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Background Cerebral venous thrombosis (CVT) is a rare condition, with paucity of evidence on its management and outcomes. Across Greater Manchester, Lancashire and South Cumbria, current policy is to transfer patients with CVT to Manchester Centre for Clinical Neurosciences (MCCN).Methodology We conducted a retrospective audit of all CVT patients admitted to MCCN between 2021-2024. Current practice was evaluated against recently updated local and international guidelines.Results Within the study period 99 patients were admitted with CVT. 64.6% were female and mean age at presentation was 44.9 years (SD 18.1). Headache was the most common presenting feature in 72.7%, whilst venous haemorrhage and infarct were common complications in 42.4%. Dabigatran was the most frequently used anticoagulant in 51.1%, whilst warfarin was used in 37.2%. A range of provoking factors were identified, with genetic or acquired thrombophilia in 13.2%. Overall, mortality post-CVT was 4.1%, and rate of recurrence was 3.0%. Outcomes were comparable between dabigatran and warfarin, in terms of rate of recurrence (2.9% vs 2.1%) and recanalisation (77.3% vs 76.2%).Conclusions Findings support use of dabigatran as a safe and efficacious for anticoagulation in CVT. A significant minority of patients were identified with a genetic or acquired thrombophilia, prompting consideration of standardised screening and referral in patients with unprovoked CVT.joseph.parker11@nhs.net