Using the CHOPS score to evaluate the severe cerebral venous sinus thrombosis progression risk after anticoagulation

This aimed to evaluate the risk of severe cerebral venous sinus thrombosis (SCVST) progression after anticoagulation using clinical and radiological data.

Clinical and radiological data from 199 SCVST patients were collected and analyzed in this study. Univariate and multivariate logistic regression analyses were conducted for several factors, including age, gender, pregnancy and puerperium, oral contraceptive use, coma state, hemiplegia, sensory dysfunction, cerebral infarction, cerebral hemorrhage, and sinus involvement. Subsequently, an evaluation system was developed based on the odds ratio (OR), and the receiver operating characteristic (ROC) curve was used to determine the prediction accuracy of this evaluation system in another cohort of 32 SCVST patients.

Pregnancy and puerperium (OR = 5.525, p = 0.001), oral contraceptive use (OR = 28.720, p = 0.003), coma at admission (OR = 3.890, p < 0.001), cerebral hemorrhage (OR = 2.151, p = 0.038), and number of occluded sinuses (OR = 1.708, p < 0.001) were found to be independent risk factors predicting the SCVST progression. The CHOPS score comprising the five independent factors (coma at admission (C), cerebral hemorrhage (H), oral contraceptive use (O), pregnancy and puerperium (P), and the number of occluded sinuses (S)) was constructed, which achieved an area under the curve of 0.873.

Pregnancy and puerperium, oral contraceptive use, coma at admission, cerebral hemorrhage, and the number of occluded sinuses are independent risk factors predicting the SCVST progression after anticoagulation. The developed CHOPS score can accurately predict SCVST progression; thus, endovascular or surgical treatment may be considered after anticoagulation when clinically necessary.