Clinical and radiological predictors of outcome in cerebral venous sinus thrombosis: An observational study

Abstract

Background. Objective. There have been varying clinical and radiological presentations in cerebral venous thrombosis (CVT) and there is ambiguity about predictors for the clinical outcome, so we planned a prospective observational study to predict clinical and radiological parameters of outcome in CVT patients. Material and methods. The study was conducted in the Department of Neurology, of a tertiary care hospital. We studied demographic, clinical, and radiological features of 40 CVST patients and correlated with the clinical outcome as Independent/good or dependant/death/poor at discharge and at one year using mRS score. Results. The study included n = 40 patients with a mean age of 32.45 years. The mean duration of hospital stay was 7.85 ±3.69 days. Headache was the most prevalent clinical feature in 95%. Superior sagittal sinus with or without inferior sagittal sinus was the most commonly thrombosed in (n = 27, 67.5%) patients. In the study population, 24 (60%) patients had good/independent outcome and 16 (40%) patients had dependant/death/poor outcome at discharge. We found that 84.62% of patients with parenchymal lesions with mass effect group had dependant/death/poor outcome and none of the patients without parenchymal lesion were dependent/dead and all had independent/good outcome at discharge. Although in the majority (54%) patients of parenchymal lesion with mass effect, the late outcome (at one year) was good. Conclusions. Our study concluded that higher GCS score at admission and discharge with radiological features of the absence of parenchymal lesion and parenchymal lesion without mass effect were strong predictors for good/ Independent clinical outcome (early as well late). But presentation as focal neurological deficits, headache with lower GCS, presence of parenchymal lesion with mass effect, and unilateral large parenchymal lesions were strong predictors for dependant/death/poor outcome.

Keywords

• cerebral venous thrombosis
• follow-up
• mri
• mrv
• cvst score
• stroke
• outcome
• risk factors