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Clinical and radiological characteristics and predictors of outcome of cerebral venous sinus thrombosis, a hospital-based study

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Abstract

Cerebral venous sinus thrombosis is an uncommon cause of stroke, which is more prevalent in Iran and the Middle East. We aimed to assess the etiology, radiologic, and clinical manifestations of cerebral venous sinus thrombosis, specifically the predictors of patients’ outcome in Namazi hospital, Shiraz, Iran. In this retrospective study, we included all adult patients with the diagnosis of cerebral venous sinus thrombosis, who were admitted in hospital, from 2012 to 2016. Demographic data, radiologic findings, clinical presentation, risk factors, treatment, and outcome according to modified Rankin Scale (mRS) on discharge were assessed and the factors associated with hospital fatality and poor outcome (mRS > 2) were investigated through univariable and multivariable analyses. Adjusted odds ratio (OR), 95% confidence interval (CI), and p values were reported. Among 174 patients, 128 (73.6%) were female. The mean age was 37.8 ± 11.2. Total of 39 patients (22.4%) had poor discharge outcome and nine patients died in hospital. Older age (OR = 1.041, CI = 1.000–1.08), decreased level of consciousness (OR = 5.46, CI = 2.17–13.72), focal neurologic deficit (OR = 5.63, CI = 2.14–14.77), and expansion of intracranial hemorrhage (ICH) (OR = 9.13, CI = 1.96–42.64) were predictors of poor outcome according to the logistic regression model. Older age (p = 0.02), focal neurologic deficit (p = 0.005), deep venous system thrombosis (p = 0.002), early intracranial hemorrhage (p = 0.049), delayed hemorrhage (p = 0.007) and hemorrhage expansion (p = 0.002), infratentorial hemorrhagic lesions (p = 0.005), and higher CRP (p = 0.011) were associated with hospital fatality. The patients with gynecologic risk factors were at lower risk of hospital death (p = 0.005). Age, decreased consciousness and focal neurological deficit on admission, and expanded intracranial hemorrhage are predictors of poor outcome. The patients who are at higher risk of unfavorable outcome should be recognized and closely monitored.

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Acknowledgements

This study is part of the thesis project for MPH degree by Dr. Banafsheh Shakibajahromi. We would appreciate assistance of Mrs. Vojoud and Mr. Neydavoodi and also Mr. Argasi at the Research Consultation Center of Shiraz University of Medical Sciences.

Funding

This work was supported by the Office of Vice Chancellor for Research in Shiraz University of Medical Sciences [Grant no# 14818].

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Authors and Affiliations

  1. MPH Department, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran

    Banafsheh Shakibajahromi & Hossein Molavi Vardanjani

  2. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Banafsheh Shakibajahromi & Afshin Borhani Haghighi

  3. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

    Banafsheh Shakibajahromi

  4. Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Alireza Salehi

  5. Department of Radiology, Namazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

    Mehrnaz Ghaedian

  6. Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Anahid Safari

  7. Division of Interventional Neuroradiology, Department of Radiology, University of California Los Angeles (UCLA) Medical Center, Los Angeles, CA, USA

    Ashkan Mowla

Authors
  1. Banafsheh Shakibajahromi
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  2. Afshin Borhani Haghighi
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  4. Hossein Molavi Vardanjani
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Correspondence to Alireza Salehi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards (Approval code: 14818).

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Shakibajahromi, B., Haghighi, A.B., Salehi, A. et al. Clinical and radiological characteristics and predictors of outcome of cerebral venous sinus thrombosis, a hospital-based study. Acta Neurol Belg 120, 845–852 (2020). https://doi.org/10.1007/s13760-018-1009-6

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  • DOI: https://doi.org/10.1007/s13760-018-1009-6

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