Clinical profile and geographical distribution of cerebral venous sinus thrombosis at a tertiary care hospital

Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke that accounts for 0.5–1.0% of all strokes. Clinical presentation, predisposing factors, neuroimaging findings, and outcomes of CVST are extremely diverse, which causes a high index of suspicion in diagnosis. Therefore, early diagnosis of CVST is crucial for prompt treatment to prevent morbidity and mortality. Objective: The purpose of this prospective study is aimed at assessing the clinical characteristics, potential risk factors, and neuro-radiological features along with the topography of venous sinus involved in CVST patients in a tertiary care hospital, Lahore, Pakistan. Material and Methods: Consecutive patients enrolled in this study had a computed tomography (CT) scan, magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) along with a clinical presentation to confirm the diagnosis of CVST. Categorical data were presented as percentages. Continuous variable and categorical data were compared (parenchymal lesions vs. non-parenchymal lesions) using the Student’s t-test and Chi-square test, respectively. Results: A total of 3261 patients with stroke were presented during the study period. Out of all patients, 53 confirmed patients with CVST (1.6%) were recruited; the predominant population was female (84.91%), having a male to female ratio of 1:4. Mean age of the cohort was 28.39 ± 7.19 years. Most frequent symptoms observed were headache (92.45%) followed by vomiting (75.47%), seizures (62.26%), papilledema (54.72%), visual impairment (41.51%), and altered consciousness disturbance (52.83%). The presumed risk factors associated with CVST were puerperium (52.83%), use of oral contraceptives (13.21%), antiphospholipid syndrome (7.55%), elevated serum levels of protein C and S (5.66%), and CNS infection (3.77%). On cranial CT scans, 50 patients (94.33%) showed abnormalities while 32 patients exhibited various parenchymal lesions. Seizures were more frequent in CVST patients with parenchymal lesions compared with subjects lacking parenchymal lesions. Seventy-two sinuses, either single or in combination, were involved in CVST patients, being more common in patients with parenchymal lesions than those without parenchymal lesions. The most frequent locations of CVST were the superior sagittal and transverse sinus. Conclusion: In short, non-contrast CT brain may be used as a first line investigation in suspected cases of CVST. Our study also demonstrates some regional differences in the clinical features, risk factors, and neuroimaging details of CVST as described by some other studies. Therefore, care must be taken while diagnosing and predicting the outcome of the CVST.

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Clinical profile and outcome of cerebral venous sinus thrombosis at tertiary care center

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.133559 ◽

2014 ◽

Vol 5 (3) ◽

pp. 218 ◽

Cited By ~ 11

Author(s):

VirendraC. Patil ◽

Kushal Choraria ◽

Neeraj Desai ◽

Sumit Agrawal

Keyword(s):

Sinus Thrombosis ◽

Care Center ◽

Tertiary Care ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Clinical Profile ◽

Tertiary Care Center ◽

Venous Sinus Thrombosis

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Cerebral venous sinus thrombosis a study to assess clinical profile among female patients in a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20190110 ◽

2019 ◽

Vol 6 (1) ◽

pp. 86

Author(s):

Amruth Gujjar ◽

Sudindra Babu ◽

Kalinga B. E.

Keyword(s):

Sinus Thrombosis ◽

Tertiary Care ◽

Transverse Sinus ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Care Hospital ◽

Focal Neurological Deficit ◽

Venous Sinus Thrombosis ◽

Peripartum Period ◽

Neurosurgical Intervention

Background: The Incidence of Cerebral Venous Thrombosis (CVT) is around 3-4 cases among one million population affecting children and young adults. In India the puerperal CVT is 10-12 times more common than western countries. Even though there is apparent “rarity” of the condition but advances in knowledge and available investigation in terms of imaging (CT scan/MRI) diagnosis can be done early for appropriate treatment and decreasing the morbidity and mortality.Methods: A prospective study was conducted at Karnataka Institute of Medical Sciences, Hubli, Karnataka from December 2014 to November 2015. A total of 36 patients were included in the study.Results: Mean age of females in the study was 27.06±9.033years. 75% had seizures, 47.2% had headache, 19.4% had focal neurological deficit, 13.9% had altered sensorium, 8.3% had cranial nerve deficits 5.6% had speech deficits. 72.22% of patients and were in peripartum period and 27.8% were non-pregnant. 72.2% had superior sagittal sinus involvement, 47.2% had transverse sinus, 47.2% had sigmoid sinus, and 13.9% had internal jugular vein and 5.6% straight sinus. 47.2% had single sinus involvement, and 52.8% had multiple sinus involvement. 94.4% patients were managed conservatively and 5.6% were managed by neurosurgical intervention. 94.4% patients survived and 5.6% had mortality.Conclusions: Cerebral venous sinus thrombosis is most common in young females during peripartum period. Early diagnosis, treatment and if necessary neurosurgical intervention has good outcome.

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CORRELATION BETWEEN CEREBRAL VENOUS SINUS THROMBOSIS AND SERUM HOMOCYSTEINE LEVELS IN A TERTIARY CARE HOSPITAL, INDIA A PROSPECTIVE OBSERVATIONAL STUDY

International Journal of Advanced Research ◽

10.21474/ijar01/12302 ◽

2021 ◽

Vol 9 (01) ◽

pp. 251-274

Author(s):

Sanskriti Kamran ◽

◽

Sanjay Sharma ◽

Sayani Banerjee ◽

Sujoy Das Thakur ◽

...

Keyword(s):

Risk Factor ◽

Sinus Thrombosis ◽

Tertiary Care ◽

Clinical History ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Care Hospital ◽

Fasting Serum ◽

Venous Sinus Thrombosis ◽

Serum Homocysteine

Objective: To study correlation between Cerebral Venous Sinus Thrombosis and Serum Homocysteine levels. Patients and Methods: 76 patients having Cerebral Venous Thrombosis were admitted to our hospital from September 2017 to September 2019. In each patient fasting serum homocysteine levels and serum B12 levels were taken and analyzed. Every patient was subjected to a detailed clinical history and neurological examination. In each patient fasting serum homocysteine levels and serum B12 levels were done. The serum homocysteine levels were done by kinetic biochemistry using R1 and R 2 reagents. The serum B12 levels were done by using ELISA Technique. On the basis of serum homocysteine levels, the patients were divided into 4 categories: Normal Level, Mild Hyperhomocysteinrmia, Moderate Hyperhomocysteinemia and Severe Hyperhomocysteinemia. On the basis of serum B12 levels, the patients were again divided into 4 categories: Severe Deficiency, Mild Deficiency, Normal range and High levels. Conclusion: Hyperhomocysteinemia could be a risk factor accounting forCerebral Venous Sinus Thrombosis. The results of this study have shown that homocysteine levels were significantly higher in CVST patients and serum hyperhomocysteinemia is one of the risk factor in the etiology of Cerebral Venous Sinus Thrombosis patients. Though, Serum B12 levels showed no correlation in patients of CVST. Thus, Serum homocysteine estimation needs to be sent from emergency department of all patients with diagnosis of Cerebral Venous Sinus Thrombosis.

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