A Study of Prognostic Scores to Predict the Outcome in Cerebral Venous Thrombosis

Abstract

Background:Cerebral Venous Thrombosis (CVT) is a multifactorial condition with wide clinical presentation. They have favourable prognosis but 15% die or become dependent. Hence, there is need for user friendly risk scoring system which helps in clinical decision making and predicting prognosis. Methods:The present study was a prospective observational study of CVT patients from April, 2018 to February, 2019 at Department of Neurology, King George Hospital, Andhra Medical College, Visakhapatnam, and followed up for three months. Patients with confirmed diagnosis of CVT based on history and radiological findings were studied. All the patients were assessed for CVT Grading Scale, CVST Scoring and CVT Risk Score. Results:Sixty-six CVT patients were enrolled with mean age of 32.4years. CVT Risk score can predict poor outcome if cut off score is above 3 with sensitivity of 92 % and specificity of 20 %. Prediction of prognosis and brain lesions by CVT risk score analysed by Fischer exact test is highly significant (p= 0.00). CVT Risk Score and CVT Grade Scale had high sensitivity in predicting prognosis at one and three months. CVT grading scale with mild scores had good outcome and those with severe grading had poor outcome. Conclusion:Prognostic Scores in Indian population was a novel study in CVT patients. Despite low specificity, it can be used to avoid unnecessary or dangerous intervention in low-risk patients and identifies high-risk patients with poor prognosis, who require intensive interventions, such as local IV thrombolysis and decompressive surgery.