Related Experiment Video
Updated: May 6, 2026
14:58
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
9.7K
Critical Prognostic Factors in Cerebral Venous Sinus Thrombosis: An Observational Study
Sandeep Gurram1,2, Magith Thambi1, Ashwini Naik1
1Department of Neurology, Kasturba Medical College, Manipal, Karnataka, India.
Annals of Indian Academy of Neurology
|March 18, 2024
Summary
Early diagnosis and treatment of cerebral venous sinus thrombosis (CVST) improve patient outcomes. Key indicators of poor prognosis include low Glasgow Coma Scale scores and neurological deficits, not traditional factors like age or seizure onset.
Area of Science:
- Neurology
- Neuroscience
- Vascular Neurology
Background:
- Cerebral venous sinus thrombosis (CVST) historically has a high mortality rate, up to 50%, though recent advances have reduced it to 10%-20%.
- CVST presents with diverse neurological symptoms, complicating diagnosis and prognosis.
- Identifying critical prognostic factors is essential for improving patient outcomes.
Purpose of the Study:
- To identify critical prognostic factors associated with poor outcomes in patients diagnosed with cerebral venous sinus thrombosis (CVST).
- To evaluate the impact of various clinical and radiological factors on 30-day outcomes in CVST patients.
Main Methods:
- Retrospective analysis of 149 adult CVST patients from July 2015 to July 2020.
- Outcome assessment using the modified Rankin Scale (mRS) at 30 days, with mRS <3 defined as a good outcome.
- Bivariate analysis using Chi-square or Fischer's exact test to identify associated variables with poor outcomes.
Main Results:
- Poor outcomes were significantly associated with Glasgow Coma Scale (GCS) <9 (P<0.001), focal neurological deficits (P=0.05), mass effect (P<0.001), and need for decompressive hemicraniectomy (P<0.001).
- Factors such as age, gender, diagnostic delay, seizures at onset, papilledema, parenchymal lesions, deep sinus involvement, and multiple sinus thrombosis were not significantly associated with poor outcomes.
- A total of 149 subjects were studied.
Conclusions:
- Early diagnosis and treatment of CVST are linked to favorable outcomes, even with conventional risk factors like age and seizure onset.
- The study suggests that factors like GCS, neurological deficits, mass effect, and need for hemicraniectomy are critical prognostic indicators.
- Further large-scale, prospective, country-wide studies are recommended to better elucidate prognostic factors in CVST.
Related Concept Videos
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
593
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
593
01:30Venous Thrombosis I: Introduction
834
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
834
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
470
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
470
01:29Venous Thrombosis III: Interprofessional Care
482
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
01:30Venous Thrombosis IV: Nursing Management
418
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
418
01:29Hemorrhagic Stroke ll: Pathophysiology
57
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
57