Inflammatory Markers Differentiate Cerebral Venous Sinus Thrombosis from Mimics

Area of Science:

• Neurology
• Immunology
• Medical Imaging

Background:

• Cerebral venous sinus thrombosis (CVST) is often misdiagnosed due to anatomical variants, termed CVST mimics.
• Differentiating true CVST from mimics is crucial for accurate diagnosis and treatment.

Purpose of the Study:

• To investigate the role of inflammatory markers in distinguishing CVST from its mimics.
• To assess the correlation of these markers with CVST severity and prognosis.

Main Methods:

• Recruited 146 patients with CVST and 93 with mimics.
• Utilized receiver operating characteristic (ROC) analysis to evaluate marker sensitivity and specificity.
• Employed rank logistic regression to analyze marker association with CVST severity and prognosis.

Main Results:

• CVST patients exhibited significantly higher inflammatory markers, including neutrophil count, interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR), compared to mimics.
• ROC analysis indicated IL-6, neutrophil count, and NLR as potential discriminators.
• After propensity score matching, IL-6 remained a strong differentiator (AUC >0.8).
• Ranked logistic regression identified IL-6, CSF IgA, CSF IgM, and CSF IgG as independent predictors of CVST severity and prognosis (mRS).

Conclusions:

• Distinct inflammatory profiles exist between CVST and its mimics.
• Inflammatory markers, particularly IL-6, are valuable in differentiating CVST from mimics.
• These markers can also serve as prognostic indicators for CVST severity and patient outcomes.