ISC 2026 | Cognition, mood, anxiety and return to work after decompressive surgery for severe CVT

I presented the results of the sub-study of the DECOMPRESS2 International Prospective Study last week during the ISC. So DECOMPRESS2 was an observational study led by Professor Josef Ferrero. And the rationale for this study is that even though cerebral venous thrombosis generally has a favorable outcome, approximately 4% of the patients may die from herniation due to large brain lesions. So DECOMPRESS2 included 118 patients with severe cerebral venous thrombosis treated with decompressive surgery. At one year, about two-thirds of the patients were alive and one-third were functionally independent. And these results were published in Stroke in 2024. So this sub-study that I presented last week focused on what happens to cognition, mood, and return to work after decompressive surgery for cerebral venous thrombosis. So nine centers across eight countries participated in this sub-study. We assessed cognitive function with the Mini Mental State Examination. We assessed mood with the Hospital Anxiety and Depression Scale. And we also assessed paid work status at six months and at 12 months after decompressive surgery for severe cerebral venous thrombosis. So approximately two-thirds of the patients in this sub-study were women. Two-thirds were from low- and middle-income countries, and 40% had signs of brain herniation in the initial CT scan. So there are two main findings from this sub-study. So first is that recovery of cognition and mood continues beyond the first six months. So Mini Mental State Examination scale scores significantly improved between 6 and 12 months. The second point is that despite the initial severity, by one year, about half of the patients had normal Mini Mental State Examination scores, so equal or greater than 24, and nearly three-quarters of the patients had normal Hospital Anxiety and Depression scores. And also, despite the initial severity, about one in seven patients were in paid employment at one year. And it’s interesting to highlight that all patients who returned to work had normal cognitive scores and none had significant depressive scores, indicating that cognition and mood are strongly linked to functional reintegration. And these findings are relevant to clinical practice because they show that even after very severe cerebral venous thrombosis requiring decompressive surgery, favorable neuropsychiatric outcomes are achievable. There are still many unanswered questions about cerebral venous thrombosis, and international collaboration remains essential to advance the field. So please check out the website, cerebralvenousthrombosis.com, for opportunities to collaborate.

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