Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients

Abstract

The prognosis of cerebral venous sinus thrombosis (CVST) is variable, and outcome may range from complete recovery to death. Prognostic factors to predict outcome in the acute phase of CVST have not been analysed in a prospective study. Prognostic factors in patients enrolled in a clinical treatment trial were prospectively investigated. Poor outcome after 12 weeks, defined as death or dependency (Oxford handicap score>3), was used as the principle outcome measure. Univariate relations between possible prognostic factors and outcome at 12 weeks were analyzed with 2 tests. Treatment and all factors associated with prognosis (p< 0.25) were forced into a logistic regression model with a forward selection procedure. Fifty nine patients (50 women, nine men) were studied, with a mean age of 37 years (range 18 to 80 years). After 12 weeks 10 patients (17%) had a poor outcome. The univariate identified factors related to poor outcome were papilloedema, altered consciousness, coma, age older than 33 years, diagnostic delay<10 days, intracerebral haemorrhage, and involvement of the straight sinus. Isolated intracranial hypertension and a delta sign on CT were associated with good outcome. In the multivariate analysis coma and cerebral haemorrhage were significantly associated with a poor outcome, with odds ratios of 8.2 (95% confidence interval (95% CI) 1.3-50.1) and 20.7 (95% CI 1.6-264.3) respectively. Involvement of the straight sinus was also weakly, but not significantly, associated with poor outcome. In conclusion, coma and intracerebral haemorrhage are independent predictors for poor outcome of CVST. (J Neurol Neurosurg Psychiatry 2001;70:105-108)

Subarachnoid hemorrhage in isolated cortical vein thrombosis: are presentation of an unusual condition

“…Worthy of mention, though, is one series with 32 patients that reported 50% of them with more than 100 erythrocytes per cubic millimeter of CSF, although no MR imaging scans were available, and only two patients presented with sudden onset headache 8 . The exact cause of its association with CVT is object of speculation, with most of the theories suggesting rupture of small cortical veins secondary to hemorrhagic infarction or to venous hypertension 9 .…”

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

“…39,42 The clinical evolution of this entity and its natural history differ significantly from the various subtypes of arterial stroke, while its clinical presentation is characterized by a wide spectrum of symptoms and signs, depicted in an increasing body of previously published studies. 17,21,29,62,68 The initial reports concerning CVST, which were based on autopsy series, led to the underestimation of the actual incidence of CVST. 2 More recently, the evolution of noninvasive diagnostic imaging methodologies such as CT angiography and venography, as well as MR imaging, angiography, and venography, 47,56,57 enriched our knowledge regarding the full clinical spectrum of CVST and provided us with a more accurate estimation of its true incidence.…”

Trombose da veia de Galeno: relato de caso

“…O prognóstico da TVC é geralmente bom, mas ainda são necessários mais estudos prospectivos em pacientes com esta condição, a fim de se estabelecer a sua evolução a longo prazo 4,13,25 .…”