Abstract
PURPOSE: Intracranial hypertension is the most common symptom of cerebral venous sinus thrombosis. Recent studies have indicated that both the coagulation and inflammation systems play roles in the occurrence and development of cerebral venous sinus thrombosis. Therefore, this study aimed to explore the individual and combined effects of coagulation-related biomarker [fibrinogen (FIB)] and inflammation-related biomarker [C-reactive Protein (CRP)] in predicting intracranial hypertension. PATIENTS AND METHODS: We retrospectively and consecutively included 157 cerebral venous sinus thrombosis patients, who were divided into four groups according to the cut-offs of CRP and FIB by the receiver operating characteristics curves: low CRP low FIB, high CRP low FIB, low CRP high FIB and high CRP high FIB. Logistic regression models were used to compute the odds ratios and 95% confidence intervals for intracranial hypertension across the four subgroups. RESULTS: Cerebral venous sinus thrombosis patients with intracranial hypertension had much higher CRP and FIB levels than those without intracranial hypertension did (all P<0.05). After adjusted by gender, age, modified Rankin scale, duration, headache, seizure, smoking, history of thrombosis and other risk factors, white blood cell, systemic immune-inflammation index and estimated glomerular filtration rate, patients in high CRP high FIB group were 5.286 (95% CI: 2.04-13.701, P=0.001) times more frequent to experience intracranial hypertension than those in low CRP low FIB group did. The addition of CRP and FIB to the basic model significantly improved discriminatory power for intracranial hypertension, as area under the curve increased from 0.692 (95% CI: 0.609-0.775, P<0.001) to 0.767 (95% CI: 0.692-0.843, P<0.001). CONCLUSION: Higher levels of both CRP and FIB are associated with an increased risk of intracranial hypertension following cerebral venous sinus thrombosis. The combination of CRP and FIB has a better predictive ability for intracranial hypertension in patients with cerebral venous sinus thrombosis than either CRP or FIB alone.