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Clinical Characteristics, Etiology, Recanalization Rates and Neurological Outcomes in CVT: A Prospective Cohort
Rajendra Singh Jain1, P V Sripadma1, Shankar Tejwani1
1Department of Neurology, SMS Medical College, Jaipur, Rajasthan, India.
Annals of Indian Academy of Neurology
|June 13, 2022
Summary
Cerebral venous thrombosis (CVT) patients showed over 90% recanalization rates, with most achieving favorable neurological outcomes. Isolated superior sagittal sinus thrombosis and younger age predicted successful recanalization in this Indian cohort.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Cerebral venous thrombosis (CVT) recanalization rates and neurological outcomes are debated globally, with limited data from India.
- This study addresses the clinical profile, recanalization predictors, and outcomes of CVT in an Indian population.
Purpose of the Study:
- To investigate the clinical characteristics of patients with cerebral venous thrombosis (CVT).
- To determine recanalization rates and identify predictors of successful vessel recanalization in CVT.
- To evaluate the neurological outcome associated with CVT and its treatment.
Main Methods:
- A prospective single-center cohort study included 101 patients with radiologically confirmed acute CVT.
- Patients received anticoagulation for 3-12 months or lifelong for thrombophilias.
- Vessel recanalization was assessed via CT/MR venography at 3-6 months and 12 months post-ictus.
Main Results:
- Complete recanalization was achieved in 67.4% of patients by 12 months, with overall recanalization rates improving from 83.09% at 3-6 months to 93.9% at 12 months.
- Headache (75.9%) and seizures (66.2%) were common symptoms; transverse-sigmoid sinuses (66.2%) and superior sagittal sinus (SSS, 65.0%) were predominantly involved.
- Thrombophilia (27.7%) and postpartum state (15.6%) were common etiologies; 95.1% of patients achieved a favorable modified Rankin Scale (mRS) score.
Conclusions:
- Over 90% of cerebral venous thrombosis patients achieved recanalization, with most experiencing favorable neurological outcomes (mRS 0-1).
- Predictors of complete recanalization included isolated superior sagittal sinus thrombosis and age under 50 years.
- Anticoagulation therapy appears effective in improving recanalization rates and functional outcomes in CVT.
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