Abstract
OBJECTIVE: Cerebral venous sinus thrombosis (CVST) is uncommon but clinically serious. Evidence regarding specific environmental factors, such as high-altitude exposure, remains limited. This study was done to identify patient-level and environmental factors associated with CVST and to summarize a single-center management model. METHODS: We conducted a single-center retrospective case-control study. Participants included imaging-confirmed, consecutive adult patients with CVST (n = 33, study group) who were treated at a tertiary Hospital between March 2018 and January 2022, and controls (n = 882) without CVST during the same period. Pre-specified exposure factors included living or working at high altitudes (≥4000 meters for 6 consecutive months within the past 12 months), recent surgery (≤3 months), systemic diseases (e.g., autoimmune diseases or nephrotic syndrome), and exogenous hormone exposure (≤3 months). Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were calculated using multivariate logistic regression analysis. RESULTS: In the adjusted model, high altitude exposure, systemic disease, and recent surgery were all independently associated with a higher risk of CVST. Older age was negatively associated with CVST. By univariate analysis, exogenous hormone exposure showed a positive correlation, but this correlation was no longer significant after adjustment. Imaging studies most commonly showed involvement of the transverse sinus and superior sagittal sinus. CONCLUSIONS: In this single-center cohort, high altitude exposure, systemic disease, and recent surgery were independently associated with CVST, while the negative correlation with age may reflect residual confounding factors. These findings suggest a need for multicenter, altitude-stratified studies and careful consideration of environmental context factors when evaluating suspected CVST.