The higher risk in men could potentially be attributable to more correctable or transient risk factors in women (use of OCs, pregnancy, etc) or may simply reflect the fact that this study enrolled fewer patients (n=145) and may have been under- powered for sex-specific analysis.197 Recurrence tends to occur within the first year of the index CVT. Patients with severe thrombophilia (antithrombin, pro- tein C, or protein S deficiency; antiphospholipid antibodies; or combined abnormalities) have an increased risk of VTE The recurrent event is more often a VTE than a recurrent CVT, and provid- ers should have a high index of suspicion for other thrombotic complications (pulmonary embolism, deep venous thrombo- sis) in patients with a prior CVT. Sex Differences in Outcome Overall, patients with CVT have lower mortality and bet- ter functional outcomes than most stroke subtypes.191,192 Predictors for poor outcome include age, malignancy, central nervous system infection, and intracranial hemorrhage.191 The mortality rate was only 2.8% in the most recent large study, and in general, patients had good functional outcomes (89.1% of patients had a complete recovery, with a modified Rankin score of 0 1).199 A post hoc analysis of patients followed up in the ISCVT found that male sex was associated with poorer outcomes at follow-up (HR, 1.59; 95% CI, 1.01 2.52) and that significantly more women recovered completely after 6 This was driven in large part by improved outcomes in a subset of women who had an identified gender-specific risk factor (OC use, pregnancy, puerperium, and hormone replacement therapy), present in Women with other underlying risk factors for CVT unrelated to these sex-specific factors had similar outcomes as males. 