Recanalization and its correlation to outcome after cerebral venous thrombosis

Abstract 

Background

Only few small studies have assessed rates of recanalization and impact of recanalization on outcome in patients after cerebral vein thrombosis (CVT).

Methods

In this retrospective cohort study, we included 91 consecutive patients—treated in Helsinki University Central Hospital—who had non-invasively verified CVT and follow-up imaging at 4months or later, or autopsy. We categorized vessel status at follow-up as complete, partial, or no recanalization. A complete recovery was defined as a score of 0 on the modified Rankin Scale.

Results

Of the 91 patients (median age, 36years; 70% females), 43 (47%) achieved complete recanalization, in 31 (34%) patients recanalization was partial, and 17 (19%) had no recanalization. Males, patients aged ≥37years, and those with no identified risk factors for CVT had more frequently partial or no recanalization. Patients aged ≥37years, those with chronic onset of symptoms (>30days), and those with no recanalization had worse outcome in univariate analysis. Only increasing age associated with no recanalization (OR, 1.04; 95% CI, 1.01–1.08) when adjusted for age, sex, and number of causes for CVT. Increasing age (OR 1.05; 95% CI 1.01–1.09) and chronic mode of onset (OR 9.41; 95% CI 1.02–87.07) predicted incomplete recovery or death when adjusted for age, sex, mode of onset, and status of recanalization. Headache was more common in patients with no recanalization (44%).

Conclusions

Half of the patients after CVT had complete recanalization. Despite the univariate association, recanalization did not associate with poor outcome in multivariate analysis. However, residual headache was more common in those with no recanalization.

Keywords: Cerebral veins, Magnetic resonance imaging, Outcome, Recanalization, Sinus thrombosis