The CHOPS score, comprising coma at admission, cerebral hemorrhage, oral contraceptive use, pregnancy and puerperium, and number of occluded sinuses, can accurately predict severe cerebral venous sinus thrombosis progression after anticoagulation with an area under the curve of 0.873.
Oral contraceptive use was the strongest independent risk factor predicting SCVST progression after anticoagulation.
Pregnancy and puerperium was identified as an independent risk factor predicting SCVST progression after anticoagulation.
Coma at admission was an independent risk factor predicting SCVST progression after anticoagulation.
Cerebral hemorrhage was an independent risk factor predicting SCVST progression after anticoagulation.
Number of occluded sinuses was an independent risk factor predicting SCVST progression after anticoagulation.
The CHOPS score achieved an area under the curve of 0.873 in predicting SCVST progression after anticoagulation.
Factors including age, gender, hemiplegia, sensory dysfunction, and cerebral infarction were analyzed but not found to be independent predictors of SCVST progression.
This research suggests that certain clinical and imaging features can predict whether patients with severe cerebral venous sinus thrombosis (CVST) — a condition where blood clots form in the brain's drainage veins — will get worse even after receiving blood-thinning (anticoagulation) treatment. The researchers analyzed data from 199 patients and found five key risk factors associated with disease progression: being in a coma at hospital admission, having bleeding in the brain, using oral contraceptives, being pregnant or recently postpartum, and having a greater number of blocked venous sinuses in the brain. These five factors were combined into a scoring tool called the CHOPS score. The CHOPS score was then tested in a separate group of 32 patients, where it demonstrated strong predictive accuracy with an area under the curve of 0.873 (a value of 1.0 would be perfect prediction, and 0.5 would be no better than chance). Notably, oral contraceptive use carried the highest associated risk (nearly 29 times greater odds of progression), while pregnancy/puerperium, coma, brain bleeding, and the number of blocked sinuses each also significantly increased the risk. This research suggests that the CHOPS score could help clinicians identify which CVST patients are at high risk of deteriorating despite standard anticoagulation therapy, potentially guiding decisions about whether more aggressive treatments — such as endovascular procedures or surgery — should be considered. Having a validated, structured scoring system may support earlier and more targeted intervention for high-risk patients.
Liu Y, Xu W, Zhang G, Huang X, Xu Y, Wang Q. (2026). Using the CHOPS score to evaluate the severe cerebral venous sinus thrombosis progression risk after anticoagulation.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1848582