Cerebral venous sinus thrombosis in Iran : cumulative data, shortcomings and future directions

Abstract EN

Background : Cerebral venous sinus thrombosis (CVST) is a frequent cause of cerebrovascular disease in Iran. Objectives : In this study we report cumulative data of published Iranian studies in a systematic manner with critically appraisal and presenting future directions. Materials and Methods : The authors systematically searched the ISI web of knowledge, Pubmed, Scopus, EBESCO and iran medex for keywords attributed to cerebral venous sinus thrombosis.

Methodological and demographic characteristics, etiology, site of involvement and clinical manifestations of patients with CVST were investigated. Results : seven eligible series with 465 patients were found.

Age of the patients were between 29.5 - 43.8 in these series.

Female to male ratio was 2.79.Mortality rate was 11.4 %.

Oral contraceptive pills was the single most common risk factor in all series (40 – 71 % of female patients).

Headache (80 – 97 %), sensori / motor deficits (39 – 64 %) and seizure (20 – 62 %) were the most common clinical presentations.

Hemorrhagic transformation was seen in 11-58 % of patients.

All included studies suffer substantial shortcomings.

Majority of studies were retrospective and only one study was population based.

Despitethe ethnic heterogeneity in Iran, none of these studies reported ethnic information Detailed methodology was missing in all studies.

Extent of investigation for hematological or neoplastic disorders was not clear methods.

Only one study reported a subgroup with multifactorial etiology.

Neither Barthel index nor modified Rankin scale were reported in any studies.

Mortality was reported only in three studies.

Analysis of prognostic factors was not done in any study. Conclusions : To overcome these shortcomings, more well-structured epidemiologic studies should be conducted in Iran as a CVST-raising country.