Etiological associations of Cerebral Venous Sinus Thrombosis (CVT) among Sudanese patients in Khartoum state Neurological Centers, Sudan, 2020

Abstract Background As cerebral venous sinus thrombosis is common in our country and it carries a high risk of morbidity and mortality if it is not detected and treated early. The common aetiological associations of CVST are post-partum, pregnancy and oral contraceptive pills. Objectives To study the etiological association of CVST among Sudanese patients in Khartoum state in neurological centers. Methodology This is a descriptive prospective hospital based study was conducted on CVST patients in four neurological centers in Khartoum state in the period from March to October 2020. Results Sixty patients were studied for etiological association of CVST using standardized questionnaire including medical history, clinical examination, investigation and treatment. The most common etiological association were pregnancy in 15(25%) OCP in 11(18.3) and being in the post-partum period in 23(38.3%). Recommendation Cerebral venous sinus thrombosis is a treatable condition and has good outcome. Early detection of patients and performing suitable work up including thrombophilia and connective tissue disease screening is essential. Conclusion Post-partum, pregnancy and oral contraceptive pills were the most common etiological associations of cerebral venous sinus thrombosis compared with other populations.

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Evaluation of Estrogen level in Oral Contraceptive Pills used by the women with cerebral venous- sinus thrombosis

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.ca1.16 ◽

2017 ◽

pp. 16

Author(s):

Abdolreza Ghoreishi

Keyword(s):

Oral Contraceptive ◽

Sinus Thrombosis ◽

Muslim Women ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Oral Contraceptive Pills ◽

Venous Sinus Thrombosis ◽

Estrogen Level ◽

Contraceptive Effect ◽

Contraceptive Pills

Introduction: Muslim women are not allowed to perform religious ceremonies in menstrual period. Some of them use oral contraceptive pills (OCPs) to delay menstruation, which can lead to cerebral venous - sinus thrombosis (CVST). Therefore, the incidence of CVST is significantly higher in Iranian women. Thrombosis incidence is directly related to estrogen level of OCPs. In this study, the estrogen level of OPCs was evaluated in a group of female CVST patients.Methods: This study was conducted from 2010 to 2011, including two consecutive months of Ramadan in Zanjan Province of Iran. The remaining tablets of patients with CVST and OCP consumption history were analyzed by HPLC method.Results: Of 32 female CVST patients, 27 patients had a history of OCPs consumption. 24 cases of them consumed LD. Analysis of LD tablets revealed normal level of estrogen except for one case.Conclusion: Using contraceptive products among Muslim women in incorrect manner to delay menstruation should be considered by healthcare system. It is recommended to decrease amount of estrogen in OCPs till their contraceptive effect is unaffected.

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Cerebral venous sinus thrombosis due to oral contraceptive use: Postmortem 3T-MRI and autopsy findings

Human Pathology Case Reports ◽

10.1016/j.ehpc.2016.01.002 ◽

2016 ◽

Vol 6 ◽

pp. 32-36

Author(s):

Masahiro Uemura ◽

Yoshihiro Tsukamoto ◽

Yasuhisa Akaiwa ◽

Masaki Watanabe ◽

Ayako Tazawa ◽

...

Keyword(s):

Oral Contraceptive ◽

Contraceptive Use ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

3T Mri ◽

Venous Sinus Thrombosis ◽

Autopsy Findings ◽

Oral Contraceptive Use

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A case report of oral contraceptive misuse induced cerebral venous sinus thrombosis and dural arteriovenous fistula

Medicine ◽

10.1097/md.0000000000016440 ◽

2019 ◽

Vol 98 (33) ◽

pp. e16440 ◽

Cited By ~ 1

Author(s):

Qingling Huang ◽

Xue Chai ◽

Chaoyong Xiao ◽

Xuan Cao

Keyword(s):

Case Report ◽

Oral Contraceptive ◽

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis

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Cerebral Venous Sinus Thrombosis in Early Pregnancy : A Case Report

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v18i1.42139 ◽

2019 ◽

Vol 18 (1) ◽

pp. 54-56

Author(s):

Salma Akhter

Keyword(s):

Sinus Thrombosis ◽

Post Partum ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Low Molecular Weight ◽

Contributing Factors ◽

Venous Sinus Thrombosis ◽

Mother And Child ◽

Uncommon Condition ◽

Neuro Imaging

Cerebral Venous Sinus Thrombosis (CVST) in pregnancy is an uncommon condition and affects about 5 women per million. Actual etiology is difficult to confirm, a hypercoagulable state along with protein Sand C deficiency, hyperhomocystinaemia are the contributing factors. MRV like neuro imaging is the main stay of diagnosis. Treatment with Low molecular weight heparin throughout the pregnancy and post partum period can save the life of both mother and child. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 54-56

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A rare case of post-partum cerebral venous sinus thrombosis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180211 ◽

