Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Export

@article{citeulike:5104228, abstract = {BACKGROUND AND PURPOSE: The natural history and long-term prognosis of cerebral vein and dural sinus thrombosis (CVT) have not been examined previously by adequately powered prospective studies. METHODS: We performed a multinational (21 countries), multicenter (89 centers), prospective observational study. Patients were followed up at 6 months and yearly thereafter. Primary outcome was death or dependence as assessed by modified Rankin Scale (mRS) score >2 at the end of follow-up. RESULTS: From May 1998 to May 2001, 624 adult patients with CVT were registered. At the end of follow-up (median 16 months), 356 patients (57.1\%) had no symptom or signs (mRS=0), 137 (22\%) had minor residual symptoms (mRS=1), and 47 (7.5\%) had mild impairments (mRS=2). Eighteen (2.9\%) were moderately impaired (mRS=3), 14 (2.2\%) were severely handicapped (mRS=4 or 5), and 52 (8.3\%) had died. Multivariate predictors of death or dependence were age >37 years (hazard ratio [HR]=2.0), male sex (HR=1.6), coma (HR=2.7), mental status disorder (HR=2.0), hemorrhage on admission CT scan (HR=1.9), thrombosis of the deep cerebral venous system (HR=2.9), central nervous system infection (HR=3.3), and cancer (HR=2.9). Fourteen patients (2.2\%) had a recurrent sinus thrombosis, 27 (4.3\%) had other thrombotic events, and 66 (10.6\%) had seizures. CONCLUSIONS: The prognosis of CVT is better than reported previously. A subgroup (13\%) of clinically identifiable CVT patients is at increased risk of bad outcome. These high-risk patients may benefit from more aggressive therapeutic interventions, to be studied in randomized clinical trials.}, author = {Ferro, J. M. and Canh\~{a}o, P. and Stam, J. and Bousser, M. G. and Barinagarrementeria, F. and {}}, citeulike-article-id = {5104228}, citeulike-linkout-0 = {http://dx.doi.org/10.1161/01.STR.0000117571.76197.26}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/14976332}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=14976332}, comment = {Fink}, doi = {10.1161/01.STR.0000117571.76197.26}, issn = {1524-4628}, journal = {Stroke; a journal of cerebral circulation}, keywords = {stroke, syllabus}, month = {March}, number = {3}, pages = {664--670}, posted-at = {2009-07-10 10:29:08}, priority = {2}, title = {Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT).}, url = {http://dx.doi.org/10.1161/01.STR.0000117571.76197.26}, volume = {35}, year = {2004} }

TY - JOUR ID - citeulike:5104228 L3 - citeulike-article-id:5104228 N2 - BACKGROUND AND PURPOSE: The natural history and long-term prognosis of cerebral vein and dural sinus thrombosis (CVT) have not been examined previously by adequately powered prospective studies. METHODS: We performed a multinational (21 countries), multicenter (89 centers), prospective observational study. Patients were followed up at 6 months and yearly thereafter. Primary outcome was death or dependence as assessed by modified Rankin Scale (mRS) score >2 at the end of follow-up. RESULTS: From May 1998 to May 2001, 624 adult patients with CVT were registered. At the end of follow-up (median 16 months), 356 patients (57.1%) had no symptom or signs (mRS=0), 137 (22%) had minor residual symptoms (mRS=1), and 47 (7.5%) had mild impairments (mRS=2). Eighteen (2.9%) were moderately impaired (mRS=3), 14 (2.2%) were severely handicapped (mRS=4 or 5), and 52 (8.3%) had died. Multivariate predictors of death or dependence were age >37 years (hazard ratio [HR]=2.0), male sex (HR=1.6), coma (HR=2.7), mental status disorder (HR=2.0), hemorrhage on admission CT scan (HR=1.9), thrombosis of the deep cerebral venous system (HR=2.9), central nervous system infection (HR=3.3), and cancer (HR=2.9). Fourteen patients (2.2%) had a recurrent sinus thrombosis, 27 (4.3%) had other thrombotic events, and 66 (10.6%) had seizures. CONCLUSIONS: The prognosis of CVT is better than reported previously. A subgroup (13%) of clinically identifiable CVT patients is at increased risk of bad outcome. These high-risk patients may benefit from more aggressive therapeutic interventions, to be studied in randomized clinical trials. IS - 3 JF - Stroke; a journal of cerebral circulation SN - 1524-4628 EP - 670 TI - Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). VL - 35 SP - 664 KW - stroke KW - syllabus N1 - Fink AU - Ferro, JM AU - Canhão, P AU - Stam, J AU - Bousser, MG AU - Barinagarrementeria, F PY - 2004/03// UR - http://dx.doi.org/10.1161/01.STR.0000117571.76197.26 ER -