scholarly journals Clinical profile of cerebral venous thrombosis in pregnancy and puerperium in South India

2017 ◽  
Vol 6 (7) ◽  
pp. 3124
Author(s):  
Ramasamy Sasikala ◽  
Jagan Aishwarya ◽  
Syed Dilshath
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
South India ◽  
Total Mortality ◽  
Acute Onset ◽  
Clinical Profile ◽  
Focal Neurological Deficit ◽  
Presenting Symptoms ◽  
Laboratory Investigations ◽  
In Pregnancy

Background: Cerebral venous thrombosis (CVT) is any thrombosis occurring in intracranial veins and sinuses, which is a rare disorder affecting 5 persons per million per year with huge regional variation. Pregnancy and puerperium are the most prevalent prothrombotic states leading to cerebral venous thrombosis. The objective of this study was to analysis the clinical profile of CVT in pregnancy and puerperium.Methods: In this prospective study, we analysed 52 consecutive patients admitted with impairment of consciousness, seizures or focal neurological deficit at our hospital. The diagnosis of CVT was confirmed by neuroimaging. Detailed history, clinical examination and laboratory investigations were carried out in all the cases and analysed.Results: The incidence of CVT associated with pregnancy and puerperium at our Hospital was 3.9 per 1000 obstetric admissions. The age of the patients varied from 18-35 years with a maximum age incidence (77%) in the III decade (21-30 years). The maximum incidence was during the first two weeks of puerperium (61.8%). The most common presenting symptoms were focal or generalised seizures (88.4%) followed by headache (65.3%). In spite of the alarming clinical picture, recovery was rapid and remarkable. Total mortality was 15.5% (8 cases).Conclusions: CVT is more common during the puerperium than in the antenatal period. Obstetric CVT has a more acute onset with excellent recovery when promptly diagnosed and treated.

scholarly journals Clinical profile of postpartum cerebral venous thrombosis

2017 ◽  
Vol 6 (4) ◽  
pp. 1192
Author(s):  
Umesh G. Rajoor ◽  
Seema B. N.
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Clinical Profile ◽  
Coagulation System ◽  
Common Finding ◽  
Prothrombotic State ◽  
Hemorrhagic Infarction ◽  
Economic Class ◽  
Presenting Symptoms ◽  
Laboratory Investigations

Background: Pregnancy and puerperium are most prevalent prothrombotic states leading to cerebral venous thrombosis (CVT). Pregnancy induces several changes in coagulation system, which persists at least during early puerperium, rendering it a prothrombotic state. The objective of the study was to study the clinical profile of postpartum CVT.Methods: A total of 32 consecutive patients admitted in medicine and obstetrics and gynecology ward between April 2012 and March 2015 with radiologically confirmed diagnosis of CVT were included in the study. Detailed history, clinical examination, and laboratory investigations were carried out in all the cases.Results: Out of 32 patients of CVT studied, the age of patients varied from 18 to 40 years. Maximum incidence was seen in 21-30 age group comprising 74% of the cases, with mean age being 25.5 years. Two-third of the patients belongs to the low socio-economic class. The majority of them had subacute presentation with the headache in 93.75%, followed by altered sensorium (90.6%) and convulsions (75%) being the most common presenting symptoms. Radiologically the most common finding noted was hemorrhagic infarction (85.3%), followed by non-hemorrhagic infarction (15.7%).Conclusions: Pregnancy and puerperium are most prevalent prothrombotic states leading to CVT.

Validation of ICD-10 codes shows intracranial venous thrombosis incidence to be higher than previously reported

2018 ◽  
Vol 49 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Joel D Handley ◽  
Hedley CA Emsley
Keyword(s):  
Positive Predictive Value ◽  
Cerebral Infarction ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
International Classification Of Diseases ◽  
Coding System ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
In Pregnancy

Background: Intracranial venous thrombosis (ICVT) accounts for around 0.5% of all stroke cases. There have been no previously published studies of the International Classification of Diseases, Tenth Edition (ICD-10) validation for the identification of ICVT admissions in adults. Objective: The aims of this study were to validate and quantify the performance of the ICD-10 coding system for identifying cases of ICVT in adults and to derive an estimate of incidence. Method: Administrative data were collected for all patients admitted to a regional neurosciences centre over a 5-year period. We searched for the following ICD-10 codes at any position: G08.X (intracranial and intraspinal phlebitis and thrombophlebitis), I67.6 (non-pyogenic thrombosis of intracranial venous system), I63.6 (cerebral infarction due to cerebral venous thrombosis, non-pyogenic), O22.5 (cerebral venous thrombosis in pregnancy) and O87.3 (cerebral venous thrombosis in the puerperium). Results: Sixty-five admissions were identified by at least one of the relevant ICD-10 codes. The overall positive predictive value (PPV) for confirmed ICVT from all of the admissions combined was 92.3% (60 out of 65) with the results for each code as follows: G08.X 91.5% (54 of 59), O22.5 100% (4 of 4), I67.6 100% (1 of 1), I63.6 100% (1 of 1) and O87.3 100% (1 of 1). There were 40 unique cases of ICVT over a 5-year period giving an annual incidence of ICVT of 5 per million. Conclusions: All codes gave a high PPV. Implications for practice: As demonstrated in previous studies, the incidence of ICVT may be higher than previously thought.

