Inflammatory Biomarkers May Predict Poor Outcome in Patients with Chronic Cerebrospinal Venous Insufficiency.

Abstract Background and purpose Chronic cerebrospinal venous insufficiency (CCSVI) related inflammatory process is still unclear. This study aimed to evaluate peripheral inflammatory biomarkers in both intracranial CCSVI and the extracranial CCSVI group, as well as the relationship between the inflammatory state and prognosis of CCSVI.Methods Patients with CCSVI were included from July 2017 to July 2019, divided into three groups by location of stenosis. The inflammatory biomarker assay included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red blood cell distribution width (RDW), C-reactive protein (CRP), interleukin- 6 (IL-6)) and neuron-specific enolase (NSE). The clinical outcome was assessed by the modified Rankin Scale (mRS) and Patient Global Impression of Change (PGIC) score. Univariate and multivariate regression analysis was performed to identify significant prognostic factors for poor outcome. Then a nomogram based on multivariate regression analysis was established.Results In total, 248 consecutive patients were enrolled, 102 males and 146 females, with an average age of 57.85 ± 12.28 years. Patients with cerebral venous sinus stenosis (CVSS) were more likely to be younger age and present headaches and severe papilledema. Higher levels of NLR, RDW, and CRP were also observed in the CVSS group. In multivariate analysis, NLR, PLR, and IL-6 became the independent prognostic factors for predicting the poor outcome of CCSVI.Conclusions The clinical presentations and the increased levels of NLR, PLR, and CRP may be more remarkable in the group with CVSS-related CCSVI than that with internal jugular venous stenosis (IJVS)-related CCSVI. The pro-inflammatory state may relate to CCSVI. An elevated level of NLR, PLR, and IL-6 played a negative role in the prognosis of CCSVI.