{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:17:32Z","timestamp":1791253052181,"version":"4.1.0"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"Importance<\/jats:title>One of 10 patients develop epilepsy in the late phase after cerebral venous thrombosis (CVT) diagnosis but predicting the individual risk is difficult.<\/jats:p><\/jats:sec>Objective<\/jats:title>To develop and externally validate a prognostic score to estimate the individual risk of post-CVT epilepsy.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This observational cohort study included both retrospective and prospective patients enrolled from 1994 through 2022. For development of the DIAS3<\/jats:sup> score, data from the International CVT Consortium (n\u2009=\u20091128), a large international hospital-based multicenter CVT cohort, were used. For validation, data from 2 independent multicenter cohorts, the ACTION-CVT (n\u2009=\u2009543) and the Israel CVT study (n\u2009=\u2009556), were used. Of 2937 eligible, consecutively enrolled adult patients with radiologically verified CVT, 710 patients with a history of epilepsy prior to CVT, follow-up less than 8 days, and missing late seizure status were excluded.<\/jats:p><\/jats:sec>Exposure<\/jats:title>The prediction score (DIAS3<\/jats:sup>) was developed based on available literature and clinical plausibility and consisted of 6 readily available clinical variables collected during the acute phase: decompressive hemicraniectomy, intracerebral hemorrhage at presentation, age, seizure(s) in the acute phase (excluding status epilepticus), status epilepticus in the acute phase, and subdural hematoma at presentation.<\/jats:p><\/jats:sec>Main Outcome and Measure<\/jats:title>Time to a first late seizure, defined as occurring more than 7 days after diagnosis of CVT.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 1128 patients included in the derivation cohort (median age, 41 [IQR, 30-53] years; 805 women [71%]), 128 (11%) developed post-CVT epilepsy during a median follow-up of 12 (IQR, 3-26) months. According to the DIAS3<\/jats:sup> score, the predicted 1-year and 3-year risk of epilepsy in individual patients ranged from 7% to 68% and 10% to 83%, respectively. Internal and external validation showed adequate discrimination in the derivation cohort (1 year and 3 years: C statistic, 0.74; 95% CI, 0.70-0.79) and the 2 independent validation cohorts, (ACTION-CVT) 1 year: C statistic, 0.76; 95% CI, 0.67-0.84; 3 years: C statistic, 0.77; 95% CI, 0.66-0.84; and Israel CVT study 1 year: C statistic, 0.80; 95% CI, 0.75-0.86. Calibration plots indicated adequate agreement between predicted and observed risks.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The DIAS3<\/jats:sup> score (freely available online) is a simple tool that can help predict the risk of post-CVT epilepsy in individual patients. The model can improve opportunities for personalized medicine and may aid in decision-making regarding antiseizure medication, patient counseling, and facilitation of research on epileptogenesis in CVT.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2024.3481","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T15:33:05Z","timestamp":1729524785000},"page":"1274","source":"Crossref","is-referenced-by-count":19,"title":["Development and Validation of a Clinical Score to Predict Epilepsy After Cerebral Venous Thrombosis"],"prefix":"10.1001","volume":"81","author":[{"given":"Erik","family":"Lindgren","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqi","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naaem","family":"Simaan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ziv Medical Center, Safed, Israel and The Azrieli Faculty of Medicine, Safed, Bar Ilan University\u2019s, Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Krzywicka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"de Winter","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, UMC Utrecht, Utrecht, the Netherlands and Department of Internal Medicine, Diakonessenhuis, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayte","family":"S\u00e1nchez van Kammen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Molad","sequence":"additional","affiliation":[{"name":"Department of Neurology & Stroke, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piers","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radiology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hen","family":"Hallevi","sequence":"additional","affiliation":[{"name":"Department of Neurology & Stroke, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel"},{"name":"Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rani","family":"Barnea","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rabin Medical Center, Petach-Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam R.","family":"Heldner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sini","family":"Hiltunen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Aguiar","family":"de Sousa","sequence":"additional","affiliation":[{"name":"Stroke Centre, Lisbon Central University Hospital Center, Lisbon, Portugal; 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