Long-term outcome and predictors in cerebral venous sinus thrombosis: a prospective cohort study

Although cerebral venous sinus thrombosis (CVT) is a rare disease with an overall favorable prognosis, 3%-15% CVT patients may experience death or severe disability during acute phase from symptom onset. We examined clinical characteristics in CVT patients and identify predictors associated with 12-month functional outcomes in patients with newly diagnosed CVT. In this prospective cohort study, 61 patients with newly diagnosed CVT between Jan 2024 and Aug 2025 were enrolled and followed up for 12 months. The primary outcome was functional disability at 12 months, defined by a modified Rankin Scale (mRS) score ≥ 2. Clinical, radiological, and demographic variables were assessed as potential predictors. Logistic regression was used to identify independent predictors of poor 12-month outcome. At 12 months, fifty-seven patients (93.4%) had a favorable outcome (mRS < 2), while 4 patients (6.6%) had a poor outcome (mRS 2–4). Poor outcome was associated with higher admission NIH Stroke Scale (NIHSS) scores, impaired consciousness, brain parenchymal infarction, and extensive thrombosis. In multivariable analysis, admission NIHSS score was independently associated with poor outcome (odds ratio 1.21 per point; 95% CI 1.052–1.396). An NIHSS score ≥ 9 had a sensitivity of 75.0% and specificity of 93.0% for predicting disability at 12 months. An NIHSS score ≥ 9 at admission independently predicts poor 12-month outcome in CVT and may guide early risk stratification and management decisions. This is a secondary analysis of prospectively collected data from the registered clinical trial (URL: https://www.chictr.org.cn; No. ChiCTR2400080136; Registration date: Jan 22, 2024).