Outcome Of Cerebral Venous Thrombosis Research Articles

Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States.

Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT). The 2016-2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality. Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes. Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.

Frequency and outcome of cerebral venous thrombosis attributed to oral contraceptive pills

Background: Oral contraceptive (OCP) use is a significant risk factor for cerebral venous thrombosis (CVT). There is limited research on its association with CVT development in Islamic countries. Therefore, our study aimed to assess the risk of different OCPs in developing CVT and their prognosis. Methods: This is an observational retrospective single-center cohort study that included CVT patients between March 2018 and March 2021. All CVT participants were registered in the organized registry system (CVT registry code: 9001013381) at the Neurology Research Center of Shiraz University of Medical Science. Univariate analysis and multivariable binary logistic regression modeling were applied to determine the associated factors leading to poor outcome. Results: A total of 204 patients (139 women, 65 men) were enrolled in the study. Seventy-four females (53.25% of total female patients) used OCPs, with second-generation OCPs being the most commonly used type (70%). OCP consumption was associated with a lower mortality rate (P=0.004, aOR=11.732) and a better 3-month follow-up outcome (p=0.001, aOR=9.882) than their female counterparts who did not use OCPs. The duration and generation of OCPs did not affect the follow-up outcome (P=0.148, P=0.428, respectively) or mortality (P=0.555, P=0.569, respectively). In multivariable analysis, the use of OCPs was a predictor of a favorable 3-month follow-up outcome in females (aOR =4.423, 95% CI: 0.423-46.248). Conclusion: These results suggest that OCPs may have a positive impact on the prognosis of CVT in women. However, further research is required to understand the underlying mechanisms and validate these findings.

Outcome of cerebral venous thrombosis in a critically Ill COVID-19 infected patient: A case report

Outcome of cerebral venous thrombosis in a critically Ill COVID-19 infected patient: A case report

Abstract 131: Trends in Cerebral Venous Thrombosis: Analysis of the National Inpatient Sample 2016‐2020

Introduction Cerebral venous thrombosis (CVT) is an uncommon form of stroke with relatively low mortality but higher incidence in younger adults.1–3 Previous work has suggested decreased overall stroke hospitalization volumes, but preserved CVT hospitalization volumes and increased CVT mortality during the COVID‐19 pandemic.4,5 We sought to provide updated incidence and trend data for cerebral venous thrombosis (CVT) in the United States from 2016‐2020, examine the impact of the COVID‐19 pandemic on CVT, and identify predictors of in‐hospital mortality. Methods Validated ICD‐10 codes were used to identify patients with CVT in the National Inpatient Sample (NIS) between 2016 and 2020. The NIS is part of the Healthcare Cost and Utilization Project (HCUP) and is maintained the Agency for Healthcare Research and Quality. The NIS provides a stratified nationally representative 20% sample of all hospital discharges in the United States, excluding rehabilitation and long‐term acute care hospitals. Annual updates to the NIS are released approximately 20 months after the conclusion of the data year. Sample weights were applied to generate nationally representative estimates, and census data were used to compute incidence rates. The first wave of the COVID‐19 pandemic was defined as January‐May 2020. Predictor variables for mortality were selected based upon previous studies of incidence and outcomes of CVT and biological plausibility.6–8 Multivariable logistic regression was conducted using all predictor variables that achieved p<0.10 in univariable regression. Trend analysis was completed using Joinpoint regression. Results From 2016 to 2020, the incidence of CVT increased from 24.34 per 1,000,000 population per year (MPY) to 33.63 per MPY (Annual Percentage Change (APC) 8.6%; p<0.001). CVT incidence was higher in women than men (37.07 per MPY vs 30.10 per MPY) and the rate of increase was also higher in women (APC 10.1% vs APC 6.8%). Racial differences in incidence rate increases were noted, with incidence increasing by 9.8% annually for White patients, 16.1% for Black patients, and 6.7% for Hispanic patients. All‐cause in‐hospital mortality was 4.9% [95% CI 4.5‐5.4]. On multivariable analysis, use of thrombectomy, increased age, atrial fibrillation, stroke diagnosis, infection, presence of prothrombotic hematologic conditions, and male sex were associated with in‐hospital mortality. CVT incidence was similar comparing the first 5 months of 2020 and 2019 (31.37 vs 32.04; p=0.322) with no difference in median NIHSS (2 [IQR 1‐10] vs. 2 [1‐9]; p=0.959) or mortality (4.2% vs. 5.6%; p=0.176). Mortality was 6.7% [2.3‐17.9] in patients with both CVT and COVID (vs. no COVID 5.5% [4.6‐6.6]; p=0.705). Conclusion CVT incidence increased in the US from 2016 to 2020 while mortality did not change. CVT incidence was higher in women and Black patients. Increased age, prothrombotic state, stroke diagnosis, infection, atrial fibrillation, male sex, and use of thrombectomy were associated with in‐hospital mortality following CVT. During the first wave of the COVID‐19 pandemic, CVT volumes and mortality were similar to the prior year.

