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Chronic intracranial hypertension after cerebral venous and sinus thrombosis - frequency and risk factors

Christina Geisbüsch1, Christian Herweh2, Christoph Gumbinger1

  • 1Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Neurological Research and Practice
|May 17, 2021
PubMed

Insights

Around 10% of patients with cerebral venous sinus thrombosis (CVST) develop intracranial hypertension (IH). Visual disturbances at initial admission and insufficient recanalization may increase IH risk after CVST.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Neurosurgery

Background:

  • Cerebral venous sinus thrombosis (CVST) can lead to chronic intracranial hypertension (IH) due to impaired venous drainage.
  • Understanding the risk factors and incidence of IH post-CVST is crucial for patient management.

Purpose of the Study:

  • To determine the risk of developing intracranial hypertension (IH) after cerebral venous sinus thrombosis (CVST).
  • To identify and stratify underlying risk factors associated with IH development post-CVST.

Main Methods:

  • Retrospective cohort analysis of patients treated for acute CVST between 2013 and 2019.
  • Diagnosis of IH using modified Dandy criteria during follow-up.
  • Descriptive comparison of CVST patients with and without IH based on clinical, radiological data, and outcomes.

Main Results:

  • 10% of 70 patients with complete follow-up data developed symptomatic IH within 6 months.
  • Visual deterioration at initial admission (57.1% vs 20.6%) and insufficient vessel recanalization (28.6% vs 4.8%) were significantly associated with IH.
  • Patients with IH had a higher incidence of recurrent sinus thrombosis (57.1%) and showed less vessel recanalization on follow-up MRI.

Conclusions:

  • Intracranial hypertension (IH) occurs in approximately 10% of patients following cerebral venous sinus thrombosis (CVST).
  • Insufficient recanalization and initial visual disturbances are potential indicators for developing IH.
  • Patients with IH post-CVST may have an increased risk of recurrent cerebral venous thrombosis.
Abstract

Keywords:
Cerebral venous and sinus thrombosisIntracranial hypertensionVisual impairment

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