• The increased risk of thromboembolic events, bleeding, and mortality among patients with CVT depended on sex and age.

  • Clinicians should be aware of the importance of age and sex heterogeneity in the prognosis of CVT.

Cerebral venous thrombosis (CVT) predominantly affects young to middle-aged women. Scarce data exist on the long-term prognosis. We examined the clinical course of patients with CVT overall and according to age and sex. Using Danish registries, we identified all patients with a first-time primary inpatient diagnosis of CVT from 1996 to 2018 (N = 653, median age 41 years, 67% women) and individuals from the general population, matched on age, sex, and calendar year (N = 65,300). Patients with CVT were at increased risk of venous thromboembolism (VTE) in other sites, ischemic stroke, major bleeding, and mortality. For both sexes, the increased risks of VTE in other sites were most prominent among the young (18-54 years), while the increased risks of ischemic stroke, major bleeding, and mortality were most prominent among the older (≥55 years). Among young women, the 10-year risks of VTE in other sites for CVT patients compared with members of the matched cohort were 2.2% vs. 0.4% (risk difference: 1.8% [95% confidence interval (CI): 0.0, 3.6]). Among older women, compared with members of the matched cohort, the 10-year risks were 12.8% vs. 3.1% (risk difference: 9.7% [95% CI: 1.6, 17.9]) for ischemic stroke, 11.1 vs. 4.6% (risk difference: 6.5% [95% CI: -1.0, 14.1]) for major bleeding, and 43.1% vs. 26.7% (risk difference: 16.4% [95% CI: 3.7, 29.1]) for all-cause mortality. Risks were not elevated for myocardial infarction. Clinicians should be aware of the importance of age and sex heterogeneity in the prognosis of CVT.

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