Characteristics of Cerebral Sinus Venous Thrombosis Patients Presenting with Intracerebral Hemorrhage

Naaem Simaan, Jeremy Molad, Shlomi Peretz, Andrei Filioglo, Eitan Auriel, Hen Hallevi, Estelle Seyman, Rani Barnea, José E. Cohen, Ronen R. Leker, Asaf Honig

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5 Scopus citations

Abstract

Patients with cerebral venous sinus thrombosis (CVST) occasionally present with intracerebral hemorrhage (ICH). In this study, we aimed to identify predictors for ICH in CVST patients. Prospective CVST databases from three academic centers were retrospectively analyzed. CVST patients with and without ICH upon presentation were compared. Among the 404 included patients (mean age 41.8 years, 33% male), 74 (18.3%) had an ICH. The patients with ICH were older (45 ± 20.6 vs. 41.1 ± 18 years, p = 0.045), and were more often pregnant or postpartum women (15% vs. 6%, p = 0.011), or chronically hypertensive (15% vs. 5%, p = 0.001). The ICH patients had higher rates of seizures (60% vs. 15%, p < 0.001), and focal neurological deficits (53% vs. 23%, p < 0.001). The ICH group had lower rates of excellent outcome measured by 90-day mRS 0 (56.7% vs. 80.3%, p < 0.001) and higher rates of 90-day mortality (8% vs. 3%, p = 0.041). Radiological variables associated with ICH included superior sagittal sinus (SSS) thrombosis (63% vs. 36%), isolated cortical vein thrombosis (38% vs. 8%), and presence of venous infarction (34% vs. 7%) (p < 0.001 for all). Upon multivariate analysis, chronic hypertension (OR 3.7, p = 0.027), being either pregnant or postpartum (OR 4.3, p = 0.006), isolated cortical thrombosis (OR 3.5, p = 0.007), and SSS involvement (OR 3.4, p < 0.001) were independently associated with ICH upon admission. In conclusion, among CVST patients, the following present higher for ICH: pregnant or postpartum women, and individuals with chronic hypertension, cortical vein, or SSS involvement.

Original languageEnglish
Article number1040
JournalJournal of Clinical Medicine
Volume11
Issue number4
DOIs
StatePublished - 17 Feb 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Cerebral venous sinus thrombosis
  • Intracerebral hemorrhage
  • Superior sagittal sinus thrombosis

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