A PROSPECTIVE OBSERVATIONAL STUDY OF PREDICTORS OF POOR OUTCOMES IN PATIENTS WITH CEREBRAL SINUS VENOUS THROMBOSIS AT A TERTIARY CARE CENTER IN INDIA

Abstract

Objective: The objective of this study was to evaluate the factors associated with poor outcome in cerebral sinus venous thrombosis (CSVT) patients at 3 and 6 months. Methods: This was a prospective observational study in which CSVT patients hospitalized at a tertiary care center in Davangere, India during November 2016–October 2018 were included and followed up for 6 months. CSVT diagnosis was confirmed with imaging findings of computed tomography, magnetic resonance imaging, and magnetic resonance venography. Modified Rankin Scale score of 0–1 was considered indicative of “good outcome,” while that of ≥2 indicated “poor outcome.” Results: Data of 44 patients were collected, of which 59% (n=26) were male, 68.2% of the patients belonged to the age group 25–45 years (mean age: 34.91±11.23 years). Fifteen patients (34.09%) had acute, 24 patients (54.55%) had sub-acute, and five patients (11.36%) had chronic symptom duration. At 3 months, age >45 years (p=0.008), focal seizure (p<0.001), hemiparesis (p<0.001), cerebellar signs (p<0.008), infarct (p=0.006), hemorrhage (p=0.049), edema (p=0.012) and midline shift (p=0.007), involvements of straight sinus (p=0.035), inferior sagittal sinus (p=0.007), frontal lobe (p=0.038), and Glasgow coma scale (GCS) score of 8–12 (p=0.008) were significantly associated with “poor outcome.” At 6 months, patients with focal seizures (p=0.001), hemiparesis (p=0.008), hemorrhage (p=0.044), midline shift (p=0.013), involvement of parietal lobe (p=0.025), presence of hemorrhage (p=0.044), and GCS score of 8–12 (p=0.001) significantly higher rate of “poor outcome.” Conclusion: This real-world observational study identifies the clinicodemographic and neuroimaging variables significantly associated with “poor outcome” in CSVT patients.