{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:12:53Z","timestamp":1792203173409,"version":"4.4.0"},"reference-count":36,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Gender has been shown to be an important variable in cerebral venous thrombosis (CVT) risk and significantly influences its clinical manifestations and outcome. The aim of our study was to investigate the gender-specific risk factor profile and clinical picture of this rare cerebrovascular disorder. Materials and methods: We retrospectively reviewed the medical records of 89 consecutive cases of CVT at a tertiary neurology clinic in T\u00e2rgu Mures, Romania, between June 2009 and January 2021 to analyze the gender-related differences in etiology, clinical presentation, and outcome. Results: Women comprised 62.5% of the cohort. Females were significantly younger than males (37.3 years versus 48.8 years, respectively, p = 0.001), and the main risk factors were hormone related in 37.9% of the cases, followed by primary thrombophilia (34.4%), smoking (25.8%), obesity (17.2%), infections (17.2%), mechanical factors (17.2%), cancer (8.6%), systemic autoimmune disorders (8.6%), and hematological disorders (8.6%). In male patients, the main risk factors were smoking (41.9%), primary thrombophilia (29%), infections (22.6%), heavy alcohol consumption (16.1%), and venous thromboembolism in the medical history (12.9%). Frequency of headache was higher in females than in males (75.9% versus 67.7%), whereas frequency of coma (6.5% in males versus 1.7% in females) and dizziness (19.4% in males versus 10.3% in females) was higher in males. CVT onset was acute in 41.4% of females and 38.7% of males. The Rankin score at discharge was significantly lower in females compared with males (0.6 versus 1.6), reflecting a more favorable short-term outcome. Mortality was 6.4% in males and 1.7% in females. Conclusions: CVT is a multifactorial disorder that has a broad spectrum of risk factors with important gender-related differences in clinical manifestation and prognosis. Female patients, especially those with hormone-related risk factors, have a more favorable outcome than male patients.<\/jats:p>","DOI":"10.3390\/jcm10071382","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T09:57:04Z","timestamp":1617098224000},"page":"1382","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Gender Differences in Risk Factor Profile and Clinical Characteristics in 89 Consecutive Cases of Cerebral Venous Thrombosis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7379-4743","authenticated-orcid":false,"given":"Zoltan","family":"Bajko","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Medicine, Pharmacy, Sciences and Technology Targu Mures, 540136 Targu Mures, Romania"},{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Motataianu","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Medicine, Pharmacy, Sciences and Technology Targu Mures, 540136 Targu Mures, Romania"},{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adina","family":"Stoian","sequence":"additional","affiliation":[{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"},{"name":"Department of Pathophysiology, University of Medicine, Pharmacy, Sciences and Technology Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Barcutean","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Medicine, Pharmacy, Sciences and Technology Targu Mures, 540136 Targu Mures, Romania"},{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Andone","sequence":"additional","affiliation":[{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smaranda","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Medicine, Pharmacy, Sciences and Technology Targu Mures, 540136 Targu Mures, Romania"},{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia-Adela","family":"Dr\u0103ghici","sequence":"additional","affiliation":[{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrada","family":"Cioban","sequence":"additional","affiliation":[{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodica","family":"Balasa","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Medicine, Pharmacy, Sciences and Technology Targu Mures, 540136 Targu Mures, Romania"},{"name":"Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1161\/CIRCULATIONAHA.107.699579","article-title":"General cardiovascular risk profile for use in primary care: The Framingham Heart Study","volume":"117","author":"Vasan","year":"2008","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1586\/17474086.1.1.3","article-title":"Sex differences in thrombosis","volume":"1","author":"Nordstrom","year":"2008","journal-title":"Expert Rev. Hematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1001\/jama.295.12.1420","article-title":"Sex differences in platelet reactivity and response to low-dose aspirin therapy","volume":"295","author":"Becker","year":"2006","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1055\/s-0038-1656045","article-title":"Gender differences inplateletGPIIb-IIIa activation","volume":"77","author":"Faraday","year":"1997","journal-title":"Thromb. Haemost."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1046\/j.1365-2141.1997.1222936.x","article-title":"Epidemiology of coagulation factors, inhibitors and activation markers: The Third Glasgow MONICA Survey. I. Illustrative reference ranges by age, sex and hormone use","volume":"97","author":"Lowe","year":"1997","journal-title":"Br. J. Haematol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/S0140-6736(03)14066-4","article-title":"Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk","volume":"362","author":"Scarabin","year":"2003","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1159\/000509802","article-title":"Cerebral Venous Thrombosis: A Comprehensive Review","volume":"83","author":"Idiculla","year":"2020","journal-title":"Eur Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1161\/STROKEAHA.108.543884","article-title":"Cerebral Venous and Sinus Thrombosis in Women","volume":"40","author":"Coutinho","year":"2009","journal-title":"Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1017\/S0317167100012725","article-title":"Sex Differences in Adult Cerebral Venous Sinus Thrombosis: A 10-Year Experience","volume":"39","author":"Hinnell","year":"2012","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1177\/1747493015620708","article-title":"Sex differences in cerebral venous thrombosis: A systematic analysis of a shift over time","volume":"11","author":"Zuurbier","year":"2016","journal-title":"Int. J. Stroke"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1161\/STROKEAHA.120.031026","article-title":"Cerebral Venous Thrombosis: Finnish Nationwide Trends","volume":"52","author":"Ruuskanen","year":"2021","journal-title":"Stroke"},{"key":"ref_12","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_13","doi-asserted-by":"crossref","first-page":"3023","DOI":"10.1161\/STROKEAHA.120.030800","article-title":"Incidence and Mortality of Cerebral Venous Thrombosis in a Norwegian Population","volume":"51","author":"Kristoffersen","year":"2020","journal-title":"Stroke"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"E12","DOI":"10.3171\/2018.4.FOCUS1891","article-title":"Cerebral venous thrombosis requiring invasive treatment for elevated intracranial pressure in women with combined hormonal contraceptive intake: Risk factors, anatomical distribution, and clinical presentation","volume":"45","author":"Roethlisberger","year":"2018","journal-title":"Neurosurg. Focus."