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Factors associated with the initial intracranial hemorrhage occurrence in patients with cerebral venous thrombosis
Suppakorn Yamutai1, Pitchayaporn Sornplaeng1, Nuttha Sanghan2
1Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla 90110, Thailand.
Insights
Intracranial hemorrhage (ICH) occurred in 36.63% of Thai patients with cerebral venous thrombosis (CVT). Seizures, focal neurological deficits, and superior sagittal sinus thrombosis were independently associated with ICH in CVT patients.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Intracranial hemorrhage (ICH) is a rare but serious complication of cerebral venous thrombosis (CVT).
- Limited studies have investigated the specific factors associated with ICH in CVT patients, particularly in Asian populations.
Purpose of the Study:
- To identify clinical, radiological, and etiological factors associated with the occurrence of ICH in Thai patients diagnosed with CVT.
- To provide insights into risk stratification and management strategies for CVT patients at risk of hemorrhage.
Main Methods:
- A retrospective cohort study was conducted on 202 patients with CVT admitted to a tertiary university hospital from 2002 to 2022.
- Patients were categorized into ICH and non-ICH groups, and baseline characteristics, clinical presentations, and radiographic findings were compared.
- Multivariable logistic regression analysis was employed to determine independent predictors of ICH in CVT.
Main Results:
- The incidence of ICH among CVT patients was 36.63%.
- ICH was significantly associated with higher prevalence of focal neurological deficits, seizures, dependency at admission, superior sagittal sinus thrombosis, superficial cortical vein thrombosis, and hormonal use.
- Seizures (aOR 4.537), focal neurological deficits (aOR 2.431), and superior sagittal sinus thrombosis (aOR 1.922) were identified as independent predictors of ICH in CVT patients.
Conclusions:
- Seizures, focal neurological deficits, and superior sagittal sinus thrombosis are significant independent risk factors for intracranial hemorrhage in patients with cerebral venous thrombosis.
- These findings highlight the importance of recognizing these clinical and radiological signs for early detection and management of ICH in CVT.
Objectives:
Studies focusing on intracranial hemorrhage (ICH) in patients with cerebral venous thrombosis (CVT) are limited; thus, we aimed to identify factors associated with the occurrence of ICH in Thai patients with CVT.
Methods:
This retrospective cohort study recruited patients with CVT admitted to a tertiary university-based hospital between 2002 and 2022. The baseline characteristics, clinical presentations, radiographic findings, and etiologies were compared between the ICH and non-ICH groups. The factors with p < 0.2 in the univariate analysis were further analyzed using multivariable logistic regression analysis to identify independent factors associated with ICH in patients with CVT.
Results:
Of 228 screenings, 202 patients were eligible. The incidence rate of ICH was 36.63%. The ICH group showed a higher prevalence of focal neurological deficits (63.51% vs. 26.56%, p < 0.001), seizures (68.92% vs. 21.88%, p < 0.001), dependency status at admission (60.81% vs. 39.84%, p = 0.004), superior sagittal sinus thrombosis (71.62% vs. 39.07%, p < 0.001), superficial cortical vein thrombosis (36.49% vs. 10.16%, p < 0.001), and hormonal use (17.57% vs. 7.03%, p = 0.021) than the non-ICH group. In contrast, the ICH group showed a lower prevalence of isolated increased intracranial pressure (10.81% vs. 21.88%, p = 0.048) than the non-ICH group. Seizures (adjusted odds ratio [aOR], 4.537; 95% confidence interval [CI], 2.085-9.874; p < 0.001), focal neurological deficits (aOR, 2.431; 95% CI, 1.057-5.593; p = 0.037), and superior sagittal sinus thrombosis (aOR, 1.922; 95% CI, 1.913-4.045; p = 0.045) were independently associated with ICH in the multivariable logistic regression analysis.
Conclusions:
Seizures, focal neurological deficits, and superior sagittal sinus thrombosis are associated with ICH in patients with CVT.
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