ABSTRACT NUMBER: ESOC2026A1147 CEREBRAL VENOUS AND DURAL SINUS THROMBOSIS – A RETROSPECTIVE SINGLE-CENTER STUDY OF THE EPIDEMIOLOGY, CLINICAL AND NEUROIMAGING CHARACTERISTICS

Abstract Background and aims Cerebral Venous and Dural Sinus Thrombosis (CSVT) is a rare cerebrovascular condition, with incidence of 1.32 per 100,000 and accounting for 0.5–3% of all stroke cases. This study aims to retrospectively evaluate the epidemiological, clinical, and neuroimaging characteristics of CSVT in a single tertiary stroke center. Methods We retrospectively reviewed all acute ischemic stroke admissions between January 2015 and December 2024. Patients with confirmed CSVT were included. Demographic data, clinical manifestations, neuroimaging findings, and clinical outcomes were analyzed. Results Among 16 690 ischemic stroke admissions, 40 patients (0.24%) had confirmed CSVT. The mean age was 52.83 ± 17.41 years, with a female predominance (60%). The most commonly affected venous structures were the transverse and sigmoid sinuses (67.5%), followed by the superior sagittal sinus (37.5%). Multiple venous territories were involved in 70% . Parenchymal lesions were present in 52.5%, most frequently venous infarction (42.5%) and intraparenchymal hemorrhage (17.5%). The predominant clinical symptoms were headache (62.5%) and paresis (52.5%), with acute onset in 22.5%. At discharge 67.5% had a Modified Rankin Scale (mRS) score of 0–2, while 17.5% had moderate to severe disability (mRS 3–5). Mortality was 12.5%. Impaired consciousness on admission was associated with a significantly increased risk of death (RR 9, 95%, CI 1.19–68.13, p=0.034). Conclusions CSVT is a rare cerebrovascular disorder, primarily affecting younger women and typically presenting subacutely with headache. CT/MR angiography is the diagnostic gold standard, often revealing multi-sinus involvement. While most patients achieve favorable outcomes, impaired consciousness at presentation is associated with increased mortality risk. Conflict of interest Vladina DImitrova-Kirilova: nothing to disclose Figure 1 - belongs to Results