Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.

<h4>Background</h4>Cerebral venous sinus thrombosis (CVST) is a rare type of thrombosis that affects the cerebral venous system. The data on neurological outcomes are limited.<h4>Objectives</h4>This study aimed to investigate the neurological outcomes of CVST, contributing fa...

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Main Authors: Pasook Sitthilok, Piangrawee Niprapan, Adisak Tantiworawit, Teerachat Punnachet, Nonthakorn Hantrakun, Pokpong Piriyakhuntorn, Thanawat Rattanathammethee, Sasinee Hantrakool, Ekarat Rattarittamrong, Lalita Norasetthada, Chatree Chai-Adisaksopha
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0316849
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author Pasook Sitthilok
Piangrawee Niprapan
Adisak Tantiworawit
Teerachat Punnachet
Nonthakorn Hantrakun
Pokpong Piriyakhuntorn
Thanawat Rattanathammethee
Sasinee Hantrakool
Ekarat Rattarittamrong
Lalita Norasetthada
Chatree Chai-Adisaksopha
author_facet Pasook Sitthilok
Piangrawee Niprapan
Adisak Tantiworawit
Teerachat Punnachet
Nonthakorn Hantrakun
Pokpong Piriyakhuntorn
Thanawat Rattanathammethee
Sasinee Hantrakool
Ekarat Rattarittamrong
Lalita Norasetthada
Chatree Chai-Adisaksopha
author_sort Pasook Sitthilok
collection DOAJ
description <h4>Background</h4>Cerebral venous sinus thrombosis (CVST) is a rare type of thrombosis that affects the cerebral venous system. The data on neurological outcomes are limited.<h4>Objectives</h4>This study aimed to investigate the neurological outcomes of CVST, contributing factors, clinical presentation, treatment and mortality.<h4>Methods</h4>This was a single-center, retrospective study at a university-based referral hospital in Thailand. Consecutive patients diagnosed with CVST between January 2010 and December 2020 were included. Outcomes were neurological outcomes measured by modified Rankin Scale (mRS), anticoagulant treatment, recurrence, and mortality.<h4>Results</h4>One hundred and seven CVST patients were included with a mean age (± SD) of 42.7 ± 20.4 years. Following the treatment, neurological outcomes significantly improved, with the proportion of patients with mRS 0-1 increasing from 18.7% at diagnosis to 83.2% and 85.1% at three and six months, respectively (P < 0.001). Clinical variables were associated with residual neurological symptoms (mRS≥1) included age ≥ 50 years (OR 4.1, 95% CI; 1.7-9.4, P 0.001), male sex (OR 3.0, 95%CI; 1.4-6.6, P 0.006), the thrombus involvement in deep sinus system (OR 6.1, 95%CI; 1.1-76.9, P 0.04) and cerebral vein and dural sinus thrombosis (CVT) risk score ≥ 1 (OR 3.1, 95%CI; 1.3-7.5, P 0.014). Patients whose CVST was associated with hormonal therapy were found to have a lower risk of residual neurological symptoms (OR 0.2, 95%CI 0.1-0.6, P 0.004). Hormonal therapy was associated with anticoagulant discontinuation (OR 2.7, 95% CI 1.1-7.0; P = 0.04). The presence of malignancy increased the risk of bleeding (OR 5.8, 95% CI 1.4-24.1; P 0.016). Overall mortality was 2.8%. Of which 50% were related to major bleeding.<h4>Conclusions</h4>A significant improvement in neurological outcomes was observed at 3 and 6 months after diagnosis. Older age, male sex, thrombus involvement in deep sinus system were associated with residual neurological symptoms.
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spelling doaj-art-2eec89419b424406a245f5a1c07cc00a2025-08-20T03:31:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031684910.1371/journal.pone.0316849Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.Pasook SitthilokPiangrawee NiprapanAdisak TantiworawitTeerachat PunnachetNonthakorn HantrakunPokpong PiriyakhuntornThanawat RattanathammetheeSasinee HantrakoolEkarat RattarittamrongLalita NorasetthadaChatree Chai-Adisaksopha<h4>Background</h4>Cerebral venous sinus thrombosis (CVST) is a rare type of thrombosis that affects the cerebral venous system. The data on neurological outcomes are limited.<h4>Objectives</h4>This study aimed to investigate the neurological outcomes of CVST, contributing factors, clinical presentation, treatment and mortality.<h4>Methods</h4>This was a single-center, retrospective study at a university-based referral hospital in Thailand. Consecutive patients diagnosed with CVST between January 2010 and December 2020 were included. Outcomes were neurological outcomes measured by modified Rankin Scale (mRS), anticoagulant treatment, recurrence, and mortality.<h4>Results</h4>One hundred and seven CVST patients were included with a mean age (± SD) of 42.7 ± 20.4 years. Following the treatment, neurological outcomes significantly improved, with the proportion of patients with mRS 0-1 increasing from 18.7% at diagnosis to 83.2% and 85.1% at three and six months, respectively (P < 0.001). Clinical variables were associated with residual neurological symptoms (mRS≥1) included age ≥ 50 years (OR 4.1, 95% CI; 1.7-9.4, P 0.001), male sex (OR 3.0, 95%CI; 1.4-6.6, P 0.006), the thrombus involvement in deep sinus system (OR 6.1, 95%CI; 1.1-76.9, P 0.04) and cerebral vein and dural sinus thrombosis (CVT) risk score ≥ 1 (OR 3.1, 95%CI; 1.3-7.5, P 0.014). Patients whose CVST was associated with hormonal therapy were found to have a lower risk of residual neurological symptoms (OR 0.2, 95%CI 0.1-0.6, P 0.004). Hormonal therapy was associated with anticoagulant discontinuation (OR 2.7, 95% CI 1.1-7.0; P = 0.04). The presence of malignancy increased the risk of bleeding (OR 5.8, 95% CI 1.4-24.1; P 0.016). Overall mortality was 2.8%. Of which 50% were related to major bleeding.<h4>Conclusions</h4>A significant improvement in neurological outcomes was observed at 3 and 6 months after diagnosis. Older age, male sex, thrombus involvement in deep sinus system were associated with residual neurological symptoms.https://doi.org/10.1371/journal.pone.0316849
spellingShingle Pasook Sitthilok
Piangrawee Niprapan
Adisak Tantiworawit
Teerachat Punnachet
Nonthakorn Hantrakun
Pokpong Piriyakhuntorn
Thanawat Rattanathammethee
Sasinee Hantrakool
Ekarat Rattarittamrong
Lalita Norasetthada
Chatree Chai-Adisaksopha
Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.
PLoS ONE
title Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.
title_full Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.
title_fullStr Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.
title_full_unstemmed Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.
title_short Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study.
title_sort clinical course and neurological outcomes of cerebral venous sinus thrombosis a single center retrospective observational study
url https://doi.org/10.1371/journal.pone.0316849
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