{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:22:23Z","timestamp":1786980143200,"version":"build-2736575974"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The hyperdense sinus sign (HDSS) is a readily identifiable non-contrast CT marker of acute thrombus in cerebral venous sinus thrombosis (CVST). We aimed to characterize HDSS associated features and prognostic significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from prospective multicenter CVST registries was analysed. HDSS was defined as attenuation\u2009&gt;\u200970 Hounsfield units within a thrombosed venous structure. Baseline characteristics and outcomes were compared between patients with and without HDSS on admission CT. Multivariable logistic regression identified independent predictors of Excellent-Functional-Outcome (mRS 0\u20131) and remote seizures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 465 patients (mean age 41.9\u2009\u00b1\u200918.4\u00a0years; 64.3% female), 178 (38.3%) exhibited HDSS. Patients with HDSS had higher rates of oral contraceptives use (28% vs 18%, p\u2009=\u20090.009), seizures at presentation (23% vs 14%, p\u2009=\u20090.015), superior sagittal (45% vs 35%, p\u2009=\u20090.028) and transverse sinus involvement (78% vs 67%, p\u2009=\u20090.01), deep venous thrombosis (8% vs 2%, p\u2009=\u20090.003), cortical vein thrombosis (19% vs 9%, p\u2009=\u20090.004), and multisite occlusion (34% vs 22%, p\u2009=\u20090.002). Parenchymal lesions were more common in HDSS patients, including intracerebral hemorrhage (27% vs 13%, p\u2009&lt;\u20090.001) and venous infarction (22% vs 11%, p\u2009=\u20090.004). On day-90, HDSS was associated with lower Excellent-Functional-Outcome rates (71% vs 82%, p\u2009=\u20090.022), higher rates of remote seizures (9% vs 3%, p\u2009=\u20090.001), and similar recanalization rates. HDSS independently predicted reduced odds of Excellent-Functional-Outcome (OR\u2009=\u20090.491 [0.261\u20130.926], p\u2009=\u20090.028) and increased remote seizures (OR\u2009=\u20092.693 [1.057\u20136.861], p\u2009=\u20090.038).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HDSS identifies a CVST subgroup with more extensive thrombosis, greater parenchymal injury, and poorer outcomes, supporting its utility in early risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-13660-0","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T18:10:44Z","timestamp":1770487844000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Admission hyperdense sinus sign predicts poorer outcomes in cerebral venous sinus thrombosis"],"prefix":"10.1007","volume":"273","author":[{"given":"Asaf","family":"Honig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Eliahou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naaem","family":"Simaan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hen","family":"Hallevi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issa","family":"Metanis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rom","family":"Mendel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rani","family":"Barnea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eitan","family":"Auriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Naftali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shorooq","family":"Aladdin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Orion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronen R.","family":"Leker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6868-4849","authenticated-orcid":false,"given":"Jeremy","family":"Molad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,7]]},"reference":[{"key":"13660_CR1","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1093\/neuros\/nyab366","volume":"89","author":"A Bhambri","year":"2021","unstructured":"Bhambri A, Adapa AR, Liu Y, Boeckh-Behrens T, Proch\u00e1zka V, Hern\u00e1ndez-Fern\u00e1ndez F, Barbella-Aponte RA, Hashimoto T, Savastano LE, Gemmete JJ et al (2021) Thrombus histology as it relates to mechanical thrombectomy: a meta-analysis and systematic review. 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The following local institutional review boards approved the study:Tel-Aviv Sourasky Medical Center \u2013 18\u20130535, Hadassah-Hebrew University Medical Center \u2013 HMO-0711\u201320, Assuta Medical Center 0138\u201322-AAA, Rabin Medical Center RMC-18\u20130452, Sheba Medical Center SMC-8308\u201321, Ziv Medical Center 046\u201321.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"120"}}