Related Experiment Video
Updated: Jun 2, 2025
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective
Pasook Sitthilok1, Piangrawee Niprapan2, Adisak Tantiworawit2
1Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Background:
Cerebral venous sinus thrombosis (CVST) is a rare type of thrombosis that affects the cerebral venous system. The data on neurological outcomes are limited.
Objectives:
This study aimed to investigate the neurological outcomes of CVST, contributing factors, clinical presentation, treatment and mortality.
Methods:
This was a single-center, retrospective study at a university-based referral hospital in Thailand. Consecutive patients diagnosed with CVST between January 2010 and December 2020 were included. Outcomes were neurological outcomes measured by modified Rankin Scale (mRS), anticoagulant treatment, recurrence, and mortality.
Results:
One hundred and seven CVST patients were included with a mean age (± SD) of 42.7 ± 20.4 years. Following the treatment, neurological outcomes significantly improved, with the proportion of patients with mRS 0-1 increasing from 18.7% at diagnosis to 83.2% and 85.1% at three and six months, respectively (P < 0.001). Clinical variables were associated with residual neurological symptoms (mRS≥1) included age ≥ 50 years (OR 4.1, 95% CI; 1.7-9.4, P 0.001), male sex (OR 3.0, 95%CI; 1.4-6.6, P 0.006), the thrombus involvement in deep sinus system (OR 6.1, 95%CI; 1.1-76.9, P 0.04) and cerebral vein and dural sinus thrombosis (CVT) risk score ≥ 1 (OR 3.1, 95%CI; 1.3-7.5, P 0.014). Patients whose CVST was associated with hormonal therapy were found to have a lower risk of residual neurological symptoms (OR 0.2, 95%CI 0.1-0.6, P 0.004). Hormonal therapy was associated with anticoagulant discontinuation (OR 2.7, 95% CI 1.1-7.0; P = 0.04). The presence of malignancy increased the risk of bleeding (OR 5.8, 95% CI 1.4-24.1; P 0.016). Overall mortality was 2.8%. Of which 50% were related to major bleeding.
Conclusions:
A significant improvement in neurological outcomes was observed at 3 and 6 months after diagnosis. Older age, male sex, thrombus involvement in deep sinus system were associated with residual neurological symptoms.
More Related Videos
Related Concept Videos
01:19Veins of Head and Neck
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...