Impact of Anemia on Cerebral Venous Thrombosis Patients Compared to Arterial Stroke

BACKGROUND:
Cerebral venous thrombosis (CVT) is a condition where a thrombotic event involves cerebral venous sinuses of varied temporal evolution. It causes stroke with incidence of ≈1.3 per 100000 especially in young female. Many - risk factors had attributed in its etiology assuming, anemia, as one of these factor, - based on case reports and case series.
AIM OF STUDY:
Toassess the impact of anaemia on cerebral venous thrombosis (CVT) in comparison with arterial stroke
PATIENTS AND METHODS:
A case control prospective study performed at Al-Imamain Al-Kadhimain Medical City throughout the period from December-2017 to December-2019. It included 42 randomly selected cerebral venous thrombosis (CVT) patients who compared with another 60 patients with arterial stroke as control patient group -Both groups were offered complete blood count (CBC) within 48 hours as part of routine investigation. Those discovered to have anemia were categorized according to severity using WHO definition in both groups as well as their mean corpuscular volume (MCV). Statistical analyses performed to define the relationship between anemia, microcytosis and CVT diagnosis. Kaplan-Meier curve used to assess the survival of patients with CVT during the early outcome period of 14 days.
RESULTS:
Mean patients Hb was 11.05±3.11mg/dl versus 13.62±3.73 mg/dl in control group (p value < 0.001) with lower MCV (74.88±12.85 fl versus86.43±9.02 fl) (p value < 0.001). Severe anemia and severe microcytosis were associated significantly with CVT (OR= 13.5, 95% CI= 2.47-73.71, p= 0.001), (OR=2.87, 95%CI=2.17-3.8, p<0.001) respectively independently but not as such in combination with other confirmed other risk factors like age and gender. It is observed that mean duration of death was 8.5 days in CVT patients with anamia ( p value 0.227 ). All dead cases had severe anemia.
CONCLUSION:
There is inverse association between severity of anemia, microcytosis with CVT incidence, which may be considered as separate risk factors. The presence of anemia in CVT patient may result in - poor outcome and increasing early mortality rate.

Keywords

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