A Study of Clinico-Radiological Profile and Outcomes of Cerebral Venous Thrombosis

ABSTRACT Background: Cerebral venous thrombosis (CVT) includes highly variable clinical presentations ranging from headache to coma. It often affects young to middle-aged patients. Early diagnosis and treatment improve outcomes. Outcome determinant factors are the extent of the disease, jugular occlusion, spread to deep or cortical veins, level of sensorium at onset, background factors, and presence of raised intracranial pressure. Objectives: This study aims to study the clinical profile, radiological features, and outcomes of CVT. Materials and Methods: Fifty-seven patients admitted to SSIMS&RC, Davangere, clinically suspected of CVT, were subjected to neuroimaging techniques, patients with a confirmed diagnosis of CVT (radiologically) were recruited by simple random sampling, and data collected was analyzed by correlational studies. Follow-up was done until 6 months. Results: Of the 57 patients, 30 (53%) were females and 27 (47%) were males, with a maximum incidence of 84% in the age group 18–40 years. The most common symptoms were headache (86%), seizures (65%), focal deficits (58%), and altered sensorium (52.6%). Radiologically, the most common sinus involved was the superior sagittal sinus 72%. In total, out of 57 patients, 6 patients died during hospitalization. Out of the surviving patients, 39 patients (70%) had a complete recovery. Poor prognostic factors were stupor and coma on admission and evidence of hemorrhagic infarction in the primary computed tomography (CT) scan. Conclusion: Compared to the previous studies, the prevalence of CVT was higher in women. Clinical manifestations, prognostic factors, “commonly involved sinuses,” and “image findings of this study” were similar to those of other studies. The overall prognosis was good, but a small percentage of patients died.

Clinical and prognostic characteristics of cerebral venous thrombosis at high altitude: a single-center retrospective study of Tibet.

Data regarding diagnosis, management, and prognosis of patients with cerebral venous thrombosis (CVT) from high altitude are limited. The aim of the present study is to identify the clinical features, risk factors, and outcomes of cerebral venous thrombosis (CVT) in Tibet. We retrospectively included patients with a diagnosis of CVT consecutively admitted to Tibet Autonomous Region People's Hospital between July 2015, and September 2022. The risk factors, clinical and radiological presentations, treatment and outcomes were analyzed. A total of 38 patients with CVT were included in this study. The median age was 31years, and females accounted for 63.2%. Patients of Tibetan nationality accounted for 71.1% (n = 27) and the median altitude of residence in Tibet was 3800m (3657, 4054). Headache was the most common symptom (92.1%). The most common risk factors of CVT were infection in the past 4weeks (34.2%) and pregnancy or puerperium (23.7%). Lateral sinus (transverse and/or sigmoid sinus) (68.4%) and superior sagittal sinus (55.3%) were the most commonly involved. The D-dimer increased in 31 patients (81.6%). All three patients who died in hospital and during follow-up had risk factor of recent infection. Favorable outcome at follow-up with a median length of 454days (189, 1059) was observed in 85.3% of patients. CVT at high altitude is more common in young patients and women, with various clinical manifestations and risk factors. Recent infection is the most common risk factor and may increase the mortality of CVT at high altitude. The long-term prognosis of CVT at high altitude is favorable.

Outcome of Cerebral Venous Thrombosis in a Critically Ill CoVID-19 Infected Patient: A Case Report

Outcome of Cerebral Venous Thrombosis in a Critically Ill CoVID-19 Infected Patient: A Case Report

Outcome Prediction in Cerebral Venous Thrombosis: The IN-REvASC Score.

