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Blood, 15 August 2006, Vol. 108, No. 4, pp. 1129-1134.
Prepublished online as a Blood First Edition Paper on April 11, 2006; DOI 10.1182/blood-2005-12-4795.


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Submitted December 13, 2005
Accepted March 23, 2006

Natural history of cerebral vein thrombosis: A systematic review

Francesco Dentali, Monica Gianni, Mark A Crowther*, and Walter Ageno

Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Medicine, University of Insubria, Varese, Italy
Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Medicine, University of Insubria, Varese, Italy
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Department of Clinical Medicine, University of Insubria, Varese, Italy

* Corresponding author; email: crowthrm{at}mcmaster.ca.

Cerebral vein thrombosis (CVT) has been considered until a few years ago an uncommon disease with significant long-term morbidity and a high mortality rate. New non-invasive diagnostic techniques have increased the frequency with which this disease is diagnosed; despite this, there continues to be little data on its natural history. To evaluate the mortality rate, the rate of disability at long-term follow-up and the incidence of recurrences after a first episode of CVT; to determine clinical and radiological predictors of death and dependence; and to identify possible risk factors for recurrence. MEDLINE and EMBASE databases, reference lists of selected articles and authors' libraries Nineteen studies were identified. Mortality rate during peri-hospitalization period is 5.6 % (range 0 to 15.2%), and 9.4 % (range 0 to 39%) at the end of follow-up period. Eighty-eight percent of surviving patients recover completely or have only a mild functional or cognitive deficit. Two third of patients with CVT recanalized within the first few months after presentation and 2.8 % (range 0 to 11.7%) had objectively confirmed recurrence. We conclude that patients with CVT have a low risk of death and most patients have a good long-term prognosis.


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