Prognosis and Outcome of Cerebral Sinus Venous Thrombosis—A Multicenter Cohort Study

Abstract

Objectives. Cerebral sinus venous thrombosis (CSVT) is a rare stroke subtype and data regarding prognostic factors to predict outcomes are lacking. Thus, we aimed to identify predictors for outcome among CSVT patients. Materials and Methods. Prospective CSVT databases from four academic medical centers were retrospectively studied. Demographics, clinical presentations, risk factors, radiological, and outcome parameters were compared. Results. Out of 508 patients diagnosed with CSVT, 21 patients (4%) died, and 91 (18.6%) had unfavorable outcome ( $\text{mRS}\ge 2$ ). Age (55.0 vs. 38.5, $p<0.001$ ), hypertension (26% vs. 6%, $p<0.001$ ), hyperlipidemia (23% vs. 6%, $p<0.001$ ), diabetes (17% vs. 4%, $p<0.001$ ), malignancy (35% vs. 11%, $p<0.001$ ), absence of headache (51% vs. 78%, $p<0.001$ ), focal neurological deficit (54% vs. 19%, $p<0.001$ ), and ICH (28% vs. 13%, $p<0.001$ ) were all associated with unfavorable outcome. After multivariate analysis malignancy (OR 4.2, $p=0.003$ ), the presence of focal neurological deficit (OR 5.2, $p<0.001$ ) and the presence of headache upon presentation (OR 0.334, $p=0.018$ ) remained significant predictors for favorable outcome. Conclusions. Among CSVT patients, malignancy, focal neurological deficits, and absence of headache at presentation were associated with unfavorable outcomes.