Background: We identified risk factors, derived and validated a prognostic score for poor neurological outcome and death for use in cerebral venous thrombosis (CVT).
Methods: We performed an international multicenter retrospective study including consecutive patients with CVT from January 2015 to December 2020. Demographic, clinical, and radiographic characteristics were collected. Univariable and multivariable logistic regressions were conducted to determine risk factors for poor outcome, mRS 3-6. A prognostic score was derived and validated.
Results: A total of 1,025 patients were analyzed with median 375 days (interquartile range [IQR], 180 to 747) of follow-up. The median age was 44 (IQR, 32 to 58) and 62.7% were female. Multivariable analysis revealed the following factors were associated with poor outcome at 90- day follow-up: active cancer (odds ratio [OR], 11.20; 95% confidence interval [CI], 4.62 to 27.14; P<0.001), age (OR, 1.02 per year; 95% CI, 1.00 to 1.04; P=0.039), Black race (OR, 2.17; 95% CI, 1.10 to 4.27; P=0.025), encephalopathy or coma on presentation (OR, 2.71; 95% CI, 1.39 to 5.30; P=0.004), decreased hemoglobin (OR, 1.16 per g/dL; 95% CI, 1.03 to 1.31; P=0.014), higher NIHSS on presentation (OR, 1.07 per point; 95% CI, 1.02 to 1.11; P=0.002), and substance use (OR, 2.34; 95% CI, 1.16 to 4.71; P=0.017). The derived IN-REvASC score outperformed ISCVT-RS for the prediction of poor outcome at 90-day follow-up (area under the curve [AUC], 0.84 [95% CI, 0.79 to 0.87] vs. AUC, 0.71 [95% CI, 0.66 to 0.76], χ2 P<0.001) and mortality (AUC, 0.84 [95% CI, 0.78 to 0.90] vs. AUC, 0.72 [95% CI, 0.66 to 0.79], χ2 P=0.03).
Conclusions: Seven factors were associated with poor neurological outcome following CVT. The INREvASC score increased prognostic accuracy compared to ISCVT-RS. Determining patients at highest risk of poor outcome in CVT could help in clinical decision making and identify patients for targeted therapy in future clinical trials.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561213 | PMC |
| http://dx.doi.org/10.5853/jos.2022.01606 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Bibliometric Analysis of the Composition of Landmark Cerebral Venous Sinus Thrombosis Research.
Int J Cerebrovasc Dis Stroke
August 2024
Department of Neurology, Neurosurgery, & Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Background: Cerebral Venous Sinus Thrombosis (CVST) is a relatively rare type of stroke, accounting for less than 3% of all stroke cases, and is associated with significant morbidity and mortality in young females. However, when promptly diagnosed and treated, it can have favorable outcomes. Several knowledge gaps remain regarding pathophysiology, diagnosis, and management of CVST, so critical assessment of past and present research could help close these gaps or establish targeted future research goals.
View Article and Find Full Text PDFSelective Fetal Growth Restriction Leading to Cerebral Injury in Monochorionic Twins: A Case Report.
Cureus
December 2024
Neonatology Department, Daniel de Matos Maternity, Coimbra Local Health Unit, Coimbra, PRT.
Monochorionic twin pregnancies carry a risk of perinatal complications due to shared placental anastomoses, which can cause uneven blood distribution and lead to conditions like selective fetal growth restriction (sFGR). This case describes a monochorionic pregnancy complicated by preeclampsia and late-onset sFGR of twin B. Labor was prematurely induced and a 45% weight discordance between the twins was confirmed.
View Article and Find Full Text PDFEarly Microcirculatory Dysfunction on Perfusion CT Is Related to Prognosis After Aneurysmal Subarachnoid Hemorrhage.
Transl Stroke Res
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4 Ring West Road, Beijing, 100070, Fengtai District, China.
Microcirculatory dysfunction is an important pathophysiology mechanism of early brain injury after aneurysmal subarachnoid hemorrhage (aSAH), which contributes to poor outcomes. The study was performed in Beijing Tiantan Hospital from October 2020 to July 2023. Patients with aSAH who underwent computed tomographic perfusion (CTP) within 24 h after ictus were enrolled prospectively.
View Article and Find Full Text PDFSubtemporal approach for posterior communicating artery aneurysms.
Front Neurol
December 2024
Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Background And Objectives: Direct visualization of the aneurysmal neck and its related perforating arteries during microsurgical clipping of posterior communicating artery (PCoA) aneurysms with posterior projection or true PCoA aneurysms through the pterional approach may be difficult and complicated.
Methods: From January 2022 to January 2023, the clinical and angiographic information regarding PCoA aneurysms were retrospectively collected. Among them, 10 consecutive patients with PCoA aneurysms treated with microsurgical clipping via the subtemporal approach in our single institution were included.
Awake resection of a right motor cortex arteriovenous malformation in a pediatric patient: A case report and review of the literature.
Surg Neurol Int
December 2024
Department of Surgery, Section of Neurosurgery, Aga Khan University, Karachi, Pakistan.
Background: Intracranial arteriovenous malformations (AVMs) are extremely rare in the pediatric population, with an estimated prevalence of 0.014-0.028%.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!