Análise epidemiológica, clínica e imaginológica de pacientes acometidos por trombose venosa cerebral admitidos em hospitais terciários da região norte do Estado do Ceará

Abstract

Cerebral venous thrombosis (CVT) is a rare yet potentially severe neurovascular disorder caused by the occlusion of dural venous sinuses and/or cerebral veins, leading to increased intracranial pressure, venous infarction, and intracerebral hemorrhage. Early recognition of CVT is crucial for improving clinical outcomes; however, the national literature lacks comprehensive epidemiological data regarding its clinical presentation, risk factors, and prognostic implications, particularly in the Northeast region of Brazil. This retrospective, observational, bicentric study analyzed the epidemiological, clinical, and neuroimaging profiles of patients diagnosed with CVT and admitted to Santa Casa de Misericórdia de Sobral (SCMS) and Hospital Regional Norte (HRN) between 2015 and 2024. Data collection was based on a systematic review of medical records, including demographic information, risk factors, clinical manifestations, and radiological findings obtained through computed tomography (CT), magnetic resonance imaging (MRI), and MR venography. Clinical outcomes were classified using the modified Rankin Scale (mRS) and categorized as complete recovery, permanent neurological deficits, or death. A total of 82 patients were diagnosed with CVT based on clinical and imaging findings. The mean age was 36 years, ranging from 9 to 74 years. The studied population was predominantly female, accounting for 76.8% of cases. Headache was the most frequent clinical manifestation, reported in 92.6% of patients. Among the identified risk factors, oral contraceptive use was the most common, reported in 55.5% of women. Among the patients identified with the presence of thrombophilia (17%), antiphospholipid syndrome (APS) was the most frequent (35.7%), followed by protein S deficiency (28.5%). The transverse sinus was the most frequently affected vascular structure (87.8%). Overall, 7.3% of patients experienced unfavorable functional outcomes (mRS 3 to 5), and 6.1% progressed to death. The epidemiological and clinical characterization of CVT in this cohort enhances neurological care in the northern region of Ceará and informs public health policies to prevent the disease.