Long-term headache following cerebral venous thrombosis: a systematic review
Abstract
Background: Cerebral venous thrombosis (CVT) predominantly affects young adults and frequently presents with headache. Although functional outcomes are generally favorable, many patients report persistent or recurrent headache long after the acute event. This systematic review aimed to assess the prevalence, clinical characteristics, associated factors, and management of long-term headache following CVT.
Main body: A systematic search of PubMed and Embase (2000-2025) identified studies reporting original data on long-term headache after CVT in adult populations. Case series including fewer than 30 patients were excluded. Given substantial heterogeneity in study design, definitions, and outcome measures, a qualitative synthesis was performed. Fifteen studies including 2,136 patients were analyzed. The reported prevalence of post-CVT headache ranged from 14% to 59%. Headache most often resembled primary headache disorders, particularly tension-type and migraine-like phenotypes. Available data suggest that de novo headache may represent the most frequent presentation, although modification of pre-existing headache disorders also occurs. Pre-existing headache and depression were associated with post-CVT headache, whereas intracerebral hemorrhage was not. Associations with venous recanalization, thrombosis location, and anticoagulation delay were inconsistent. Secondary mechanisms, including intracranial hypertension, dural arteriovenous fistula, CVT recurrence, and…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,136 participants or records.
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