Evaluation of Clinical, Radiological, and Demographic Characteristics of Juxtacortical Hemorrhages in Cerebral Venous Thrombosis

Abstract

Objective: Cerebral venous thrombosis (CVT) is a rare form of cerebrovascular disease. Intracranial hemorrhage may occur in 40% of the patients with CVT. The morphology of the intracranial hemorrhages ranges from small juxtacortical hemorrhages (JH) to large parenchymal hematomas. Although it has been suggested that JH is a characteristic of CVT, studies examining the relationship between JH and CVT are limited. In this study, it was aimed to determine the clinical, radiological, and demographic characteristics of JH in patients with CVT.

Materials and Methods: In this study, a total of 157 patients who were followed up with the diagnosis of CVT between 2015 and 2021 were included retrospectively. Patients were categorized as, those with and without JH. Variables associated with JH were determined by comparing the demographic, clinical, and radiological characteristics, CVT etiologies and clinical outcomes of the patients.

Results: When the clinical, demographic, and radiological characteristics of the patients with and without JH were compared; female gender (p=0.037), clinical initial symptom (0.003), early superior sagittal sinus (SSS) thrombosis (p<0.001), venous collateral scale (VCS) (p<0.001), being in the postpartum period (p=0.006), development of intracranial herniation (p<0.001), and poor clinical outcome (p<0.001) were significantly related with JH. When the significant variables were evaluated with the binary logistic regression, the most significant and independent variables were found to be SSS thrombosis (p=0.043), cortical vein thrombosis (CoVT) (p=0.010), and seizures after CVT (p=0.004). By contrast, no relationships were found between the groups in terms of VCS in binary logistic regression.

Conclusion: Diagnosis of CVT is possible with high clinical suspicion and correct interpretation of radiological imaging. JH could be detected with noncontrast cranial computed tomography, which is the first imaging modality, and may cause the clinician to suspect from SSS thrombosis and CoVT. More precise results could be obtained with the prospective multicenter studies.

Approval for the study was obtained from the Clinical Research Ethics Committee of Uludag University Faculty of Medicine dated 26 May, 2021 and numbered 2021-6/41.

Retrospective study

Externally and internally peer-reviewed.

Surgical and Medical Practices: Y.D., R.Ö., M.B., B.H., Concept: Y.D., R.Ö., M.B., B.H., Design: Y.D., R.Ö., M.B., B.H., Data Collection or Processing: Y.D., R.Ö., Analysis or Interpretation: Y.D., R.Ö., M.B., B.H., Literature Search: Y.D., R.Ö., Writing: Y.D., R.Ö.

No conflict of interest was declared by the authors.

The authors declared that this study received no financial support.