Predictors of outcome of cerebral venous sinus thrombosis at a tertiary care centre in Central India
Cerebral venous sinus thrombosis (CVST) is a less common cause of stroke when compared to arterial thrombosis but its clinical presentation is varied and atypical. Early diagnosis may prevent morbidity & mortality which in untreated cases has been reported as 13.8 -48%.
Materials and Methods: This prospective observational study included 40 radiologically diagnosed cases of CVST, to evaluate the predictors of outcome by using modified Rankin’s Scale (mRS). The primary outcome measure was death or dependency at the end of 12 weeks.
Results: Of 40 patients, 18 cases (45.5%) had mRS 0-3 & 22(55%) had mRS >3. Mean age of the cases was 32.22 yrs with M:F= 1: 0.81. Purperium was the commonest risk factor. In univariate analysis, Age>30(p==0.10), Coma (p=0.010) and Cheyne stokes breathing (p-<0.001) were statistically significant predictors of poor outcome. On CT imaging haemorrhagic infarct & Deep venous sinus thrombosis was a significant predictor of poor outcome (p=<0.001). On multivariate analysis age>30, cerebral haemorrhage and Deep venous sinus thrombosis were the predictors of poor outcome. Rankin’s score of < 2 had good prognosis at 12 weeks follow up. Overall mortality was 15% at 12 weeks follow up.
Conclusion: CVST is an important cause of stroke in puerperium. Neuroimaging plays pivotal role in diagnosis. Modified Rankin’s scale is a simple score system risk stratification of patients with neurodeficit. Low MRS score at hospitalization is associated with better outcome at 12 weeks.
Keywords: Cerebral venous sinus thrombosis (CVST), modified Rankin’s scale (mRS) <2, good outcome.