Anaemia, alcohol major risk factors behind brain clots, finds ICMR study

Of the 34,792 stroke cases registered in the hospital-based stroke registry (HBSR) from January 2020 to December 2022, 575 (1.6 per cent) cases were diagnosed with CVT and were included in the study.

A majority of these patients — 72.4 per cent — were between the age of 18–44. Males constituted 60 per cent of the study population, while females accounted for 40 per cent; while 59.8 per cent of the patients were from rural areas. The incidence of CVT-related stroke among men has further shown an increasing trend in recent years.

According to the study, “A striking sex difference was noted, with anaemia, pregnancy and oral contraceptives/hormone therapy-related risk factors more common among women, whereas alcohol and tobacco use were predominant among men.”

In India, CVT-related stroke predominantly affects young males, with anaemia, alcohol use and hyperhomocysteinemia, a condition characterised by abnormally high levels of the amino acid, as the major risk factors. Besides, older age, delayed hospital presentation between 12-24 hours, impaired consciousness, and dysphagia at onset, predicted higher mortality rate.

In young women, the CVT is often linked to pregnancy and use of oral contraceptives.

Headache, motor impairment, and seizures were the most frequent presenting symptoms, consistent with reports from other Asian countries. However, the study pointed out: “Only one-fourth of patients presented within 24 hours of symptom onset, highlighting gaps in awareness of stroke symptoms and timely access to acute care.”

“Neuroimaging revealed a high proportion of haemorrhagic infarctions, comparable to previous Indian studies. It was particularly more common among females,” the study added.

“The CVT becomes life threatening if the patients arrive late to the hospital,” Dr Sudhir Sharma, Department of Neurology, Atal Institute of Medical Super Specialities, Shimla, told The Tribune. He also cited alcohol consumption as one of the risk factors that were found in patients who had CVT.