Department of Neurological Sciences, Christian Medical College, Vellore, India.
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Cerebrovasc Dis Extra. 2024;14(1):177-184. doi: 10.1159/000541937. Epub 2024 Oct 15.
Cerebral venous sinus thrombosis (CVT) is a life-threatening cause of stroke in Asian countries. South Asia, comprising of India, Pakistan, and Bangladesh, contributed to 40% of strokes in women. Major CVT registries are from the Western nations, which differs from the Asian countries with respect to epidemiology, gender biases, and risk factors. This review focuses on the various aspects of relevance in evaluation and management of patients with CVT in the Asian context.
The incidence of CVT is higher in Asia than in Western nations. Young age, female gender, especially in pregnancy and puerperal period, and dehydration appear to be the critical risk factors. Tropical infections like malaria, scrub typhus, and flaviviral encephalitis predispose to CVT. There is a higher prevalence of inherited thrombophilia in the Asian cohorts, contributing to prothrombotic states. Anticoagulation and supportive management offer excellent outcomes. Newer anticoagulants are safe and efficacious. In medically refractory cases, endovascular treatment offers modest benefits. Decompressive hemicraniectomy, when done early, offers mortality benefits in patients with large hemorrhagic venous infarctions.
CVT is an important cause of stroke with a high burden in South Asian countries. Establishment of robust registries is the need of the hour to study the natural history, course, and outcomes and to develop management algorithms tailored to the available resources.
脑静脉窦血栓形成（CVT）是亚洲国家危及生命的卒中原因。南亚由印度、巴基斯坦和孟加拉国组成，占女性卒中的 40%。主要的 CVT 登记处来自西方国家，其在流行病学、性别偏见和危险因素方面与亚洲国家不同。本综述重点关注亚洲背景下评估和管理 CVT 患者的各个方面。
CVT 在亚洲的发病率高于西方国家。年轻、女性，尤其是妊娠和产褥期、脱水似乎是关键的危险因素。热带感染，如疟疾、丛林斑疹伤寒和黄病毒脑炎，易导致 CVT。亚洲队列中存在更高的遗传性血栓形成倾向，导致血栓形成状态。抗凝和支持性治疗提供了极好的结果。新型抗凝剂安全有效。在药物难治性病例中，血管内治疗对大出血性静脉梗死患者有适度的益处。早期行去骨瓣减压术可降低大出血性静脉梗死患者的死亡率。
CVT 是一个重要的卒中原因，在南亚国家负担沉重。建立强大的登记处是当前的需要，以研究自然史、病程和结局，并制定针对现有资源的管理算法。
