Age of onset of cerebral venous thrombosis: the BEAST study

Abstract

BACKGROUND: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in young adults. We aimed to determine the impact of age, gender and risk factors (including sex-specific) on CVT onset. METHODS: We used data from the BEAST (Biorepository to Establish the Aetiology of Sinovenous Thrombosis), a multicentre multinational prospective observational study on CVT. Composite factors analysis (CFA) was performed to determine the impact on the age of CVT onset in males and females. RESULTS: A total of 1309 CVT patients (75.3% females) aged ⩾18 years were recruited. The overall median (IQR-interquartile range) age for males and females was 46 (35-58) years and 37 (28-47) years ( p < 0.001), respectively. However, the presence of antibiotic-requiring sepsis ( p = 0.03, 95% CI 27-47 years) among males and gender-specific risk factors like pregnancy ( p < 0.001, 95% CI 29-34 years), puerperium ( p < 0.001, 95% CI 26-34 years) and oral contraceptive use ( p < 0.001, 95% CI 33-36 years) were significantly associated with earlier onset of CVT among females. CFA demonstrated a significantly earlier onset of CVT in females, ~12 years younger, in those with multiple (⩾1) compared to '0' risk factors ( p < 0.001, 95% CI 32-35 years). CONCLUSIONS: Women suffer CVT 9 years earlier in comparison to men. Female patients with multiple (⩾1) risk factors suffer CVT ~12 years earlier compared to those with no identifiable risk factors.