BackgroundWe identified risk factors, derived and validated a prognostic score for poor neurological outcome and death for use in cerebral venous thrombosis (CVT). Methods We performed an international multicenter retrospective study including consecutive patients with CVT from January 2015 to December 2020. Demographic, clinical, and radiographic characteristics were collected. Univariable and multivariable logistic regressions were conducted to determine risk factors for poor outcome, mRS 3-6. A prognostic score was derived and validated. Results A total of 1,025 patients were analyzed with median 375 days (interquartile range [IQR], 180 to 747) of follow-up. The median age was 44 (IQR, 32 to 58) and 62.7% were female. Multivariable analysis revealed the following factors were associated with poor outcome at 90- day follow-up: active cancer (odds ratio [OR], 11.20; 95% confidence interval [CI], 4.62 to 27.14; P<0.001), age (OR, 1.02 per year; 95% CI, 1.00 to 1.04; P=0.039), Black race (OR, 2.17; 95% CI, 1.10 to 4.27; P=0.025), encephalopathy or coma on presentation (OR, 2.71; 95% CI, 1.39 to 5.30; P=0.004), decreased hemoglobin (OR, 1.16 per g/dL; 95% CI, 1.03 to 1.31; P=0.014), higher NIHSS on presentation (OR, 1.07 per point; 95% CI, 1.02 to 1.11; P=0.002), and substance use (OR, 2.34; 95% CI, 1.16 to 4.71; P=0.017). The derived IN-REvASC score outperformed ISCVT-RS for the prediction of poor outcome at 90-day follow-up (area under the curve [AUC], 0.84 [95% CI, 0.79 to 0.87] vs. AUC, 0.71 [95% CI, 0.66 to 0.76], χ2 P<0.001) and mortality (AUC, 0.84 [95% CI, 0.78 to 0.90] vs. AUC, 0.72 [95% CI, 0.66 to 0.79], χ2 P=0.03). Conclusions Seven factors were associated with poor neurological outcome following CVT. The INREvASC score increased prognostic accuracy compared to ISCVT-RS. Determining patients at highest risk of poor outcome in CVT could help in clinical decision making and identify patients for targeted therapy in future clinical trials.

Outcomes of Cerebral Venous Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase.

Background:Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization.Methods:We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0–2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization).Results:Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94–194). Two patients died during follow-up (3% [95% CI, 1%–11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%–94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed).Conclusions:In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.

Clinical Profile and Short-Term Outcome of Cerebral Venous Thrombosis in a Nepalese Population: A Retrospective Study

Introduction: Cerebral venous thrombosis (CVT) is a rare cause of stroke. The increased awareness among the physicians and the suspiciousness of the myriad of its clinical presentation with increased availability of investigation modules and therapeutic options has led to a decrement of mortality and morbidity. The study intends to assess the clinical etiological profile of patients of CVT and also to assess short-term outcomes and if any factors are associated with it. Methods: It was a hospital-based retrospective, observational cross-sectional study at a tertiary care center in Kathmandu among adult CVT patients from August 2019 to August 2021. Clinical, etiological, and radiological data, the outcome at discharge, and any factors influencing this were assessed where possible. Data were analyzed using SPSS 25 software. Analysis of the descriptive data was performed and independent factors influencing short-term outcome (admission date &lt; 7 days) were analyzed. Results: There were a total of 15 cases included in the study. The study showed female predominance (66.7%. The mean age of the patients was 48.87 years. Four (26.7%) patients had hypertension. The history of oral contraceptive pill (OCP) use was among five (33.33%) females. A significant association was present with direct signs in CT scan (p=0.02), and low erythrocyte sedimentation rate (ESR), p= (0.02). Conclusions: OCP and hypertension are increasingly recognized as independent risk factors for CVT. The presence of direct signs in the CT head and the presence of high ESR have independent predictive value in assessing short-term outcomes.

Neutrophil-to-lymphocyte Ratio Predicts the Outcome of Cerebral Venous Thrombosis.