Underlying prothrombotic states in pregnancy associated cerebral venous thrombosis

2010 ◽  
Vol 58 (4) ◽  
pp. 555 ◽  
Author(s):  
M Alexander ◽  
T Maya ◽  
V Mathew ◽  
M Goel ◽  
SC Nair ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
In Pregnancy

scholarly journals A young woman with headache and seizures

2013 ◽  
pp. 25-29
Author(s):  
A.M. Pizzini ◽  
M. Silingardi ◽  
I. Iori
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Mr Angiography ◽  
Sinus Thrombosis ◽  
Factor V Leiden ◽  
Transverse Sinus ◽  
Acute Onset ◽  
Factor V ◽  
Neuroimaging Techniques

CASE REPORT We describe a 31 year-old woman with headache and acute onset of seizures. Medical history and physical examination were unremarkable. She has been on therapy with oral contraceptives for many years for dysmenorrhea. A CT scan was negative, but MRI and MR-angiography showed left transverse sinus thrombosis. Screening for thrombophilia revealed hyperhomocysteinemia and Factor V Leiden heterozigousity. The patient received unfractionated heparin, followed by long-term anticoagulation with warfarin (INR 2-3). CONCLUSIONS Cerebral venous thrombosis is a rare cerebrovascular disorder, frequently in young adult (about 75% are women). The diagnosis might be difficult with consequent high long-term morbidity and mortality rate. New neuroimaging techniques (MRI and MR-angiography) and more effective treatment (anticoagulation and endovascular thrombolysis) have improved the prognosis and the natural history. The risk factors, the clinical presentation, the diagnostic evaluation and the management of cerebral venous thrombosis are reviewed.

scholarly journals Clinical profile of children with tuberculosis from a semi urban referral centre in South India: a prospective observational study

2019 ◽  
Vol 6 (4) ◽  
pp. 1450
Author(s):  
Anuradha G. ◽  
Muraleetharan G.
Keyword(s):  
Clinical Examination ◽  
Complete Blood Count ◽  
Childhood Tuberculosis ◽  
Diagnostic Methods ◽  
Clinical Profile ◽  
Mantoux Test ◽  
Presenting Symptoms ◽  
Bacteriological Diagnosis ◽  
Laboratory Investigations ◽  
Extra Pulmonary

Background: Global TB report 2018 reports that in India, an estimated 2.2 lakh children become ill with tuberculosis (TB) each year. In spite of new rapid diagnostic methods, lack of gold standard test for confirming childhood tuberculosis remains an obstacle for the effective reporting of childhood TB and hence these cases often remain under diagnosed. The main objective was to study the clinical profile of childhood tuberculosis with relevant laboratory investigations aiding in early diagnosis.Methods: A prospective observational hospital-based study was conducted in IRT-Perundurai medical college hospital from April 2016 to March 2018. Children less than 18 years of age with tuberculosis were included in the study. Demographic details, presenting symptoms, family history of TB contact, nutritional status and clinical examination findings were documented. Complete blood count, ESR, Mantoux test, chest X-ray and sputum analyses for AFB were done for all patients.Results: Out of the total 124 children studied, the most common age of presentation of tuberculosis was >10 years of age (n=58, (46.8%)). There was a female preponderance (n=71 (57.25%)). Pulmonary tuberculosis (n= 87, (70.16%)) was the most common form followed by extra pulmonary (n=32, (25.80%)) and disseminated type (n=5, (4%)).  Lymph node TB was the most common manifestation (n=20, 62.50%) among extra pulmonary form. Cough (n=75, 60.5%) with sputum (n=55,44.4%) were the predominant symptoms noted followed by fever (n=53, 42.7%). Bacteriological diagnosis was possible in 19.5% (n=17) patients only.Conclusions: This study reinforces that the diagnosis of childhood tuberculosis is based on the constellation of symptom evaluation, contact history, clinical examination, with relevant laboratory investigations.

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