Severe impairment or death were more likely in those aged over 37 years, male, affected by coma, mental status disorder, intracerebral hemorrhage, thrombosis of the deep cerebral venous system, central nervous system infection and cancer. A subsequent systematic review of nineteen studies in 2006 showed that mortality is about 5.6% during hospitalisation and 9.4% in total, while of the survivors 88% make a total or near-total recovery. After several months, two thirds of the cases has resolution ("recanalisation") of the clot. The rate of recurrence was low (2.8%).In children with CVST the risk of death is high. Poor outcome is more likely if a child with CVST develops seizures or has evidence of venous infarction on imaging. Epidemiology
Cerebral venous sinus thrombosis is rare, with an estimated 3-4 cases per million annual incidence in adults. While it may occur in all age groups, it is most common in the third decade. 75% are female. Given that older studies show no difference in incidence between men and women, it has been suggested that the use of oral contraceptives in women is behind the disparity between the sexes. A 1995 report from Saudi Arabia found a substantially larger incidence at 7 cases per 100,000; this was attributed to the fact that Behçets disease, which increases risk of CVST, is more common in the Middle East.A 1973 report found that CVST could be found on autopsy (examination of the body after death) in nine percent of all people.
Clinical practice guidelines now recommend heparin or low molecular weight heparin in the initial treatment, followed by warfarin, provided there are no other bleeding risks that would make these treatments unsuitable. Some experts discourage the use of anticoagulation if there is extensive hemorrhage; in that case, they recommend repeating the imaging after 7–10 days. If the hemorrhage has decreased in size, anticoagulants are started, while no anticoagulants are given if there is no reduction.The duration of warfarin treatment depends on the circumstances and underlying causes of the condition. If the thrombosis developed under temporary circumstances (e.g. pregnancy), three months are regarded as sufficient. If the condition was unprovoked but there are no clear causes or a "mild" form of thrombophilia, 6 to 12 months is advised. If there is a severe underlying thrombosis disorder, warfarin treatment may need to continue indefinitely.Heparin and platelet transfusions should not be used as a treatment for any form of cerebral venous thrombosis caused by immune thrombotic thrombocytopenias including Heparin induced thrombocytopenia (HIT), auto-immune heparin induced thrombocytopenia (aHIT) or vaccine induced immune thrombotic thrombocytopenia (VITT) due to unpredictable effects of heparin on anti-platelet factor-4 antibodies (PF-4). In cases of VITT, intravenous immune globulins (IVIG) are recommended as they block the anti-PF4 antibody interaction with platelets and a non-heparin anticoagulant. In refractory cases, plasma exchange may be used.Thrombolysis (removal of the blood clot with "clot buster" medication) has been described, either systemically by injection into a vein or directly into the clot during angiography.