Increasing evidences suggest that Neutrophil-to-Lymphocyte Ratio (NLR) is an independent predictor of poor prognosis in patients with cardiovascular disease. However, the relationship between NLR and prognosis in patients with Cerebral Venous Thrombosis (CVT) has not been studied. Consecutive CVT patients from November 2011 through April 2019 were retrospectively identified. Poor outcome was defined as a modified Rankin Scale (mRS) of 3-6. Multivariate regression analysis was conducted to assess the relationship between total and differential leukocyte counts, NLR and clinical outcome in CVT patients. The Receiver Operating Characteristic (ROC) analysis was further performed to evaluate the ability to predict mortality, and subgroup analysis was conducted to explore the potential interaction effects. A total of 360 CVT patients were included, and the median duration of follow-up was 9.0 months. Multivariate logistic regression analysis suggested that NLR value, as a continuous variable, was significantly associated with a high risk of poor outcome (adjusted odds ratio [OR]=1.06, 95% confidence intervals [CI] 1.01-1.11, P = 0.013) and mortality (adjusted OR = 1.08; 95% CI, 1.03-1.14; P = 0.002). Compared with the total and differential leukocyte counts, the best discriminating variable to predict the risk of mortality was NLR, and the area under the receiver operating curve was 0.81. The optimal cut-off value of NLR to predict mortality was 5.6 (sensitivity 84.2%, specificity 69.9%). Multivariate Cox regression analysis indicated that the mortality rate was significantly higher in patients with a high NLR level group (>5.6) (adjust hazard ratio=5.65, 95% CI 2.33-12.73, P<0.001). There was no potential heterogeneity in the further subgroup analysis across age (above vs. below 45 years old), sex, history of infections and pregnancy/postpartum, presence of coma and intracerebral hemorrhage. Elevated NLR value is associated with a high risk of poor outcomes in CVT patients.

Low Diastolic Blood Pressure Predicts Good Clinical Outcome in Patients With Cerebral Venous Thrombosis.

Background: Cerebral venous thrombosis (CVT) refers to a stroke subtype characterized by the disturbance of cerebral venous outflow caused by venous thrombosis. Previous studies have reported a range of factors that predict the prognosis of CVT. This study is aimed to find out whether systolic blood pressure (SBP) and diastolic blood pressure (DBP) are suitable as potential indicators of the severity and clinical outcome in CVT patients.Methods: The CVT patients admitted to Xuanwu Hospital from January 2014 to December 2019 were enrolled. The severity of CVT was assessed by the National Institute of Health Stroke Scale (NIHSS) and intracranial pressure (ICP) at the time of admission. The modified Rankin score (mRS) was assessed at 6 months of follow-up.Results: One hundred fifty-six CVT patients were enrolled with a mean age of 35.8 ± 12.8 years. A percentage of 55.8% of the CVT patients recruited were female, and 17.3% were either pregnant or in perinatal period. Headache was the most common symptom. SBP and DBP were not correlated with NIHSS at admission. Furthermore, SBP and DBP had no impact on the disturbance of consciousness, epilepsy, intracranial hemorrhage, and mental disorders. However, SBP and DBP were positively correlated with ICP at admission. SBP > 129.5 mmHg and/or DBP > 77.5 mmHg suggested the presence of intracranial hypertension (IH). Based on current results, SBP was not correlated with mRS at 6 months of follow-up. However, DBP was found to be positively correlated with mRS at 6 months of follow-up. DBP in CVT patients with good prognosis was significantly lower than in those with poor prognosis. DBP > 79.5 mmHg was identified as a cutoff value to predict a poor clinical outcome. A higher mRS and a higher rate of poor clinical outcome were found in CVT patients with SBP > 146 mmHg or DBP > 79.5 mmHg compared to those with SBP ≤ 146 mmHg or DBP ≤ 79.5 mmHg.Conclusion: SBP > 129.5 mmHg and DBP > 77.5 mmHg suggested the presence of IH in CVT patients. DBP > 79.5 mmHg predicted a poor clinical outcome.

