Bajko Zoltan, Motataianu Anca, Stoian Adina, Barcutean Laura, Andone Sebastian, Maier Smaranda, Drăghici Iulia-Adela, Cioban Andrada, Balasa Rodica
Department of Neurology, University of Medicine, Pharmacy, Sciences and Technology Targu Mures, 540136 Targu Mures, Romania.
Ist Neurology Clinic, Mures County Clinical Emergency Hospital, Targu Mures, 540136 Targu Mures, Romania.
J Clin Med. 2021 Mar 30;10(7):1382. doi: 10.3390/jcm10071382.
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.
We retrospectively reviewed the medical records of 89 consecutive cases of CVT at a tertiary neurology clinic in Târgu Mures, Romania, between June 2009 and January 2021 to analyze the gender-related differences in etiology, clinical presentation, and outcome.
Women comprised 62.5% of the cohort. Females were significantly younger than males (37.3 years versus 48.8 years, respectively, = 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.
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.
性别已被证明是脑静脉血栓形成（CVT）风险中的一个重要变量，并且显著影响其临床表现和预后。我们研究的目的是调查这种罕见脑血管疾病的性别特异性危险因素谱和临床情况。
我们回顾性分析了2009年6月至2021年1月间罗马尼亚特尔古穆列什一家三级神经科诊所连续89例CVT患者的病历，以分析病因、临床表现和预后方面的性别差异。
女性占该队列的62.5%。女性明显比男性年轻（分别为37.3岁和48.8岁，P = 0.001），主要危险因素在37.9%的病例中与激素有关，其次是原发性血栓形成倾向（34.4%）、吸烟（25.8%）、肥胖（17.2%）、感染（17.2%）、机械因素（17.2%）、癌症（8.6%）、系统性自身免疫性疾病（8.6%）和血液系统疾病（8.6%）。在男性患者中，主要危险因素是吸烟（41.9%）、原发性血栓形成倾向（29%）、感染（22.6%）、大量饮酒（16.1%）和病史中有静脉血栓栓塞（12.9%）。女性头痛的发生率高于男性（75.9%对67.7%），而昏迷（男性为6.5%，女性为1.7%）和头晕（男性为19.4%，女性为10.3%）的发生率在男性中更高。41.4%的女性和38.7%的男性CVT起病为急性。出院时女性的Rankin评分明显低于男性（0.6对1.6），反映出短期预后更有利。男性死亡率为6.4%，女性为1.7%。
CVT是一种多因素疾病，有广泛的危险因素，在临床表现和预后方面存在重要的性别差异。女性患者，尤其是那些有激素相关危险因素的患者，预后比男性患者更有利。
