Quantitative D-Dimer in Suspected Cerebral Venous Thrombosis: Diagnostic Performance and Clinical–Radiological Associations

Objective: This study aimed to evaluate the diagnostic accuracy of quantitative D-dimer levels in patients investigated for suspected cerebral venous thrombosis (CVT) and their relationship with clinical and radiological characteristics in patients diagnosed with CVT. Methods: Based on neuroimaging findings, 97 consecutive patients investigated for suspected CVT were divided into CVT (n = 54) and CVT-negative (n = 43) groups. Quantitative D-dimer levels were compared between the groups using a cutoff value of 0.5 mg/L. The sensitivity, specificity, positive and negative predictive values, likelihood ratios, and area under the ROC curve (AUC) of elevated quantitative D-dimer values for the diagnosis of CVT were calculated. In patients with CVT, correlations between quantitative D-dimer levels and sex, age, symptom duration, presence of neurological deficits, the National Institutes of Health Stroke Scale (NIHSS) score, number of thrombosed sinuses, and presence of parenchymal damage were examined. Results: Quantitative D-dimer levels were elevated in 90.7% of the CVT group and 4.7% of the CVT-negative group (p < 0.001). Quantitative D-dimer had a sensitivity of 90.74%, specificity of 95.35%, positive predictive value of 96.08%, negative predictive value of 89.13%, and AUC = 0.967 for CVT. Quantitative D-dimer levels were inversely correlated with symptom duration (p = 0.027), whereas no statistically significant correlations were found with sex (p = 0.443), age (p = 0.696), the presence of neurological deficits (p > 0.05), NIHSS score (p = 0.079), the number of thrombosed sinuses (p = 0.627), and the presence of parenchymal lesions (p > 0.05). Conclusions: Elevated quantitative D-dimer levels can support the clinical decision-making process in distinguishing CVT. Levels decrease as symptom duration increases.