Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients

The prognosis of cerebral venous sinus thrombosis (CVST) is variable, and o utcome may range from complete recovery to death. Prognostic factors to pre dict outcome in the acute phase of CVST have not been analysed in a prospec tive study Prognostic factors in patients enrolled in a clinical treatment trial were prospectively investigated. Poor outcome after 12 weeks, defined as death or dependency (Oxford handicap score greater than or equal to 3), was used as the principle outcome measure. Univariate relations between po ssible prognostic factors and outcome at 12 weeks were analyzed with chi (2 ) tests. Treatment and all factors associated with prognosis (p less than o r equal to 0.25) were forced into a logistic regression model with a forwar d selection procedure. Fifty nine patients (50 women, nine men) were studied, with a mean age of 3 7 years (range 18 to 80 years). After 12 weeks 10 patients (17%) had a poor outcome. The univariate identified factors related to poor outcome were pa pilloedema, altered consciousness, coma, age older than 33 years, diagnosti c delay less than or equal to 10 days, intracerebral haemorrhage, and invol vement of the straight sinus. Isolated intracranial hypertension and a delt a sign on CT were associated with good outcome. In the multivariate analysi s coma and cerebral haemorrhage were significantly associated with a poor o utcome, with odds ratios of 8.2 (95% confidence interval (95% CI) 1.3-50.1) and 20.7 (95% CI 1.6-264.3) respectively. Involvement of the straight sinu s was also weakly, but not significantly, associated with poor outcome. In conclusion, coma and intracerebral haemorrhage are independent predictors f or poor outcome of CVST.