Clinical Characteristics and Prognosis of Patients with Cerebral Venous Sinus Thrombosis in Southwest China

Objective Cerebral venous sinus thrombosis (CVST) is a rare cerebral vascular disease. Early diagnosis and treatments are crucial for a better prognosis. This study investigated the clinical characteristics and risk factors associated with the prognosis of patients with CVST. Methods From Jan 2009 to Jan 2013, patients who were admitted to the Department of Neurology of West China Hospital with confirmed CVST (according to the 2006 guideline of European neurology with neuroimaging when necessary) were consecutively recruited. Their medical records including demographic information and detailed clinical data were analyzed. The functional outcome of CVST was assessed 12 months after discharge using the modified Rankin Scale (mRS). Results A total of 73 patients were enrolled in this study. Acute and chronic onset of illness accounted for 13.7% and 35.6% of all patients, respectively. The earliest common symptom was headache (90.4%). Other initial symptoms included decreased visual acuity or blurred vision (2.7%), unilateral limb weakness (2.7%), diplopia (1.4%) and seizure (1.4%). CT scan was conducted in 46 patients (63.3%), which revealed 8 (17.4%) cases of cerebial hemorrhagic infarction. Delta sign and cord sign was shown in 34.8% and 30.4% CT imaging, respectively. The MRI scan confirmed that 27.5% of those patients had encephaledema, 55% had delta sign and 45% had cord sign. The commonly involved location of CVST was right lateral sinus (68.5%), left lateral sinus (57.5%), ongitudinal sinus (53.4%), left sigmoid sinus (50.7%), right sigmoid sinus (47.8%), confluence sinuum (32.9%), nferior sagittal sinus (21.9%), sinus rectus (20.5%), jugular vein (12.3%) and cerebral vein (9.6%). During the 12-month follow-up, 6.8% patients died, 72.6% had good mRS outcome (<2) and 27.4% had poor mRS outcome (≥2). CM(155.3mmThe regression analysis identified epilepsy and papilledma as independent predictors of poor prognosis of CVST. Conclusion It is difficult to recognize CVST at an early stage due to its diverse clinical presentations. Neuroimaging may be helpful for the diagnosis. Epilepsy and papilledema are potentially independent predictors for the 12-month functional outcome of patients with CVST.