Delay in the diagnosis of cerebral vein and dural sinus thrombosis: influence on outcome

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José M Ferro, Patrícia Canhão, Jan Stam

    Stroke
    |July 18, 2009
    PubMed

    Insights

    Delayed diagnosis of cerebral vein and dural sinus thrombosis (CVST) significantly increases the risk of visual deficits. For patients with isolated intracranial hypertension syndrome, diagnostic delay also correlates with increased mortality or dependency.

    Area of Science:

    • Neurology
    • Vascular Neurology
    • Diagnostic Imaging

    Background:

    • Cerebral vein and dural sinus thrombosis (CVST) diagnosis delays can negatively impact patient outcomes.
    • The International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) investigated predictors and consequences of diagnostic delays in 624 patients.

    Discussion:

    • While overall outcomes (modified Rankin Scale, death) showed no significant difference based on median diagnostic delay, persistent visual deficits were more frequent in delayed diagnosis groups.
    • Patients presenting with specific neurological signs like altered consciousness, seizures, or parenchymal lesions on imaging were diagnosed earlier.
    • Conversely, male patients and those with isolated intracranial hypertension syndrome experienced diagnostic delays.

    Key Insights:

    • Diagnostic delay in CVST is considerable, with a median of 7 days.
    • Delayed diagnosis is linked to a higher incidence of persistent visual deficits.
    • In cases of isolated intracranial hypertension syndrome, delayed diagnosis is associated with worse outcomes, including death or dependency.

    Outlook:

    • Further research should focus on strategies to expedite CVST diagnosis, particularly in high-risk patient groups.
    • Improved diagnostic protocols may mitigate the risk of visual deficits and improve functional outcomes in CVST patients.
    • Understanding predictors of diagnostic delay is crucial for developing targeted interventions.
    Abstract

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