Clinical Features And Short-term Prognosis Of Brain Lesions Secondary To Cerebral Venous Sinus Thrombosis

Objective To explore the clinical features,risk factors and short-term prognosis of brain lesions secondary to cerebral venous sinus thrombosis(CVST),and to improve the understanding of brain lesions secondary to CVST.Methods Clinical data of 125 patients with CVST admitted to the First Affiliated Hospital of Guangxi Medical University from April 2012 to October 2018 were collected,and 51 patients in the group without brain lesions(group A)and 74 patients in the group with secondary brain lesions(group B)were grouped according to CT or MRI signs of the brain.Then,according to the mRS score of patients at discharge or 30 days in hospital,74 patients with secondary brain lesions were divided into the group with good prognosis(group C),58 patients,and the group with poor prognosis(group D),16 patients.Their clinical data were analyzed retrospectively.Results The brain lesions secondary to CVST were mostly seen in the frontal and parietal lobes,among which the most common lesion was the parietal lobe lesion(36.49%),followed by the frontal lobe lesion(29.73%).Compared with the group without brain lesions,patients with secondary brain lesions were more likely to suffer from mental retardation,epilepsy,limb weakness,sensory disturbance and coma symptoms,had higher NIHSS score at admission and longer mean length of hospital stay,the plasma D-dimer and fibrinogen level were higher,and the short-term prognosis was worse,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that the higher the fibrinogen level,the greater the risk of secondary brain lesions in patients with CVST(OR=1.941,95%CI :1.294-2.913)and the risk of secondary brain lesions in puerperal CVST patients was lower than that in non-puerperal patients(OR=0.083,95%CI:0.008-0.893).Among the 74 patients with secondary brain lesions,compared with those with good short-term prognosis,those with poor short-term prognosis had more acute onset of disease,higher proportion of puerperium and infection,and were still prone to coma,higher NIHSS score,lower GCS score and higher platelet count at admission,the difference was statistically significant(P<0.05).Multivariate logistic analysis showed that the higher the NIHSS score on admission,the worse the short-term prognosis of patients with CVST secondary brain lesions was(OR=1.221,95%CI:1.022-1.459).Conclusion 1.Brain lesions secondary to CVST were more common in the frontal parietal lobe.Patients with secondary brain lesions had more severe clinical symptoms,more obvious elevation of plasma d-dimer and fibrinogen,and worse short-term prognosis.2.The higher the fibrinogen level,the greater the risk of secondary brain lesions in patients with CVST and the risk of secondary brain lesions in puerperal CVST patients was lower than that in non-puerperal patients.3.The higher the NIHSS score on admission,the worse the short-term prognosis of patients with secondary brain lesions after CVST.