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:59:11Z","timestamp":1771671551243,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke that accounts for 0.5\u20131.0% of all strokes. Clinical presentation, predisposing factors, neuroimaging findings, and outcomes of CVST are extremely diverse, which causes a high index of suspicion in diagnosis. Therefore, early diagnosis of CVST is crucial for prompt treatment to prevent morbidity and mortality. Objective: The purpose of this prospective study is aimed at assessing the clinical characteristics, potential risk factors, and neuro-radiological features along with the topography of venous sinus involved in CVST patients in a tertiary care hospital, Lahore, Pakistan. Material and Methods: Consecutive patients enrolled in this study had a computed tomography (CT) scan, magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) along with a clinical presentation to confirm the diagnosis of CVST. Categorical data were presented as percentages. Continuous variable and categorical data were compared (parenchymal lesions vs. non-parenchymal lesions) using the Student\u2019s t-test and Chi-square test, respectively. Results: A total of 3261 patients with stroke were presented during the study period. Out of all patients, 53 confirmed patients with CVST (1.6%) were recruited; the predominant population was female (84.91%), having a male to female ratio of 1:4. Mean age of the cohort was 28.39 \u00b1 7.19 years. Most frequent symptoms observed were headache (92.45%) followed by vomiting (75.47%), seizures (62.26%), papilledema (54.72%), visual impairment (41.51%), and altered consciousness disturbance (52.83%). The presumed risk factors associated with CVST were puerperium (52.83%), use of oral contraceptives (13.21%), antiphospholipid syndrome (7.55%), elevated serum levels of protein C and S (5.66%), and CNS infection (3.77%). On cranial CT scans, 50 patients (94.33%) showed abnormalities while 32 patients exhibited various parenchymal lesions. Seizures were more frequent in CVST patients with parenchymal lesions compared with subjects lacking parenchymal lesions. Seventy-two sinuses, either single or in combination, were involved in CVST patients, being more common in patients with parenchymal lesions than those without parenchymal lesions. The most frequent locations of CVST were the superior sagittal and transverse sinus. Conclusion: In short, non-contrast CT brain may be used as a first line investigation in suspected cases of CVST. Our study also demonstrates some regional differences in the clinical features, risk factors, and neuroimaging details of CVST as described by some other studies. Therefore, care must be taken while diagnosing and predicting the outcome of the CVST.<\/jats:p>","DOI":"10.3390\/diagnostics11060958","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T21:56:44Z","timestamp":1622066204000},"page":"958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Structural Imaging Characteristic, Clinical Features and Risk Factors of Cerebral Venous Sinus Thrombosis: A Prospective Cross-Sectional Analysis from a Tertiary Care Hospital in Pakistan"],"prefix":"10.3390","volume":"11","author":[{"given":"Safia","family":"Bano","sequence":"first","affiliation":[{"name":"Department of Neurology, King Edward Medical University, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Neurology, King Edward Medical University, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarwat","family":"Nazir","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Fatima Jinnah Medical University, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayesha","family":"Aslam","sequence":"additional","affiliation":[{"name":"Department of Neurology, King Edward Medical University, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Tariq","sequence":"additional","affiliation":[{"name":"Department of Neurology, King Edward Medical University, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Javed","sequence":"additional","affiliation":[{"name":"Department of Neurology, King Edward Medical University, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8485-7962","authenticated-orcid":false,"given":"Habib","family":"Rehman","sequence":"additional","affiliation":[{"name":"Department of Physiology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahsan","family":"Numan","sequence":"additional","affiliation":[{"name":"Department of Neurology, King Edward Medical University, Lahore 54000, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Clinical characteristics and prognosis of cerebral venous thrombosis in Chinese women during pregnancy and puerperium","volume":"7","author":"Liang","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/S0733-8619(18)30235-4","article-title":"Cerebral venous thrombosis","volume":"10","author":"Ameri","year":"1992","journal-title":"Neurol. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1111\/j.1468-1331.2006.01398.x","article-title":"EFNS guideline on the treatment of cerebral venous and sinus thrombosis","volume":"13","author":"Bousser","year":"2006","journal-title":"Eur. J. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1177\/000331978303401107","article-title":"Cerebral venous and arterial thrombosis in pregnancy and puerperium: A study of 135 patients","volume":"34","author":"Srinivasan","year":"1983","journal-title":"Angiology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.9734\/JAMMR\/2018\/38540","article-title":"In-hospital Imaging Prevalence, Patterns of Neurological Involvement in Cerebral Venous Sinus Thrombosis: Analysis from Pakistan","volume":"4","author":"Mubarak","year":"2018","journal-title":"J. Adv. Med. Med. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1159\/000317075","article-title":"Ischemic stroke in young Asian women: Risk factors, subtypes and outcome","volume":"30","author":"Wasay","year":"2010","journal-title":"Cerebrovasc. Dis."