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. 2018 Nov 26;15(1):329.
doi: 10.1186/s12974-018-1369-0.

Inflammation is correlated with severity and outcome of cerebral venous thrombosis

Liyan Wang  1 , Jiangang Duan  2 , Tingting Bian  1 , Ran Meng  1 , Longfei Wu  1 , Zhen Zhang  1 , Xuxiang Zhang  3 , Chunxiu Wang  4 , Xunming Ji  5
Affiliations

Inflammation is correlated with severity and outcome of cerebral venous thrombosis

Liyan Wang et al. J Neuroinflammation. .

Abstract

Background: Few studies have suggested a relationship between inflammation and cerebral venous thrombosis (CVT). This retrospective study aimed to explore the changes in inflammation in different CVT stages and the correlation between inflammation and severity and outcome of CVT.

Methods: In total, 95 suitable patients with CVT and 41 controls were compared. Patients with CVT were divided into three groups. The inflammatory factors studied included hypersensitive C-reactive protein (Hs-CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood and immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) in the cerebrospinal fluid (CSF). The severity of CVT was evaluated with the modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), fundus condition, intracranial pressure (ICP), and complications on admission. The short-term outcome was evaluated with the mRS at discharge.

Results: The following results were obtained: (1) Inflammatory factor levels in patients with CVT were higher than those in the controls. (2) Inflammatory factor levels in the acute and subacute stages were significantly higher than those in the chronic stage (all P < 0.05). (3) Serum NLR and CSF IgM levels were positively related to baseline degree of disability (odds ratio [OR], 1.279, 95% confidence interval [CI] 1.009-1.621, P = 0.042; OR 1.402, 95% CI 1.036-1.896, P = 0.028). The Hs-CRP level was positively correlated with the baseline occurrence of seizure (OR 1.040, 95% CI 1.001-1.080, P = 0.043). The baseline serum NLR (r = 0.244, P = 0.017), CSF IgA (r = 0.615, P < 0.001), CSF IgM (r = 0.752, P < 0.001), and CSF IgG (r = 0.248, P = 0.015) levels were positively associated with NIHSS. (4) The baseline NLR was significantly associated with high risk of poor outcome at discharge (OR 1.339, 95% CI 1.097-1.784, P = 0.007). Moreover, the ROC showed that NLR ≥ 4.205 could better predict the poor outcome at discharge. The data were analyzed using SPSS.

Conclusions: Inflammation may develop after CVT and gradually decrease during the course. Inflammation was significantly correlated with severity on admission and short-term poor outcome at discharge in CVT.

Keywords: Cerebral venous thrombosis; Inflammation; Outcome; Severity; Stage.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of Xuanwu Hospital.

Consent for publication

The authors agree to publish.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a The Hs-CRP level in the acute and sub-acute stages were higher than that in the chronic stage, and its level in the acute stage was higher than that in the subacute stage. b The IL-6 level in the acute and sub-acute stages were significantly higher than that in the chronic stage. c The NLR level in the acute and sub-acute stages were higher than that in the chronic stage. d The CSF IgA level in the acute and sub-acute stages were higher than that in the chronic stage. e The CSF IgM level in the acute and sub-acute stages were higher than that in the chronic stage. f The CSF IgG level in the acute and sub-acute stages were higher than that in the chronic stage
Fig. 2
Fig. 2
a, b The difference in NLR and CSF IgM level between patients with good condition and those with poor condition. c The difference in Hs-CRP level between patients with seizure and those without seizure. d, e The difference in NLR and CSF IgM level between patients with good outcome and those with poor outcome
Fig. 3
Fig. 3
Receiver operating characteristic (ROC) curve for serum NLR on predicting short-term outcome of non-inflammatory CVT. CVT, cerebral venous thrombosis; AUC, area under the curve; CI, confidence interval; NLR, neutrophil-to-lymphocyte ratio
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