Role of inflammatory, clinical, and imaging parameters in predicting short-term outcomes in cerebral venous thrombosis

Abstract

Abstract Background Cerebral venous thrombosis (CVT) is a stroke subtype characterized by occlusion of one or more of the cerebral veins and dural venous sinuses due to thrombosis. This study aims to identify predictors of outcomes in patients with CVT, using clinical, laboratory, and radiological parameters assessed upon admission. Method Ninety patients with a confirmed diagnosis of CVT were enrolled and subsequently categorized into two groups: patients with favorable outcomes and those with unfavorable outcomes, as determined by their Modified Rankin Scale (mRS) score one month post-diagnosis. A comparative analysis was conducted between the two outcome groups, including clinical presentations, laboratory biomarkers, and radiological characteristics. Additionally, the relationship between each marker and one-month mRS score was evaluated. Results In a study of 90 CVT patients, comprising 23.3% males and 76.7% females, favorable outcomes were observed in 66.7% of cases, while 33.3% experienced unfavorable outcomes. Significantly associated prognostic variables included a decreased level of consciousness, motor weakness, the presence of superior sagittal sinus thrombosis, parenchymal lesions, and a low lymphocyte-to-monocyte ratio (LMR). Conversely, age, sex, platelet-to-lymphocyte ratio, and the number of sinuses occluded were not found to be significantly correlated with the outcome. Regression analysis identified that increases in both the National Institutes of Health Stroke Scale (NIHSS) score and the Cerebral Venous Thrombosis Grading Scale (CVT-GS) score were independent and significant predictors of a poor prognosis. Furthermore, the study indicated comparable clinical outcomes for patients treated with new oral anticoagulants (NOACs) compared to those treated with warfarin. Conclusion In patients diagnosed with CVT, several variables at the time of admission were significantly associated with an unfavorable outcome, including decreased level of consciousness, motor weakness, reduced LMR, the involvement of the superior sagittal sinus thrombosis, and the presence of parenchymal lesions. Furthermore, NIHSS and CVT-GS were identified as independent predictors of short-term functional outcome in this population.