Clinical Characteristics and Prognostic Factors of Non-Infectious Cerebral Venous Sinus Thrombosis

Abstract

Non-infectious cerebral venous thrombosis (CVT) is an uncommon type of cerebrovascular disease that usually affects young patients. It occurs frequently in female patients, probably due to the association of sex-specific risk factors for coagulopathies. Currently, the prognostic factors of CVT remain unclear. We retrospectively reviewed the clinical characteristics among 260 CVT patients, including 147 females and 113 males. A favorable clinical outcome was defined by the scores of the modified Rankin Scale (mRS) ≤ 2 at hospital discharge, while a poor clinical outcome was defined by an mRS score of 3 to 6. A headache (28.5%) was the most frequent presentation. The most commonly affected sinus was the transverse-sigmoid sinus (59.6%). Most of the cases (78.5%) were treated with anticoagulants. One hundred and fifty-seven patients (60.4%) were discharged with favorable clinical outcomes. Consciousness disturbance (odds ratio: 5.01, p < 0.001) was associated with a poor clinical outcome. Patients with poor clinical outcomes demonstrated higher D-dimer levels on admission (4137.76 ± 3317.07 vs. 2476.74 ± 2330.87 ng/mL FEU, p = 0.029) and longer hospitalization days (31.81 ± 26.29 vs. 13.96 ± 8.82 days, p < 0.001) compared with favorable clinical outcomes. These findings provide important information of clinical characteristics and prognosis for CVT. Aggressive monitoring and treatment should be considered in CVT patients with poor prognostic factors.

Characteristics of Poor Prognosis in Patients with Cerebral Venous Sinus Thrombosis: A Multicenter Retrospective Study

“… 15 Likewise, in other studies conducted in China, headache was the most common symptom. 10 , 12–14 In addition, the present study revealed that headache involvement was associated with a good clinical prognosis, consistent with the findings of a previous study. 14 However, the results of present study may provide more robust evidence, as this study analyzed the clinical data of 290 patients from five large tertiary hospital.…”

“… 17 Different from these prior studies, the present study did not detect any association between hemorrhage and poor prognosis. In addition, Chen et al, 10 in their retrospective study, did not observe any association between hemorrhage and poor clinical outcomes. Of note, the current study results revealed that injury to multiple lobes was associated with a poor prognosis for CVST patients.…”

“… 5 , 8 , 9 In 2022, a systematic retrospective clinical study of 260 patients in Taiwan found that patients with a poor prognosis had higher levels of D-dimer and longer hospital stays. 10 Although significant literature is available regarding the characteristics of CVST around the world, data derived from patients in China are limited. Existing studies in China have been single-center or small-sample studies.…”

NOD-like-receptor signaling pathway mediates inflammation and triggers cerebral injury in cerebral venous thrombosis

“…CVT involves both infarction and hemorrhage, and its pathological mechanism is intricate [17]. Due to the limited availability of brain tissue samples, clinical studies can only investigate molecular changes in peripheral blood and cerebrospinal uid samples from patients.…”

Editorial: New Advances in Cerebrovascular Disorders

“…Cerebrovascular disorders are dominated by arterial diseases, with cerebral venous thrombosis (CVT) often being the “neglected child” of vascular neurology. However, in this Special Issue, Chen et al describe a large retrospective cohort of Asian patients with CVT, evaluating clinical patterns of presentation, treatment paradigms and predictors of functional outcome [ 12 ]. They confirm that CVT in more than 60% of patients has a favorable outcome and that poor prognostic factors include disturbance of consciousness and high levels of D-dimers upon admission.…”