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

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.

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

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh211004104n ◽

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.

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Polyradiculopathy and Multiple Cranial Nerve Palsies - Rare Manifestations of Cerebral Venous Sinus Thrombosis

Neurology India ◽

10.4103/0028-3886.310084 ◽

2021 ◽

Vol 69 (1) ◽

pp. 170

Author(s):

SowminiPadmaja Raman ◽

SSakthi Velayutham ◽

KMalcolm Jeyaraj ◽

MSathish Kumar ◽

K Mugundhan

Keyword(s):

Cranial Nerve ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

Cranial Nerve Palsies ◽

Multiple Cranial Nerve

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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 ◽

10.3390/diagnostics11060958 ◽

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.

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Etiology, clinical profile in cortical venous thrombosis

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20183365 ◽

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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Risk Factors for Cerebral Venous Sinus Thrombosis

Pediatric Neurology Briefs ◽

10.15844/pedneurbriefs-19-3-9 ◽

2005 ◽

Vol 19 (3) ◽

pp. 23

Author(s):

J Gordon Millichap

Keyword(s):

Risk Factors ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis

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Clinical features, management and visual outcomes of children with cerebral venous sinus thrombosis, raised intra-cranial pressure and papilledema

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/j.jaapos.2018.07.107 ◽

2018 ◽

Vol 22 (4) ◽

pp. e30-e31

Author(s):

Ryan Davies ◽

Shoaib Hassan ◽

Patrick Watts

Keyword(s):

Clinical Features ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

Visual Outcomes ◽

Intra Cranial Pressure

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Dural puncture and activated protein C resistance: risk factors for cerebral venous sinus thrombosis

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.63.3.351 ◽

1997 ◽

Vol 63 (3) ◽

pp. 351-356 ◽

Cited By ~ 51

Author(s):

E. Wilder-Smith ◽

I. Kothbauer-Margreiter ◽

B. Lammle ◽

M. Sturzenegger ◽

C. Ozdoba ◽

...

Keyword(s):

Risk Factors ◽

Protein C ◽

Dural Puncture ◽

Sinus Thrombosis ◽

Activated Protein C ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Activated Protein C Resistance ◽

Venous Sinus Thrombosis ◽

Resistance Risk

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Clinical characteristics of cerebral venous sinus thrombosis patients with new-onset of headache

10.21203/rs.3.rs-41140/v1 ◽

2020 ◽

Author(s):

Yugang Wang ◽

Qi Fang

Keyword(s):

Risk Factors ◽

Clinical Characteristics ◽

Sinus Thrombosis ◽

Chloride Ion ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

Younger Age ◽

Headache Patients ◽

New Onset

Abstract Objective : This study aimed to assess the clinical characteristics of cerebral venous sinus thrombosis (CVT) patients with new-onset headache and to identify the risk factors for headache in this population.Methods : We retrospectively reviewed the demographic and clinical data of 69 CVT patients recruited between September 2017 and September 2019. Patients were classified into two groups, the headache group and the non-headache group, according to the presence or absence of new-onset headache symptoms at admission. The following characteristics and parameters were measured and analyzed, including gender, age, Diseased sinus amount(DSA), and so on.Results : The incidence of headache was 75% in this cohort. The proportion of female patients in the headache group was higher than that in the non-headache group. Patients in the headache group were younger than those without headache. CVT patients of headache group showed higher LR, BUN, and (ICP)compared to the non-headache group, whereas MCV and levels of protein (CSF) and LDH (CSF) were lower in headache patients. The data also revealed younger age and the increased level of chloride ion CL - (CSF) were the risk factors for the occurrence of headache in CVT patients.Conclusions: The age, LR, MCV, BUN levels, ICP, protein (CSF), and LDH (CSF) in patients with headache were significantly different from those in the non-headache group at admission. Younger age and a level of CL - (CSF) were risk factors for headache in CVT patients. These findings may provide guidance for clinical diagnosis and treatment of CVT.

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