Outcomes of Cerebral Venous Thrombosis in Al-Yarmook Teaching Hospital

Background: Cerebral venous thrombosis (CVT) is a disease with multiple causes and has a low incidence rate. Seizure is one of the most common complications of CVT. The rate at which seizure occurs following CVT and the risk factors associated with that occurrence is a debated issue. Objectives: The aim of this study was to evaluate the incidence of seizure and its associated and risk factors for patients with CVT. Subjects and Methods: This was an observational study that included a total of 30 adult patients with CVT. Data, including age, sex, clinical manifestations such as fever, headache, vomiting, altered consciousness, and focal neurologic signs, such as sensory disturbances, were collected. Imaging findings that included hemorrhagic lesion, infarction, and thrombus site were also reported. Patients were followed up for 6 months from the initial diagnosis to recognize the development of seizures. Results: Within 6 months of follow-up, 13 (43.3%) patients developed generalized seizures, which was the most common type of CVT. The superior sagittal sinus (SSS) occlusion was recognized in 84.62% of patients with seizures and 48.06.5% in patients without seizures. Similarly, the right lateral sinus was occluded in 84.62% of patients with seizures as compared with 41.18% among those without seizures. Contraceptive use was reported in 61.54%of patients with seizures versus 17.65% in those without seizures with a significant difference. Conclusion: The involvement of SSS and lateral right sinus occlusion and use of contraceptives could be warning signs and a risk factor for the development of seizures in patients with CVT.

Impact of anticoagulation status on recanalization and outcome of cerebral venous thrombosis

Effective anticoagulation status may determine the recanalization and outcome of cerebral venous thrombosis (CVT). We report impact of anticoagulation status on recanalization and outcome of CVT. This is a retrospective study on 126 patients with CVT diagnosed on magnetic resonance venography (MRV). Their clinical features and risk factors were noted. The data were retrieved from a prospectively maintained registry, and international normalized ratio (INR) was noted after discharge till 3 months. All the patients were on acenocoumarol. Based on INR value, patients were categorized as Group A (effective anticoagulation INR within the therapeutic range or above) and Group B (ineffective anticoagulation INR > 50% below the therapeutic range). A repeat MRV at 3 months was done for recanalization. Outcome at 3 months was evaluated using modified Rankin Scale (mRS), and categorized as good (mRS ≤ 2) and poor (mRS 2 or more) 101(80.2%) patients were in group A and 25(19.8%) in group B. Their demographic, risk factors, magnetic resonance imaging (MRI) and MRV findings were comparable. On repeat MRV, recanalization occurred in 22/24(91.7%); 15(88%) in group A and 7(100%) in group B. Recanalization was independent of coagulation status. Seven (5.6%) patients died and 107(84.9%) had good outcome; 85(84.2%) in group A and 22(88%) in group B. Kaplan Meier analysis also did not reveal survival or good outcome benefits between the groups. In CVT, outcome and recanalization at 3 months are not dependent on coagulation status. Further prospective studies are needed regarding duration of anticoagulant and its impact on recanalization and outcome.

Cerebral Venous Thrombosis in Sub-Saharan Africa: A Systematic Review

BackgroundThe clinical epidemiology of cerebral venous thrombosis (CVT) in Sub-Saharan Africa is unknown. Such information may be relevant for service planning, prevention and for adapting existing CVT management guidelines to that zone of the World. AimsSystematic review to describe the demography, associated conditions, clinical and neuroimaging features, treatment and outcome of CVT in Sub-Saharan Africa. Summary of reviewWe searched MEDLINE, Cochrane Database of Systematic Reviews, clinicaltrials.gov and reference lists of included studies for studies reporting original data on CVT in sub-Saharan Africa. We included 20 observational studies describing 287 CVT patients, 11 case reports (13 patients) and 9 case series (274 patients). All studies had a high risk of bias. In case series 58.6 % of the patients were female, the most common associated condition was infection (63.1%), followed by oral contraceptives (7.3%), pregnancy/puerperium (6.2 %), and prothrombotic conditions (2.2%). CT was the most common method to diagnose CVT (85%). Ninety-nine percent (101/102) of patients reported in case series after the year 2000 were anticoagulated. In case series, 21/210 with information (10 %) patients died in the acute phase, while 60/129 with information (46.5%) recovered without sequels. ConclusionsThe low number of reported CVT cases from Sub-Saharan Africa suggests that CVT is either infrequent, not diagnosed or not reported. Infection is the most common risk factor. Most CVT cases were confirmed by CT alone. Almost all patients reported after year 2000 received anticoagulation. Death rate was higher than in high income countries.

Neutrophil-to-lymphocyte Ratio Predicts the Outcome of Cerebral Venous Thrombosis

Neutrophil-to-lymphocyte Ratio Predicts the Outcome of Cerebral Venous Thrombosis

Bacterial meningitis complicated by cerebral venous thrombosis.