},{"key":"ref_7","first-page":"857","article-title":"Cerebral venous thrombosis in pregnancy and puerperium\u2014A prospective study","volume":"45","author":"Panagariya","year":"1997","journal-title":"J. Assoc. Physicians India"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"318","DOI":"10.4103\/0028-3886.158191","article-title":"Cerebral venous thrombosis: An Indian perspective","volume":"63","author":"Dash","year":"2015","journal-title":"Neurol. India"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1161\/01.STR.0000117571.76197.26","article-title":"Prognosis of cerebral vein and dural sinus thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)","volume":"35","author":"Ferro","year":"2004","journal-title":"Stroke"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.jocn.2017.07.028","article-title":"Cerebral venous sinus thrombosis: Clinical features, long-term outcome and recanalization","volume":"45","author":"Gazioglu","year":"2017","journal-title":"J. Clin. Neurosci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1111\/j.1468-1331.2010.03011.x","article-title":"EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients","volume":"17","author":"Stam","year":"2010","journal-title":"Eur. J. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2707","DOI":"10.1161\/STROKEAHA.107.512814","article-title":"Cerebral venous thrombosis: A descriptive multicenter study of patients in Pakistan and Middle East","volume":"39","author":"Khealani","year":"2008","journal-title":"Stroke"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.mjafi.2017.11.004","article-title":"A study of clinical, radiological and etiological profile of cerebral venous sinus thrombosis at a tertiary care center","volume":"74","author":"Anadure","year":"2018","journal-title":"Med. J. Armed Forces India"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/NRL.0000000000000079","article-title":"Cerebral venous sinus thrombosis from a tertiary care teaching hospital in India","volume":"21","author":"Kalita","year":"2016","journal-title":"Neurologist"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"104247","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.06.005","article-title":"Asian study of cerebral venous thrombosis","volume":"28","author":"Wasay","year":"2019","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bousser, M., and Russell, R. (1997). Cerebral Venous Thrombosis: Major Problem in Neurology, W. B. Saunders.","DOI":"10.1016\/B978-012743170-3\/50107-2"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s004150050579","article-title":"Cerebral venous thrombosis: Diagnosis and management","volume":"247","author":"Bousser","year":"2000","journal-title":"J. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1111\/j.1538-7836.2012.04774.x","article-title":"Long-term outcomes of patients with cerebral vein thrombosis: A multicenter study","volume":"10","author":"Dentali","year":"2012","journal-title":"J. Thromb. Haemost."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.04.020","article-title":"A multicenter study of 1144 patients with cerebral venous thrombosis: The VENOST study","volume":"26","author":"Duman","year":"2017","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/0028-3886.96388","article-title":"Risk factors, clinical profile, and long-term outcome of 428 patients of cerebral sinus venous thrombosis: Insights from Nizam\u2019s Institute Venous Stroke Registry, Hyderabad (India)","volume":"60","author":"Narayan","year":"2012","journal-title":"Neurol. India"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jstrokecerebrovasdis.2007.10.001","article-title":"Cerebral venous thrombosis: Analysis of a multicenter cohort from the United States","volume":"17","author":"Wasay","year":"2008","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s10072-004-0363-8","article-title":"Cerebral venous thrombosis: A retrospective multicentre study of 48 patients","volume":"25","author":"Terazzi","year":"2005","journal-title":"Neurol. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"648","DOI":"10.3389\/fneur.2017.00648","article-title":"The Structural Imaging Characteristics and Its Clinical Relevance in Patients with Cerebral Venous Thrombosis\u2014A Retrospective Analysis from One Single Center in China","volume":"8","author":"Zhou","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1161\/STROKEAHA.107.487363","article-title":"Early seizures in cerebral vein and dural sinus thrombosis: Risk factors and role of antiepileptics","volume":"39","author":"Ferro","year":"2008","journal-title":"Stroke"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s12028-009-9207-y","article-title":"Prophylactic antiepileptic drug use is associated with poor outcome following ICH","volume":"11","author":"Sansing","year":"2009","journal-title":"Neurocrit. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3389\/fneur.2015.00007","article-title":"Hormonal contraceptives and cerebral venous thrombosis risk: A systematic review and meta-analysis","volume":"6","author":"Amoozegar","year":"2015","journal-title":"Front. Neurol."},{"key":"ref_27","first-page":"33","article-title":"Clinical Profile of Cerebral Venous Sinus Thrombosis","volume":"68","author":"Dhadke","year":"2020","journal-title":"J. Assoc. Physicians India"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.jns.2014.02.001","article-title":"Plasma factor VIII in non-puerperal cerebral venous thrombosis: A prospective case\u2013control study","volume":"339","author":"Anadure","year":"2014","journal-title":"J. Neurol. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2180","DOI":"10.1161\/STROKEAHA.116.013617","article-title":"Cerebral venous sinus thrombosis incidence is higher than previously thought: A retrospective population-based study","volume":"47","author":"Devasagayam","year":"2016","journal-title":"Stroke"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"364","DOI":"10.3389\/fped.2019.00364","article-title":"Clinical characteristics and outcomes of pediatric cerebral venous sinus thrombosis: An analysis of 30 cases in China","volume":"7","author":"Wang","year":"2019","journal-title":"Front. Pediatr."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/6\/958\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:08:31Z","timestamp":1760162911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/6\/958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,26]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["diagnostics11060958"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11060958","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,26]]}}}