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1161\/01.STR.0000177894.05495.54","article-title":"Cerebral Vein and Dural Sinus Thrombosis in Elderly Patients","volume":"36","author":"Ferro","year":"2005","journal-title":"Stroke"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1161\/STROKEAHA.114.007584","article-title":"Cerebral Venous Thrombosis in the Absence of Headache","volume":"46","author":"Coutinho","year":"2015","journal-title":"Stroke"},{"key":"ref_17","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_18","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1136\/bmj.316.7131.589","article-title":"Case-control study of risk of cerebral sinus thrombosis in oral contraceptive users and in [correction of who are] carriers of hereditary prothrombotic conditions. The Cerebral Venous Sinus Thrombosis Study Group","volume":"316","author":"Stam","year":"1998","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1056\/NEJM199806183382502","article-title":"High Risk of Cerebral-Vein Thrombosis in Carriers of a Prothrombin-Gene Mutation and in Users of Oral Contraceptives","volume":"338","author":"Martinelli","year":"1998","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1182\/blood-2003-02-0443","article-title":"Hyperhomocysteinemia in cerebral vein thrombosis","volume":"102","author":"Martinelli","year":"2003","journal-title":"Blood"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/ajh.21059","article-title":"Smoking increases the risk of venous thrombosis and acts synergistically with oral contraceptive use","volume":"83","author":"Pomp","year":"2007","journal-title":"Am. J. Hematol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1001\/jamaneurol.2016.0001","article-title":"Risk of Cerebral Venous Thrombosis in Obese Women","volume":"73","author":"Zuurbier","year":"2016","journal-title":"JAMA Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.thromres.2018.07.005","article-title":"Non-genetic and genetic risk factors for adult cerebral venous thrombosis","volume":"169","author":"Green","year":"2018","journal-title":"Thromb. Res."},{"key":"ref_24","first-page":"736","article-title":"Smoking and risk of venous thromboembolism: A systematic review","volume":"45","author":"Zhang","year":"2014","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/AOG.0b013e318212fca2","article-title":"Postpartum Cerebral Venous Thrombosis","volume":"118","author":"McCaulley","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/7656232","article-title":"CVT in the Peripartum Period: A Diagnostic Dilemma","volume":"2020","author":"Allbright","year":"2020","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1055\/s-2003-38897","article-title":"Hemostasis during Normal Pregnancy and Puerperium","volume":"29","author":"Hellgren","year":"2003","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e562","DOI":"10.1111\/hae.13086","article-title":"A prospective study of von Willebrand factor levels and bleeding in pregnant women withtype 1 von Willebrand disease","volume":"22","author":"Sood","year":"2016","journal-title":"Haemophilia"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/j.1538-7836.2005.01158.x","article-title":"Protein Z, protein S levels are lower in patients with thrombophilia and subsequent pregnan-cy complications","volume":"3","author":"Paidas","year":"2005","journal-title":"J. Thromb. Haemost."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1160\/TH03-02-0119","article-title":"Circulating levels of inflammatory cytokines (IL-1 beta and TNF-alpha), resistance to activated protein C, thrombin and fibrin generation in uncomplicated pregnancies","volume":"90","author":"Ku","year":"2003","journal-title":"Thromb. Haemost."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1111\/j.1471-0528.2009.02295.x","article-title":"Haemostatic changes in the puerperium \u20186 weeks postpartum\u2019 (HIP Study): Implication for maternal thromboembolism","volume":"116","author":"Saha","year":"2009","journal-title":"BJOG"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1161\/STROKEAHA.118.023017","article-title":"Postpartum Period Is a Risk Factor for Cerebral Venous Thrombosis","volume":"50","author":"Silvis","year":"2019","journal-title":"Stroke"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/j.1747-4949.2009.00260.x","article-title":"Cerebral Venous Sinus Thrombosis Risk Factors","volume":"4","author":"Saadatnia","year":"2009","journal-title":"Int. J. Stroke"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3346\/jkms.2001.16.3.351","article-title":"Systemic lupus erythematosus complicated with cerebral venous sinus thrombosis: A report of two cases","volume":"16","author":"Lee","year":"2001","journal-title":"J. Korean Med. Sci."},{"key":"ref_35","first-page":"23","article-title":"Risk factors of cerebral vein and sinus thrombosis","volume":"23","author":"Bogousslavsky","year":"2008","journal-title":"Front. Neurol. Neurosci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s11239-016-1362-3","article-title":"Ten years of cerebral venous thrombosis: Male gender and myeloproliferative neoplasm is associated with thrombotic recurrence in unprovoked events","volume":"42","author":"Lim","year":"2016","journal-title":"J. Thromb. Thrombolysis"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1382\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:33:16Z","timestamp":1760362396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["jcm10071382"],"URL":"https:\/\/doi.org\/10.3390\/jcm10071382","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]}}}