Do the Risk Factors Determine the Severity and Outcome of Cerebral Venous Sinus Thrombosis

We report the burden of risk factors in cerebral venous sinus thrombosis (CVST) and its relationship with the clinical severity, extent of MRI and MRV abnormality, and outcome. One hundred and twenty-eight consecutive patients with CVST were included. Their demographic, presenting symptoms and neurological findings were noted and risk factors of CVST were evaluated. The outcomes were assessed using modified Rankin Scale (mRS). Based on the risk factors, the patients could be categorized as prothrombotic conditions only in 46 (35.9%), prothrombotic with other risk factors in 36 (28.1%), non-prothrombotic risk factors in 20 (15.6%), and no risk factors in 26 (20.3%). More than two risk factors were present in 33 (25.8%). Sixteen out of 22 (72.7%) patients with female gender-specific risk factors also had other prothrombotic conditions. On MRV, more than two sinuses were involved in 35 (27.3%) patients and 94 (73.4%) patients had parenchymal lesions on MRI. Thirty-one (24.2%) patients had poor outcome (mRS > 2) at discharge and 25/122 (20.5%) at 3 months. The number of risk factors was not related to clinical severity and extent of MRI or MRV abnormality. On multivariate analysis, age (OR 1.05, 95%CI 1.00–1.09, P = 0.03), GCS score (OR 5.30, 95%CI 1.25–22.24, P = 0.02), and mechanical ventilation (OR 196.17, 95%CI 16.05, P = 0.001) predicted the outcome at 3 months.