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Open Access 01-12-2023 | Cerebral Sinus Venous Thrombosis | Research

A novel score to estimate thrombus burden and predict intracranial hypertension in cerebral venous sinus thrombosis

Authors: Zhongao Wang, Chaitu Dandu, Yibing Guo, Meini Gao, Duo Lan, Liqun Pan, Da Zhou, Yuchuan Ding, Xunming Ji, Ran Meng

Published in: The Journal of Headache and Pain | Issue 1/2023

Abstract

Background

Current methods to evaluate the severity of cerebral venous sinus thrombosis (CVST) lack patient-specific indexes. Herein, a novel scoring method was investigated to estimate the thrombus burden and the intracranial pressure (ICP) of CVST.

Methods

In this retrospective study from January 2019 through December 2021, we consecutively enrolled patients with a first-time confirmed diagnosis of CVST by contrast-enhanced magnetic resonance venography (CE-MRV) or computed tomography venography (CTV). In these patients, a comprehensive CVST-Score was established using magnetic resonance black-blood thrombus imaging (MRBTI) to estimate the thrombus burden semi-quantitatively. The relationship between CVST-Score and ICP was explored to assess the potential of using the CVST-score to evaluate ICP noninvasively and dynamically.

Results

A total of 87 patients were included in the final analysis. The CVST-Scores in different ICP subgroups were as follows: 4.29±2.87 in ICP<250mmH₂O subgroup, 11.36±3.86 in ICP =250-330mmH₂O subgroup and 14.99±3.15 in ICP>330mmH₂O subgroup, respectively (p<0.001). For patients with ICP ≤330mmH₂O, the CVST-Score was linearly and positively correlated with ICP (R²=0.53). The receiver operating characteristic (ROC) curves showed the optimal CVST-Score cut-off values to predict ICP ≥250mmH₂O and >330mmH₂O were 7.15 and 11.62, respectively (P<0.001). Multivariate analysis indicated CVST-Score as an independent predictor of ICP ≥250mmH₂O (odds ratio, 2.15; 95% confidence interval, 1.49-3.10; p<0.001).

Conclusions

A simple and noninvasive CVST-Score can rapidly estimate the thrombus burden and predict the severity of intracranial hypertension in patients with CVST. The CVST-Score can aid in evaluating therapeutic responses and avoiding unnecessary invasive procedures at long-term follow-up.

Graphical Abstract

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Title: A novel score to estimate thrombus burden and predict intracranial hypertension in cerebral venous sinus thrombosis
Authors: Zhongao Wang
Chaitu Dandu
Yibing Guo
Meini Gao
Duo Lan
Liqun Pan
Da Zhou
Yuchuan Ding
Xunming Ji
Ran Meng
Publication date: 01-12-2023
Publisher: Springer Milan
Keywords: Cerebral Sinus Venous Thrombosis
Intracranial Hypertension
Hypertension
Published in: The Journal of Headache and Pain / Issue 1/2023
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-023-01562-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A novel score to estimate thrombus burden and predict intracranial hypertension in cerebral venous sinus thrombosis

Abstract

Background

Methods

Results

Conclusions

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical Abstract

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