Clinical Features,Risk Factors And Prognosis Of Cerebral Venous Sinus Thrombosis In Pregnant And Puerperium Women

Objective: Cerebral venous sinus thrombosis(CVST)is a rare and serious complication during pregnancy and puerperium with a variety of clinical features.The purpose of the study is to investigate the clinical features,risk factors and prognosis of pregnancy and puerperium-related CVST.Method: A case-control study was used to identify the risk factors for pregnancy and puerperium-related CVST.Forty-one patients who were diagnosed with CVST during pregnancy or puerperium in our hospital from January 2007 to March 2018 were selected as the case group,while 164 cases of pregnant women without CVST in the same period were the control group.According to modified Rankin Scale(mRS)after4 weeks of symptom onset,forty-one patients were divided into good prognosis group(mRS?2)and poor prognosis group(mRS33).Independent risk factors and prognostic factors for CVST poor outcome were identified via multivariate logistic regression analysis.Results: Pregnancy and puerperium-related CVST were all acute or subacute onset,twenty-nine(71%)occurred during puerperium.Headache(37,90%)was found the most common clinical feature,followed by focal neurologic deficits(26,63%),seizures(24,59%),visual disorder(15,37%)and impaired consciousness(11,27%).Radiologic examinations revealed sigmoid sinus(24,59%),transverse sinus(22,54%),and superior sagittal sinus(21,51%)were the most common sinuses to be affected.The multivariate logistic analysis revealed anemia(OR=3.65,95%CI1.67-7.98)and preeclampsia/eclampsia(OR=11.14,95%CI 3.45-35.97)were independent risk factors for the formation of pregnancy and puerperium-related CVST.Intracerebral hemorrhage(OR=7.73,95%CI 1.30-45.89)and impaired consciousness(OR=15.04,95%CI 2.29-98.84)were independent prognostic factors of poor outcome during the acute phase.Conclusions: CVST often occurs during puerperium.The main clinicalmanifestations of pregnancy and puerperium-related CVST were headache,focal neurologic deficits,epileptic seizure,visual disorder,and impaired consciousness.Anemia and preeclampsia/eclampsia were independent risk factors for the formation of pregnancy-related CVST.Intracerebral hemorrhage and impaired consciousness could predict poor outcomes of pregnancy-related CVST.