Objective To describe the clinical features of cerebral vein and sinus thrombosis (CVST), to
evaluate the short-term prognosis of CVST and to determine the predictive factors for CVST.
Methods In a single center observational study, consecutive patients who were diagnosed as
having CVST were retrospectively investigated. Demographic data, symptoms and signs from onset
to diagnosis, clinical and imaging features, location of the thrombus and therapy were collected.
Patients were followed up on the day before discharge. Primary outcome as independence was
assessed by modified Rankin Scale (mRS) score 2 at the end of follow-up. Univariate analysis
and multivariate Logistic regression analysis were performed to predict the outcome. Receiver operating characteristic (ROC) curves were used to analyze the accuracy. The comparison of area
under the curve (AUC) was calculated to test the superiority of the predicting model to the previous
clinical score.
Results From May 2000 to Jun 2010, we recruited 171 adult patients with CVST. Headache (91.8%)
was the most common symptom, followed by seizure (36.5%) and disturbance of consciousness
(33.3%). 50.2% (n =89) of the patients suffered from cerebral infarction, 31.6% (n =54) from
cerebral hemorrhage. A straight sinus thrombosis was confirmed in 45 (26.3%) patients in the
cohort. Anticoagulation was initiated in 126 (73.7%) patients and thrombolysis was needed in
17 (10.0%) patients. At the end of follow-up, 137 patients (80.1%) were independent by mRS 2.
Multivariate Logistic regression analysis showed independent factors were age ( 37, relative
risk [RR] 3.25, 95% confidence interval [CI] 1.29~8.17), sex (female, RR 4.06, 95%CI 1.43~11.5
), conscious disturbance (RR 3.92, 95%CI 1.48~10.4), straight sinus thrombosis (RR 7.78, 95%
CI 1.66~36.4) and coagulation (RR 0.13, 95%CI 0.05~0.35). The AUC of the predicting model
in this study ( with the exception of anticoagulation ) and CVST score (range from 0 to 9) were
0.85 (95%CI 0.77~0.92, P <0.001) and 0.65 (95%CI 0.53~0.77, P <0.01) respectively. There was a
significant difference between the two models (P <0.01).
Conclusion The prognosis of CVST is relatively good and a subgroup (19.9%) of CVST patients
is at increased risk of bad outcome. The short-term outcome of CVST patients can be predicted well
in our study and need to be evaluated prospectively.
