Recanalization and its correlation to outcome after cerebral venous thrombosis.
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 4 months 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, 36 years; 70% females), 43 (47%) achieved complete recanalization, in 31 (34%) patients recanalization was partial, and 17 (19%) had no recanalization. Males, patients aged > or =37 years, and those with no identified risk factors for CVT had more frequently partial or no recanalization. Patients aged > or =37 years, those with chronic onset of symptoms (>30 days), 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.
Putaala
Jukka
J
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. jukka.putaala@hus.fi
Hiltunen
Sini
S
Salonen
Oili
O
Kaste
Markku
M
Tatlisumak
Turgut
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin