Inflammation is correlated with severity and outcome of cerebral venous thrombosis

J Neuroinflammation. 2018 Nov 26;15(1):329. doi: 10.1186/s12974-018-1369-0.

Abstract

Background: Few studies have suggested a relationship between inflammation and cerebral venous thrombosis (CVT). This retrospective study aimed to explore the changes in inflammation in different CVT stages and the correlation between inflammation and severity and outcome of CVT.

Methods: In total, 95 suitable patients with CVT and 41 controls were compared. Patients with CVT were divided into three groups. The inflammatory factors studied included hypersensitive C-reactive protein (Hs-CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood and immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) in the cerebrospinal fluid (CSF). The severity of CVT was evaluated with the modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), fundus condition, intracranial pressure (ICP), and complications on admission. The short-term outcome was evaluated with the mRS at discharge.

Results: The following results were obtained: (1) Inflammatory factor levels in patients with CVT were higher than those in the controls. (2) Inflammatory factor levels in the acute and subacute stages were significantly higher than those in the chronic stage (all P < 0.05). (3) Serum NLR and CSF IgM levels were positively related to baseline degree of disability (odds ratio [OR], 1.279, 95% confidence interval [CI] 1.009-1.621, P = 0.042; OR 1.402, 95% CI 1.036-1.896, P = 0.028). The Hs-CRP level was positively correlated with the baseline occurrence of seizure (OR 1.040, 95% CI 1.001-1.080, P = 0.043). The baseline serum NLR (r = 0.244, P = 0.017), CSF IgA (r = 0.615, P < 0.001), CSF IgM (r = 0.752, P < 0.001), and CSF IgG (r = 0.248, P = 0.015) levels were positively associated with NIHSS. (4) The baseline NLR was significantly associated with high risk of poor outcome at discharge (OR 1.339, 95% CI 1.097-1.784, P = 0.007). Moreover, the ROC showed that NLR ≥ 4.205 could better predict the poor outcome at discharge. The data were analyzed using SPSS.

Conclusions: Inflammation may develop after CVT and gradually decrease during the course. Inflammation was significantly correlated with severity on admission and short-term poor outcome at discharge in CVT.

Keywords: Cerebral venous thrombosis; Inflammation; Outcome; Severity; Stage.

MeSH terms

  • Adult
  • C-Reactive Protein
  • Case-Control Studies
  • Female
  • Humans
  • Immunoglobulins / cerebrospinal fluid
  • Immunoproteins
  • Inflammation / cerebrospinal fluid
  • Inflammation / diagnostic imaging
  • Inflammation / etiology*
  • Interleukin-6 / cerebrospinal fluid
  • Intracranial Pressure / physiology
  • Intracranial Thrombosis / cerebrospinal fluid
  • Intracranial Thrombosis / complications*
  • Intracranial Thrombosis / diagnostic imaging
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neuroimaging
  • Neutrophils / pathology
  • ROC Curve
  • Retrospective Studies
  • Severity of Illness Index
  • Venous Thrombosis / cerebrospinal fluid
  • Venous Thrombosis / complications*
  • Venous Thrombosis / diagnostic imaging
  • Young Adult

Substances

  • Immunoglobulins
  • Immunoproteins
  • Interleukin-6
  • C-Reactive Protein