IntroductionCommunity-acquired bacterial meningitis may be complicated by cerebral venous thrombosis (CVT), but this has not systematically been studied.MethodsWe evaluated clinical characteristics and outcome of CVT in adults with community-acquired bacterial meningitis in a prospective nationwide cohort study of bacterial meningitis (2006–2018) in the Netherlands.ResultsCVT occurred in 26 of 2220 episodes with bacterial meningitis (1%). The diagnosis of CVT was made on the day of presentation in 15 patients (58%) and during hospital stay in 11 patients after a median of 6 days (IQR 2–7). Sinusitis or otitis was present in 16 of 24 patients (67%). Patients with CVT presented more often in a coma than those without CVT (53 vs. 18%; P = 0.001) and the clinical course was more often complicated by focal neurologic deficits (58 vs. 22%; P < 0.001). Twelve patients of 26 (46%) had parenchymal lesions on neuroimaging, of whom two (8%) were specific for CVT. The transverse sinus was most frequently thrombosed (18 of 26; 69%). Streptococcus pneumoniae was the most common causative pathogen, occurring in 17 of 26 patients (65%). Eleven patients (44%) received anticoagulant therapy with heparin and none of them developed intracerebral hemorrhage during admission. Unfavorable outcome, as defined as a score on the Glasgow Outcome Scale <5, occurred in 14 of 26 patients (54%) and 4 patients (15%) died.Discussion and conclusionCVT is a rare complication of bacterial meningitis and mainly occurs in patients with coma, ear, nose and throat infections, and focal neurologic deficits.

Cerebral Perfusion Associates with Short-term Clinical Outcomes of Cerebral Venous Thrombosis

Background: To investigate the predictive value of Arterial Spin Labeling (ASL) perfusion imaging for short-term clinical outcomes of cerebral venous thrombosis (CVT) patients.

Clinical and epidemiological profile of cerebral venous thrombosis. A Multicenter retrospective study in Aseer Region Saudi Arabi.

Objectives:To assess the epidemiological pattern and correlates with the clinical outcome of Cerebral venous thrombosis (CVT) in Abha, Kingdom of Saudi Arabia.Methods:A retrospective record-based cohort design was conducted including all patients admitted with diagnosis of CVT in 2 main tertiary hospitals in Aseer Region between 2015 to the end of 2018. The study hospitals were Aseer Central Hospital and Armed Forces Hospitals Southern Region. The data were collected by structured data sheets, including sociodemographic data. Assessment of known risk factors for CVT, clinical presentation, treatment received, and clinical outcome after treatment were extracted.Results:The study included 119 patients with CVT, whose ages ranged from 15 to 97 years, with a mean age of 35.5-+14.1 years. Majority of the patients were females (81.5%). Headache was the most presenting (82.4%) symptom, followed by vomiting (30.3%) and a decreased level of consciousness. Thirty-three cases (27.7%) had complications, and recanalization was recorded among 92 cases (94.8%) based on follow up vascular imaging.Conclusion:The study revealed that most of the cases of CVT had favorable clinical outcome and recanalization, especially those who had a shorter duration untildiagnosis. Young females were the most affected group.

Anticoagulation delay does not affect the functional outcome of cerebral venous thrombosis.

Available knowledge about the impact of anticoagulation delay on outcomes of patients with cerebral venous thrombosis (CVT) is limited. We therefore assessed the factors influencing anticoagulation delay and investigated the effect of this delay on outcomes of CVT patients. Anticoagulation delay was defined as the time interval between symptom onset and anticoagulation initiation. The primary outcome was a modified Rankin Scale (mRS) score > 2 at the final follow-up. A total of 164 eligible patients were included. The median anticoagulation delay was 9 days. Cerebral hemorrhage on admission neuroimaging correlated with earlier anticoagulation (p = 0.040). Anticoagulation delay was not associated with poor functional outcome (mRS > 2), but it was associated with residual headache across the entire cohort (earlier anticoagulation: 15/76 [19.7%] vs. later anticoagulation: 28/79 [35.4%]; p = 0.029) and in the subgroup with isolated intracranial hypertension (earlier anticoagulation: 4/25 [16.0%] vs. later anticoagulation: 14/27 [51.9%]; p = 0.007). Anticoagulation delay was found to be common among patients with CVT. Anticoagulation delay was not associated with poor functional outcome, but may have led to an increased risk of residual headache across our entire cohort and in the subgroup with isolated intracranial hypertension.