Prognostic factors in patients with cerebral sinus venous thrombosis presenting with hemorrhage and papilledema

Clin Neurol Neurosurg. 2023 Nov:234:108013. doi: 10.1016/j.clineuro.2023.108013. Epub 2023 Oct 11.

Abstract

Objective: The thromboinflammatory process is considered to play a role in the pathogenesis and prognosis of cerebral sinus vein thrombosis (CSVT). The purpose of the study was to compare the thromboinflammatory parameters between individuals with CSVT and healty controls. Additionally, the study sought to compare these parameters among CSVT subgroups with and without haemorrhage, as well as with and without papilledema. Furthermore, the investigation also aimed to identify which parameters had a more significant impact on the risk of hemorrhage and the development of papilledema in CSVT.

Methods: Thromboinflammatory parameters were compared retrospectively between the CSVT group of 88 patients and 80 age- and sex-matched healthy controls, and in the CSVT subgroups with (n = 35) /without hemorrhage (n = 53) and with (n = 52) /without papilledema (n = 36) after ethics committee approval. In both groups, parameters contributing to the risk of hemorrhage and papilledema development were determined by univariate and multivariate analyses.

Results: Regarding the risk of hemorrhage in CSVT patients, the most significant factors included hematocrit of <30.2 (%), mean platelet volume of ≤8.9 fL, neutrophil count of >5600, and hsCRP of >9 mg/L. Regarding the risk of papilledema development, the most important risk factors were age of ≤49, presence of vomiting, presence of blurred vision, HDL of >47 mg/dL, and D-dimer of >178 ng/mL.

Conclusion: It was suggested that evaluating serum thromboinflammatory parameters, as well as demographic characteristics and neurological examination findings, had a critical role regarding prognosis and predictive factors in CSVT.

Keywords: Cerebral sinus vein thrombosis; Inflammation; Thromboinflammatory parameters.

MeSH terms

  • Hemorrhage / complications
  • Humans
  • Papilledema* / complications
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sinus Thrombosis, Intracranial* / complications
  • Sinus Thrombosis, Intracranial* / diagnostic imaging
  • Venous Thrombosis* / complications