2018 ◽

Vol 7 (2) ◽

pp. 762

Author(s):

Akhileshwar Singh ◽

Sanjay Singh ◽

Shakti Vardhan

Keyword(s):

Sinus Thrombosis ◽

Post Partum ◽

Cerebral Venous Sinus Thrombosis ◽

Sudden Onset ◽

Venous Sinus ◽

Definitive Treatment ◽

Motor Deficit ◽

Timely Initiation ◽

Venous Sinus Thrombosis ◽

Warfarin Sodium

Cerebral venous sinus thrombosis is a rare neurologic emergency during pregnancy. Life threatening complications can be prevented if it is detected and treated well in time. A 24 years P2L3A2 lady, who had undergone elective caesarean delivery developed sudden onset severe episodic parieto-occipital headache and bilateral diminution of vision on 4th post-partum day. She had no known risk factors for thrombosis. There was no history suggestive of sepsis or pre-eclampsia. On clinical examination her blood pressure was found to be very high (164-180/104-110 mm Hg). There was no sensory or motor deficit. Relevant haematological and biochemical investigations were within normal limits. Urinary protein was negative. With a provisional diagnosis of imminent eclampsia, she was put on antihypertensive and Magnesium Sulphate. However, in view of persistence of the symptoms even after 24 hours, contrast-enhanced computed tomography (CECT) was done, which revealed venous infarction in occipital cortex and subcortical white matter. Magnetic resonance (MR) venography confirmed thrombus in left transverse and sigmoid sinuses. Thus, definitive treatment in the form of heparin in therapeutic doses was started. Antihypertensive was continued and prophylactic anticonvulsant was added in view of presence of the infarction. Patient responded well. Vision improved, and headache resolved completely. The patient was discharged on antihypertensive, anticonvulsant and vitamin K antagonist (Warfarin sodium) with an advice of regular follow-up. Cerebral venous thrombosis (CVT) is an uncommon entity and a high index of suspicion is needed to diagnose it at an earlier stage for timely initiation of treatment and prevention of complications. Prognosis in pregnant cases is better than that during a non-pregnant state.

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A 21-Year-Old White Woman Diagnosed With Cerebral Venous Sinus Thrombosis Related to Oral Contraceptive and Factor V Leiden

Advanced Emergency Nursing Journal ◽

10.1097/tme.0b013e318243552c ◽

2012 ◽

Vol 34 (1) ◽

pp. 10-15

Author(s):

Holisa C. Wharton

Keyword(s):

Oral Contraceptive ◽

White Woman ◽

Sinus Thrombosis ◽

Factor V Leiden ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Factor V ◽

Venous Sinus Thrombosis

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Relationship between cerebral venous sinus thrombosis and intracranial arteritis during pregnancy and post partum

Journal of Investigative Medicine ◽

10.1136/jim-2020-001757 ◽

2021 ◽

pp. jim-2020-001757

Author(s):

Xiurong Li ◽

Jianan Dong ◽

Yaping Sun ◽

Qing Li ◽

Li Shi

Keyword(s):

Sinus Thrombosis ◽

Post Partum ◽

White Cell Count ◽

Fluid Pressure ◽

Clinical Manifestations ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

Disturbance Of Consciousness ◽

Imaging Results

Our study was conducted to explore the relationship between cerebral venous sinus thrombosis (CVST) and intracranial arteritis during the time of pregnancy as well as puerperium. The current retrospective case study involved a total of 153 patients with pregnancy-related CVST. CVST was diagnosed mainly based on clinical manifestations and imaging results. Detailed information on demographics, risk factors (excluding intracranial arteritis), and pregnancy outcomes was systematically recorded. The average age of patients diagnosed with CVST was 28.67±3.54 years old. Among these patients, there were 62 cases of puerperal CVST and 91 cases of pregnancy-related CVST. The clinical manifestations of patients with CVST included headache in 55 cases (35.95%), symptomatic seizures in 26 cases (16.99%), symptomatic limb weakness in 22 cases (14.38%), symptomatic nausea/vomiting in 18 cases (11.76%), symptomatic disturbance of consciousness in 15 cases (9.80%), symptomatic blurred vision in 10 cases (6.54%), and symptomatic fever in 7 cases (4.58%). A proportion of patients reported higher abnormal cerebrospinal fluid pressure (98.28%), white cell count (79.31%), total cholesterol (71.55%) and low-density lipoprotein (62.93%) (p<0.01). The proportion of intracranial arteritis lesions and CVST lesions was high, including 51 cases (43.97%) on the left side and 31 cases (26.72%) on the right side. Bilateral CVST lesions occurred in 13 cases (11.20%) of unilateral intracranial arteritis lesions, and bilateral intracranial arteritis lesions occurred in 16 cases (13.79%) of unilateral CVST lesions. In summary, CVST indicates a potential positive link to intracranial arteritis at the time of pregnancy and puerperium.

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