Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla 90110, Thailand.
Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla 90110, Thailand.
Clin Neurol Neurosurg. 2024 Jan;236:108109. doi: 10.1016/j.clineuro.2023.108109. Epub 2024 Jan 2.
Studies focusing on intracranial hemorrhage (ICH) in patients with cerebral venous thrombosis (CVT) are limited; thus, we aimed to identify factors associated with the occurrence of ICH in Thai patients with CVT.
This retrospective cohort study recruited patients with CVT admitted to a tertiary university-based hospital between 2002 and 2022. The baseline characteristics, clinical presentations, radiographic findings, and etiologies were compared between the ICH and non-ICH groups. The factors with p < 0.2 in the univariate analysis were further analyzed using multivariable logistic regression analysis to identify independent factors associated with ICH in patients with CVT.
Of 228 screenings, 202 patients were eligible. The incidence rate of ICH was 36.63%. The ICH group showed a higher prevalence of focal neurological deficits (63.51% vs. 26.56%, p < 0.001), seizures (68.92% vs. 21.88%, p < 0.001), dependency status at admission (60.81% vs. 39.84%, p = 0.004), superior sagittal sinus thrombosis (71.62% vs. 39.07%, p < 0.001), superficial cortical vein thrombosis (36.49% vs. 10.16%, p < 0.001), and hormonal use (17.57% vs. 7.03%, p = 0.021) than the non-ICH group. In contrast, the ICH group showed a lower prevalence of isolated increased intracranial pressure (10.81% vs. 21.88%, p = 0.048) than the non-ICH group. Seizures (adjusted odds ratio [aOR], 4.537; 95% confidence interval [CI], 2.085-9.874; p < 0.001), focal neurological deficits (aOR, 2.431; 95% CI, 1.057-5.593; p = 0.037), and superior sagittal sinus thrombosis (aOR, 1.922; 95% CI, 1.913-4.045; p = 0.045) were independently associated with ICH in the multivariable logistic regression analysis.
Seizures, focal neurological deficits, and superior sagittal sinus thrombosis are associated with ICH in patients with CVT.
针对颅内出血（ICH）在脑静脉血栓形成（CVT）患者中的研究有限；因此，我们旨在确定泰国 CVT 患者ICH 发生的相关因素。
本回顾性队列研究纳入了 2002 年至 2022 年间在一家三级大学附属医院住院的 CVT 患者。ICH 组和非 ICH 组比较了基线特征、临床表现、影像学发现和病因。单因素分析中 p 值<0.2 的因素进一步采用多变量 logistic 回归分析，以确定 CVT 患者 ICH 的独立相关因素。
经过 228 次筛查，202 名患者符合条件。ICH 的发生率为 36.63%。ICH 组更常见局灶性神经功能缺损（63.51%比 26.56%，p<0.001）、癫痫发作（68.92%比 21.88%，p<0.001）、入院时依赖状态（60.81%比 39.84%，p=0.004）、上矢状窦血栓形成（71.62%比 39.07%，p<0.001）、皮质浅静脉血栓形成（36.49%比 10.16%，p<0.001）和激素使用（17.57%比 7.03%，p=0.021）。相比之下，ICH 组孤立性颅内压升高的发生率较低（10.81%比 21.88%，p=0.048）。癫痫发作（调整后的优势比[aOR]，4.537；95%置信区间[CI]，2.085-9.874；p<0.001）、局灶性神经功能缺损（aOR，2.431；95%CI，1.057-5.593；p=0.037）和上矢状窦血栓形成（aOR，1.922；95%CI，1.913-4.045；p=0.045）在多变量逻辑回归分析中与 ICH 独立相关。
癫痫发作、局灶性神经功能缺损和上矢状窦血栓形成与 CVT 患者的 ICH 相关。
