Table 1

Imaging features in patients with cerebral venous thrombosis associated with a poor prognosis

Imaging featureExplanationPrognostic impact
Imaging findings related to the thrombus
Deep vein thrombosisThrombus location in one or more of the deep veinsIndependent predictor of death or dependence (median follow-up 16 months)11
DWI hyperintensity of the thrombusHyperintense signal of the thrombus on baseline DWI-MRIComplete recanalization at 2–3 months is less common in patients with DWI-hyperintense thrombi treated with anticoagulation37
Parenchymal imaging findings
Low cerebral blood volume (CBV) and cerebral blood flow (rCBF), prolonged relative mean transit time (MTT)Decrease in relative CBV and relative CBF on CT perfusion and prolongation of relative MTT in the center of the affected venous territory (compared with unaffected parenchyma)Only mildly decreased relative CBV (>75.5%) and relative CBF (>60.5%), and only mildly prolonged relative MTT (<148.5%) were associated with better clinical outcomes at 30 days compared with patients with lower relative CBV and CBF/more severe MTT prolongation25
Intracranial hemorrhageAny form of intracranial hemorrhage (eg, parenchymal, subarachnoid) at baseline imagingIndependent predictor of death or dependence (median follow-up 16 months)11
'Venous congestion'*Defined either clinically as worsening of symptoms despite anticoagulation therapy, or radiologically as intracranial hemorrhage or edema on CT or MRI.For patients fulfilling the criteria of venous congestion, standard treatment with anticoagulants is not sufficient and they need rescue treatment more often24
  • *Combined clinical and radiological definition in the study by Tsai et al. 24

  • DWI, diffusion weighted imaging.