Krajíčková Dagmar, Král Jiří, Herzig Roman, Klzo Ľudovít, Krajina Antonín, Havelka Jaroslav, Šimůnek Libor, Vyšata Oldřich, Van Quang Tran, Bar Michal, Vališ Martin
Department of Neurology, Comprehensive Stroke Center, Charles University Faculty of Medicine and University Hospital, 500 05, Hradec Králové, Czech Republic.
Department of Neurology, University Hospital Ostrava and University of Ostrava Faculty of Medicine, 708 52, Ostrava, Czech Republic.
Sci Rep. 2020 Dec 10;10(1):21633. doi: 10.1038/s41598-020-78434-8.
We aimed was to assess the factors influencing therapy choice and clinical outcome after 3-4 months in patients with cerebral venous sinus thrombosis (CVST). In a retrospective, bi-centric study, the set consisted of 82 consecutive CVST patients (61 females; mean age 33.5 ± 15.7 years). Following data were collected: baseline characteristics, presence of gender-specific risk factors (GSRF), location and extent of venous sinus impairment, clinical presentation, type of treatment, recanalization, presence of parenchymal lesions, and clinical outcome after 3-4 months (assessed using the modified Rankin Scale [mRS], with excellent outcome defined as mRS 0-1). Multivariate logistic regression analysis was used for statistical evaluation. After 3-4 months, complete recovery was achieved in 41 (50%) and excellent clinical outcome in 67 (81.7%) patients. Female sex (OR 0.11; p = 0.0189) and presence of focal neurologic deficit (OR 0.16; p = 0.0165) were identified as significant independent negative predictors and, the presence of GSRF (OR 15.63; p = 0.0011) as significant independent positive predictor of excellent clinical outcome. In conclusion, in our CVST patients, the presence of GSRF was associated with excellent clinical outcome, while the female sex itself was associated with poorer clinical outcome.
我们旨在评估影响脑静脉窦血栓形成(CVST)患者3 - 4个月后治疗选择和临床结局的因素。在一项回顾性、双中心研究中,研究对象为82例连续的CVST患者(61例女性;平均年龄33.5±15.7岁)。收集了以下数据:基线特征、性别特异性危险因素(GSRF)的存在情况、静脉窦损伤的部位和范围、临床表现、治疗类型、再通情况、实质病变的存在情况以及3 - 4个月后的临床结局(使用改良Rankin量表[mRS]评估,良好结局定义为mRS 0 - 1)。采用多变量逻辑回归分析进行统计学评估。3 - 4个月后,41例(50%)患者实现完全康复,67例(81.7%)患者获得良好临床结局。女性(OR 0.11;p = 0.0189)和存在局灶性神经功能缺损(OR 0.16;p = 0.0165)被确定为显著的独立阴性预测因素,而GSRF的存在(OR 15.63;p = 0.0011)是良好临床结局的显著独立阳性预测因素。总之,在我们的CVST患者中,GSRF的存在与良好临床结局相关,而女性本身与较差临床结局相关。