Introduction: Cerebral venous thrombosis (CVT) is an uncommon cerebrovascular condition, which presents with a wide spectrum of symptoms' onset and clinical syndromes.
Hypothesis: We assessed the hypothesis that there is a correlation among the main clinical syndromes in CVT and the sites of venous occlusion; also we analyzed functional outcome on each clinical syndrome in the acute setting (30-days).
Methods: This is a retrospective analysis from a systematic database of hospitalized patients from January 1979 to December 2014. Univariate and adjusted multivariate models were used to evaluate in a first step, association between clinical syndromes and affected vessels, and in a second step functional outcome in the acute setting (30-day follow-up). Clinical syndromes were classified as: focal syndrome, encephalopathy, isolated intracranial hypertension, meningeal syndrome. Affected vessels were classified as isolated thrombosis or vessels combinations. Functional outcome was based on modified Rankin score (mRs) at 30- and 90-day (good functional outcome, mRs = 0-2).
Results: 467 confirmed CVT patients (81.6% women, median age: 29 years, IQR: 22-38 years). Isolated superior sagittal sinus (82.0%), lateral sinus (50.1%), and the combination of them (22.1%) were the most prevalent affected vessels. Good functional outcome was present in 359 (76.9%) and 394 (84.4%) of all patients, at 30- and 90-day respectively. Focal syndrome was associated with hemorrhagic (OR 11.8, 95% CI 5.59-25.0); encephalopathy with the combination of Vein of Galen + Straight sinus (OR 6.52, 95% CI 2.13-19.9); isolated intracranial hypertension was associated with the absence of parenchymal lesion (OR 71.8, 95% CI 25.1-205); meningeal syndrome was associated with the combination of deep and superficial venous thrombosis (OR 3.22, 95% CI 1.61-6.43). Good functional outcome at 30- and 90-day was mainly associated to absence of encephalopathy (HR 0.74) and absence of meningeal syndrome (HR 0.85).
Conclusions: Focal syndrome depends on the type of parenchymal lesion; encephalopathy depends on the compromise of deep venous system; the strongest associations for 30-day mortality were found on the presence of meningeal and focal syndromes.