Department of Psychosomatic Medicine, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei 050000, China; Department of Neurology, The Second Hospital of Hebei Medical University, 215 West, Heping Road, Shijiazhuang, Hebei 050000, China.
Department of Neurology, The Second Hospital of Hebei Medical University, 215 West, Heping Road, Shijiazhuang, Hebei 050000, China.
J Clin Neurosci. 2022 Aug;102:95-100. doi: 10.1016/j.jocn.2022.06.009. Epub 2022 Jun 25.
This study identifies predictors of favourable intracranial venous collaterals and the effect of intracranial venous collaterals on outcomes and recanalization in patients with cerebral venous thrombosis (CVT). Data of 61 patients with CVT were retrospectively reviewed. Venous collateralization was defined as expanded cortical vein formation through different drainage pathways. Recanalization grades were classified into complete or partial recanalization based on images obtained during hospitalisation and follow-up. Independent predictors of collateral formation and poor prognosis were investigated via univariate and binary logistic regression analyses. The effects of different intracranial venous collaterals on recanalization in patients with CVT were assessed. A risk prediction nomogram for prognosis was constructed. Age ≤ 35 years (odds ratio (OR) = 7.067; 95% confidence interval (CI) = 1.776-28.277; P = 0.006) and male sex (OR = 5.490; 95% CI = 1.205-25.004; P = 0.028) were independent predictors of favourable venous collaterals. Venous collaterals were associated with early recanalization (P = 0.017) and not with long-term recanalization (P = 0.252). Male sex (OR = 0.047; 95% CI = 0.003-0.651; P = 0.023), subacute onset (OR = 0.026; 95% CI = 0.002-0.367; P = 0.007), and good collateral grade (OR = 0.168; 95% CI = 0.029-0.985; P = 0.048) were independent factors of favourable neurological outcomes at discharge. Haemorrhage on computed tomography at admission (OR = 10.868; 95% CI = 2.082-56.733; P = 0.005) was inversely correlated with prognosis. These findings suggested that male patients under 35 years of age are more likely to have favourable venous collaterals and good outcomes. Venous collaterals are significantly associated with early recanalization. These findings highlight the importance of venous collateral evaluation in patients with CVT.
这项研究旨在确定颅内静脉侧支循环良好的预测因素，以及颅内静脉侧支循环对脑静脉血栓形成（CVT）患者结局和再通的影响。回顾性分析了 61 例 CVT 患者的数据。静脉侧支循环定义为通过不同引流途径形成扩张的皮质静脉。根据住院和随访期间的图像，将再通程度分为完全或部分再通。通过单变量和二元逻辑回归分析探讨侧支形成和不良预后的独立预测因素。评估了不同颅内静脉侧支循环对 CVT 患者再通的影响。构建了用于预测预后的风险预测列线图。≤35 岁（优势比（OR）=7.067；95%置信区间（CI）=1.776-28.277；P=0.006）和男性（OR=5.490；95%CI=1.205-25.004；P=0.028）是静脉侧支循环良好的独立预测因素。静脉侧支循环与早期再通相关（P=0.017），但与长期再通无关（P=0.252）。男性（OR=0.047；95%CI=0.003-0.651；P=0.023）、亚急性发病（OR=0.026；95%CI=0.002-0.367；P=0.007）和良好的侧支循环分级（OR=0.168；95%CI=0.029-0.985；P=0.048）是出院时良好神经结局的独立因素。入院时 CT 显示出血（OR=10.868；95%CI=2.082-56.733；P=0.005）与预后呈负相关。这些发现表明，35 岁以下的男性患者更有可能出现良好的静脉侧支循环和良好的结局。静脉侧支循环与早期再通显著相关。这些发现强调了在 CVT 患者中评估静脉侧支循环的重要性。
