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Background <p>Prognostic assessment in cerebral venous sinus thrombosis (CVST) is challenging because of heterogeneous clinical presentations. Systemic and local venous wall inflammation may contribute to CVST pathophysiology. This study evaluated systemic and central nervous system inflammatory biomarkers and dural sinus wall enhancement on MRI as prognostic markers for 6-month functional outcomes.</p> Methods <p>84 patients with first-ever acute CVST were enrolled. Blood and cerebrospinal fluid (CSF) samples and MRI scans (CE-MRV and MRBTI) were obtained within 7&#xa0;days of symptom onset. Follow-up clinical and neuroimaging assessments were performed at 6&#xa0;months. Inflammatory markers measured included IL-6, CRP, hs-CRP, serum IgA, and CSF IgA. Functional outcomes were evaluated using the modified Rankin Scale (mRS), with favorable outcomes defined as mRS ≤ 2 and unfavorable outcomes as mRS &gt; 2.</p> Results <p>44 patients achieved favorable outcomes and 40 had unfavorable outcomes. Baseline hs-CRP (3.11 ± 0.32 vs. 1.78 ± 0.31&#xa0;mg/L, <i>p</i> &lt; 0.001) and CSF IgA (0.27 ± 0.03 vs. 0.20 ± 0.02&#xa0;mg/dL, <i>p</i> = 0.025) were higher in the unfavorable group. Patients with persistent dural sinus wall enhancement had higher hs-CRP and CSF IgA levels and worse functional recovery. A composite predictive model integrating hs-CRP, CSF IgA, admission mRS, dural sinus wall enhancement, and risk factors achieved an AUC of 0.880 (95% CI 0.799–0.960), with 77.5% sensitivity and 93.2% specificity.</p> Conclusion <p>Sustained hs-CRP and CSF IgA, and persistent dural sinus wall enhancement, are associated with poor 6-month outcomes. These markers may serve as prognostic indicators for early identification of high-risk patients.</p>

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Predicting CVST outcomes via inflammatory biomarkers and dural enhancement

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月6日

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  • Mengqi Wang,
  • Guangyu Han,
  • Da Zhou,
  • Lina Jia,
  • Xunming Ji,
  • Ran Meng

摘要

Background

Prognostic assessment in cerebral venous sinus thrombosis (CVST) is challenging because of heterogeneous clinical presentations. Systemic and local venous wall inflammation may contribute to CVST pathophysiology. This study evaluated systemic and central nervous system inflammatory biomarkers and dural sinus wall enhancement on MRI as prognostic markers for 6-month functional outcomes.

Methods

84 patients with first-ever acute CVST were enrolled. Blood and cerebrospinal fluid (CSF) samples and MRI scans (CE-MRV and MRBTI) were obtained within 7 days of symptom onset. Follow-up clinical and neuroimaging assessments were performed at 6 months. Inflammatory markers measured included IL-6, CRP, hs-CRP, serum IgA, and CSF IgA. Functional outcomes were evaluated using the modified Rankin Scale (mRS), with favorable outcomes defined as mRS ≤ 2 and unfavorable outcomes as mRS > 2.

Results

44 patients achieved favorable outcomes and 40 had unfavorable outcomes. Baseline hs-CRP (3.11 ± 0.32 vs. 1.78 ± 0.31 mg/L, p < 0.001) and CSF IgA (0.27 ± 0.03 vs. 0.20 ± 0.02 mg/dL, p = 0.025) were higher in the unfavorable group. Patients with persistent dural sinus wall enhancement had higher hs-CRP and CSF IgA levels and worse functional recovery. A composite predictive model integrating hs-CRP, CSF IgA, admission mRS, dural sinus wall enhancement, and risk factors achieved an AUC of 0.880 (95% CI 0.799–0.960), with 77.5% sensitivity and 93.2% specificity.

Conclusion

Sustained hs-CRP and CSF IgA, and persistent dural sinus wall enhancement, are associated with poor 6-month outcomes. These markers may serve as prognostic indicators for early identification of high-risk patients.