Zhang Xiaoming, Fang Kun, Lan Duo, Huang Xiangqian, Ji Xunming, Meng Ran, Zhou Da
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China.
BMC Neurol. 2025 Jan 11;25(1):17. doi: 10.1186/s12883-025-04019-5.
Cerebral venous sinus thrombosis (CVST) is a rare yet significant neurological disorder with high mortality. Understanding its evolving characteristics, risk factors, and outcomes, particularly in Chinese patients after the COVID-19 pandemic, is critical for developing effective preventive and therapeutic strategies.
A retrospective analysis was conducted on 471 CVST cases from Xuanwu Hospital, comparing data before (2013-2017, n = 243) and after (2021-2023, n = 228) the COVID-19 pandemic. Data on demographics, clinical features, risk factors, and outcomes were evaluated, with subgroup analyses based on gender and age.
The mean patient age was 38 ± 14 years, with a female preponderance (55.0%). After the COVID-19 pandemic, significant changes in symptoms and neuroimaging findings were observed, including increased visual impairment and decreased headache, neurological deficits, and seizures. Infection emerged as a prominent risk factor, including eight cases related to COVID-19 or vaccination. At discharge, favorable outcomes (mRS 0-2) were noted in 86.6% of patients. Poor outcomes were associated with central nervous system (CNS) infection, oral contraceptive use or hormone replacement therapy (HRT), hematologic disorders, anemia, and prothrombotic conditions. Anemia was identified as an independent predictor of survival.
The pandemic has significantly altered the clinical and epidemiological profile of CVST in China. Infections have emerged as key risk factors, while anemia remains a critical prognostic indicator. These findings highlight the need for targeted clinical strategies to improve outcomes.
This study protocol was reviewed and approved by the ethics committee of Xuanwu Hospital, Capital Medical University (No. 2022-004, dated on November 20, 2022). The clinical trial was registered at Chinese Clinical Trial Registry (ChiCTR2200057621).
脑静脉窦血栓形成（CVST）是一种罕见但严重的神经系统疾病，死亡率高。了解其演变特征、危险因素和预后，特别是在新冠疫情后的中国患者中，对于制定有效的预防和治疗策略至关重要。
对宣武医院的471例CVST病例进行回顾性分析，比较新冠疫情前（2013 - 2017年，n = 243）和疫情后（2021 - 2023年，n = 228）的数据。评估人口统计学、临床特征、危险因素和预后数据，并按性别和年龄进行亚组分析。
患者平均年龄为38±14岁，女性占优势（55.0%）。新冠疫情后，症状和神经影像学表现出现显著变化，包括视力障碍增加，头痛、神经功能缺损和癫痫发作减少。感染成为突出的危险因素，包括8例与新冠或疫苗接种相关的病例。出院时，86.6%的患者预后良好（改良Rankin量表评分0 - 2分）。不良预后与中枢神经系统（CNS）感染、口服避孕药使用或激素替代疗法（HRT）、血液系统疾病、贫血和血栓前状态有关。贫血被确定为生存的独立预测因素。
疫情显著改变了中国CVST的临床和流行病学特征。感染已成为关键危险因素，而贫血仍然是重要的预后指标。这些发现凸显了制定针对性临床策略以改善预后的必要性。
本研究方案经首都医科大学宣武医院伦理委员会审查批准（编号2022-004，日期为2022年11月20日）。该临床试验在中国临床试验注册中心注册（注册号：ChiCTR2200057621）。
