scholarly journals Structural Imaging Characteristic, Clinical Features and Risk Factors of Cerebral Venous Sinus Thrombosis: A Prospective Cross-Sectional Analysis from a Tertiary Care Hospital in Pakistan

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 958
Author(s):  
Safia Bano ◽  
Muhammad Farooq ◽  
Sarwat Nazir ◽  
Ayesha Aslam ◽  
Adnan Tariq ◽  
...  
Keyword(s):  
Risk Factors ◽  
Categorical Data ◽  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Sinus Thrombosis ◽  
Tertiary Care ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Care Hospital ◽  
Venous Sinus Thrombosis

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.

scholarly journals Cerebral venous sinus thrombosis associated with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection

2021 ◽  
pp. 104-104
Author(s):  
Dragan Nikolic ◽  
Marijana Basta-Nikolic ◽  
Vladimir Manojlovic ◽  
Zeljko Zivanovic ◽  
Sanja Vickovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Neurological Symptoms ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

Introduction/Objective. Coagulopathy induced by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) can be an underlying cause of cerebral venous sinus thrombosis (CVST), a less common type of stroke with a variable clinical presentation and high mortality rate. Objective: to present a series of CVST cases associated with SARS-CoV-2 infection. Methods. This retrospective study evaluated clinical, laboratory and radiological presentation, risk factors, barriers to diagnosis, treatment and outcome of patients with SARS-CoV-2 infection induced CVST. Results. The study comprised 6 patients diagnosed with COVID-19 induced CVST during the 18 months period. Majority (66.7%) had no significant risk factors for developing CVST. Median time from initial COVID-19 diagnosis to onset of neurologic deficit was 7 days (interquartile range 0.5-7 days). Clinical presentation comprised non specific neurological symptoms: headache (83.3%) and decreased consciousness (33.3%), together with elevated levels of D-dimer and inflammatory biomarkers. The transverse (n = 4 or 66.7%), superior sagittal sinuses (n = 3 or 50%) and sigmoid sinus (n = 2 or 33.3%) were most commonly affected. Five patients (83.3%) had minimal to no symptoms at discharge (mRS ? 2). In-hospital mortality in our current series was relatively high (16.7%). Conclusion. The high mortality rate of SARS-CoV-2-associated CVST urges clinicians to suspect CVST in patients with a history of COVID-19 infection presenting with non-specific neurological symptoms in order to provide proper treatment and prevent complications.

scholarly journals Etiologic and Clinical Features of Cerebral Venous Sinus Thrombosis in Saudi Arabia

2019 ◽  
Vol 10 (02) ◽  
pp. 278-282
Author(s):  
Rizwana Shahid ◽  
Azra Zafar ◽  
Saima Nazish ◽  
Abdulla Alsulaiman ◽  
Majed Alabdali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Clinical Features ◽  
Cranial Nerve ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Cranial Nerve Palsies

ABSTRACT Objective: Our study aims to evaluate the etiologic and clinical features of cerebral venous sinus thrombosis (CVST) in Saudi Arabia, and secondarily whether gender plays a role in CVST. Materials and Methods: Data were collected retrospectively from the stroke registry during the period from January 2008 to April 2018, and the patients with the diagnosis of CVST were identified, and data were analyzed for any gender-specific differences in clinical presentation and etiology of cerebral venous thrombosis. Results: There were 15 females while 11 males with a female:male ratio of 1.4:1. The mean age was 29.4± standard deviation 8.9 with the age range of 15–49. Headache was the most common and usually the first presenting symptoms present in 65% followed by hemiparesis and cranial nerve palsies. The first neurological examination was normal in 9/26 (34.6%) of the patients, while the common abnormality was cranial nerve palsies. Infections and trauma played an important part in risk factor analysis of our patient after the pregnancy- and hormone-related conditions. Some significant differences between the clinical presentation and risk factors among males and females were noted as age at presentation was higher in females while trauma and infections were common in male patients, although the involvement of the sinuses and response to treatment did not prove to be statistically significant. Conclusion: The results of this study were similar to the available literature with few differences. The relatively higher proportion of males in our study can be explained partly with more cases of traumatic CVST. Some important differences were noted between the risk factors and clinical presentation among genders. Large-scale prospective studies are needed to further clarify these differences.

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

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.

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

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.

scholarly journals Etiology, clinical profile in cortical venous thrombosis

2018 ◽  
Vol 5 (5) ◽  
pp. 1111
Author(s):  
Amar R. Pazare ◽  
Karan B Karkera
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Young Patients ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Common Symptom ◽  
Female Ratio ◽  
Venous Sinus Thrombosis ◽  
Clinical Awareness

Background: Cerebral venous sinus thrombosis (CVST) is increasingly recognized entity in young patients due to the widespread availability of MRI and rising clinical awareness. CVST is a multifactorial condition with a wide clinical presentation, variable etiologies and prognosis and it requires high index of suspicion for diagnosis.Methods: It is an observational prospective study conducted in 57 patients. Patients above 12 years of age with a diagnosis of cerebral venous sinus thrombosis were included in the study to know aetiology, risk factors, clinical presentation and prognosis.Results: Mean age for males was 40 years and for females it was 36.5 and male to female ratio was 3:2. Headache was the most common symptom (89.47%) followed by convulsions, vomiting, focal neurological deficit, altered sensorium, fever and papilloedema. Superior Sagittal Sinus was the most common sinus involved followed by transverse sinus. Common risk factors were Hyperhomocysteinemia, alcohol, tobacco, APLA syndrome. 52.63% of patients had complete neurological recovery.Conclusions: CVST is uncommon condition and it is more common in neonates, children and females. The major risk factors for CVT in adults are prothrombotic (hypercoagulable) conditions, oral contraceptives, pregnancy and the puerperium, malignancy, infection, head injury. Headache is the most common symptom may be accompanied by focal neurologic deficits, seizures, and encephalopathy. It carries 5% mortality in the acute phase and 10% over a long-term follow up.

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