Are there disparities in cerebral sinus venous thrombosis between the Arab and Jewish populations in Israel - a multicenter cohort study?

Objective: Cerebral sinus venous thrombosis (CSVT) is a rare stroke subtype and data regarding the impact of ethnicity on its presentation and outcomes are limited. Methods: The Israeli CSVT cohort, which includes databases from six academic medical centers, was retrospectively studied. Demographics, clinical presentations, risk factors, radiological findings, and outcome parameters were compared between Jewish and Arab Israeli patients. Results: The study included 554 patients with CSVT, of whom 71 (13%) were of Arab ethnicity and 483 (87%) were Jewish. Arab patients were younger (mean age 38.4 ± 15.8 vs. 42.8 ± 10.1 years, p = 0.027), and more frequently male (48% vs. 33%, p = 0.013). Rates of Behcet's disease (BD) were higher among Arabs patients (13% vs. 3%, p < 0.001), antiphospholipid syndrome (23% vs. 10%, p = 0.002) and any coagulopathy (48% vs. 35%, p = 0.04), but lower rates of hypertension (4% vs. 15%, p = 0.016), and use of oral contraceptives (9% vs. 26%, p = 0.002). Differences in clinical presentation included higher rates of headache (90% vs. 74%, p = 0.004) and vomiting (39% vs. 15%, p < 0.001) in the Arab patient group. Arab ethnicity was associated with lower rates of any recanalization (aOR 0.346 [0.172–0.695], p = 0.003), and complete recanalization (aOR 0.408 [0.209–0.795], p = 0.008). Despite these differences, rates of favorable outcomes, mortality, and CSVT recurrence were similar between the groups. Conclusions: The findings highlight notable ethnic variations in the risk factors and clinical manifestations of CSVT between Arab and Jewish populations living in the same physical surroundings. Understanding these ethnic differences is crucial for creating targeted prevention and treatment strategies that cater to the specific needs of these diverse groups.