Cerebral venous sinus thrombosis (CVST) has no identified cause in 15% of cases. Elevated factors (F) VIII and FXI have been associated with thromboembolism, but data on CVST are limited. We hypothesized that elevated plasma FVIII and FXI predispose to first and recurrent CVST. In 50 CVST survivors aged < 60 years, following anticoagulant cessation and in 50 controls, we determined plasma FVIII and FXI, along with fibrin clot properties: lysis time, permeability, maximum D-dimer (D-D_max), and maximum rate of D-dimer increase (D-D_rate). We recorded CVST recurrence during a follow-up of 58.5 (55.0–60.0) months. Plasma FVIII was 22.7% higher in CVST than in controls, with elevated FVIII > 150% in 13 (26%) vs. 4 (8%) patients, respectively (p = 0.02). Median FXI tended to be higher in CVST vs. controls (110.5 [99.0-117-0]% vs. 104.5 [97.0-116.0]%, p = 0.07), while FXI > 120% was observed more commonly in the former group (12 [24%] vs. 4 [8%], respectively, p = 0.03). Patients with FVIII > 150% were less likely to achieve complete recanalization compared with the remainder (2 [15.4%] vs. 28 [75.7%], respectively; p < 0.001). Eight patients (16%) experienced CVST recurrence. They had higher baseline FXI, but not FVIII, as compared with the remainder (125.5 [114.5–140.0]% vs. 107.5 [102.0-117.0]%, respectively, p = 0.01). Patients with FXI > 120% were four times more likely to have recurrent CVST (5 [62.5%] vs. 7 [16.7%], respectively; p = 0.01). Plasma FXI > 120% could represent a novel risk factor for first and recurrent CVST. Given advances in anti-FXI agents, CVST might be another indication for this emerging treatment.

15% 的病例中，脑静脉窦血栓 (CVST) 的病因不明。因子 (F) VIII 和 FXI 升高与血栓栓塞有关，但有关 CVST 的数据有限。我们假设血浆 FVIII 和 FXI 升高易导致首次和复发性 CVST。在 50 名年龄 < 60 岁的 CVST 幸存者中，在停止抗凝治疗后和 50 名对照中，我们测定了血浆 FVIII 和 FXI，以及纤维蛋白凝块特性：溶解时间、渗透性、最大 D-二聚体 (DD _max ) 和最大 D- 速率二聚体增加（DD_率）。我们在 58.5 (55.0–60.0) 个月的随访期间记录了 CVST 复发情况。CVST 组的血浆 FVIII 比对照组高 22.7%，分别有 13 名 (26%) 和 4 名 (8%) 患者的 FVIII 升高 > 150% (p = 0.02)。与对照组相比，CVST 组的 FXI 中位数往往更高（110.5 [99.0-117-0]% vs. 104.5 [97.0-116.0]%，p = 0.07），而 FXI > 120% 在前一组中更常见（分别为 12 [24%] 与 4 [8%]，p = 0.03）。与其余患者相比，FVIII > 150% 的患者实现完全再通的可能性较小（分别为 2 [15.4%] 和 28 [75.7%]；p < 0.001）。八名患者 (16%) 经历了 CVST 复发。与其余人相比，他们的基线 FXI 较高，但 FVIII 较高（分别为 125.5 [114.5–140.0]% 与 107.5 [102.0-117.0]%，p = 0.01）。FXI > 120% 的患者复发 CVST 的可能性是其他患者的四倍（分别为 5 例 [62.5%] 和 7 例 [16.7%]；p = 0.01）。血浆 FXI > 120% 可能代表首次和复发 CVST 的新风险因素。鉴于抗 FXI 药物的进步，CVST 可能是这种新兴治疗方法的另一个适应症。