Steroids combined with anticoagulant in acute/subacute severe cerebral venous thrombosis

作者：Shimin Hu, Yaqin Gu, Tingyu Zhao, Kaiyuan Zhang, Jingkai Li, Chen Zhou, Haiqing Song, Zhi Liu, Xunming Ji, Jiangang Duan · 发表于：Chinese Medical Journal · 年份：2025 · DOI：10.1097/cm9.0000000000003502 · 被引用次数：5 · 研究领域：Cerebral Venous Sinus Thrombosis、Vascular Malformations Diagnosis and Treatment、Neurosurgical Procedures and Complications

BACKGROUND: Inflammation plays a critical role in severe cerebral venous thrombosis (CVT) pathogenesis, but the benefits of anti-inflammatory therapies remain unclear. This study aimed to investigate the association between steroid therapy combined with anticoagulation and the prognosis of acute/subacute severe CVT patients. METHODS: A prospective cohort study enrolled patients with acute/subacute severe CVT at Xuanwu Hospital (July 2020-January 2024). Patients were allocated into steroid and non-steroid groups based on the treatment they received. Functional outcomes (modified Rankin scale [mRS]) were evaluated at admission, discharge, and 6 months after discharge. Serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), cerebrospinal fluid (CSF) IL-6, and intracranial pressure were measured at admission and discharge in the steroid group. Fundoscopic Frisén grades were assessed at admission and 6 months after discharge. Univariate and multivariate logistic regression were used to evaluat associations between steroid use and favorable outcomes (mRS ≤2) at the 6-month follow-up. Paired tests assessed changes in hs-CRP and other variables before and after treatment, and Spearman's correlations were used to analyze relationships between these changes and functional improvements. RESULTS: A total of 107 and 58 patients in the steroid and non-steroid groups, respectively, were included in the analysis. Compared with the non-steroid group, the steroid group had a ...