A Study of 50 Cases of Cerebral Venous Sinus Thrombosis

2018

Background: Cerebral venous sinus thrombosis (CVST) is an uncommon condition, with extremely diverse clinical features, predisposing factors, brain imaging findings, and outcome. Materials and Methods: This study was performed as a hospital based retrospective& prospective observational study at IHBAS, Delhi, India. Statistical Analysis: The different variables of the patients like the demographic profile, clinical presentations, risk, prognostic factors and outcome were compiled and analyzed using appropriate statistical methods in Statistical Package for Social Sciences (SPSS) 22.0 window software. Results: A total of 71 patients of CVST were included in this retrospective and prospective observational study with age more than 14 years. 30 (42%) were males and 41 (58%) were females with 29.3 ± 5.8 years and 27.14 ± 8.6, respectively. Clinical presentation was acute in 19(27%), sub-acute in 40(56%), and chronic in12 (17%) patients. Out of 71, 60(85%) patients were presented with sy...

Neurosurgical Focus, 2009

C erebral venous sinus thrombosis constitutes a rare but serious cerebrovascular disorder, which was first reported in the literature more than 100 years ago. The clinical evolution of this entity and its natural history differ significantly from the various subtypes of arterial stroke, while its clinical presentation is characterized by a wide spectrum of symptoms and signs, depicted in an increasing body of previously published studies. The initial reports concerning CVST, which were based on autopsy series, led to the underestimation of the actual incidence of CVST. 2 More recently, the evolution of noninvasive diagnostic imaging methodologies such as CT angiography and venography, as well as MR imaging, angiography, and venography, enriched our knowledge regarding the full clinical spectrum of CVST and provided us with a more accurate estimation of its true incidence. The purpose of the current study is to review the pertinent literature concerning the most recent demographic data, current pathophysiological mechanisms, predisposing conditions, and the etiological factors to outline the recent advances in the early diagnosis and the prompt management of CVST.

International Journal of Contemporary Medical Research [IJCMR]

Introduction: Cerebral Venous Thrombosis is an important cause of stroke in the young. The importance of recognising this condition is that it carries a good prognosis if recognised and treated early. Study objective was to analyse the clinical and etiological profile of Cerebral Venous Sinus Thrombosis. Material and Methods: Prospective cross sectional study in patients attending OPD or emergency at a tertiary referral centre in eastern Tamilnadu with history suggestive of CVT and in whom the diagnosis of CVT confirmed by imaging of brain (MRI and MRV) were included in the study after meeting the inclusion criteria Result: Among the 33 patients included in the study, majority affected were young males, most common clinical presentation was headache and most common sinus involved was superior sagittal sinus. Pro thrombotic state was observed in 27% of cases and alcohol addiction was found to highly prevalent in the study population. Conclusion: Cerebral Venous Thrombois is found to be significantly high in males and alcoholics. Compared to other Indian studies there was not much disparity in clinical profile and risk factors.

Bangladesh Journal of Medicine, 2023

Background: Cerebral sinus thrombus (CVST) is a rare form of stroke often affects young people with diverse clinical, etiological and radiological presentation. The aim of the study was to evaluate clinical relevance, etiologies, and imaging characteristics of CVST in Bangladesh. Methods: A prospective, observational study was done at a tertiary care hospital with patients recruited in the period of January 2021 to January 2023. 38 patients with clinical and radiological features suggestive of cerebral venous sinus thrombosis (CVST) were studied with thorough clinical evaluation and comprehensive work up. Results: The mean age of presentation was 28.42 years with female predominance (n = 24). Headache was the most common presenting symptoms (92%, n = 35) followed by vomiting (52%, n = 20). Hemi paresis (38%; n = 14) was the most common clinical sign followed by cranial nerve palsy (26%, n = 10). 31% of the patients (n=12) had provoked CVST among those the most common cause was found to be pregnancy/puerperium in 58% (n = 7 patients) followed by OCP which were 25% (n = 3). 69 % of the patients (n=26) had unprovoked CVST among those the most common cause was found to be prothrombotic conditions in 85% (n = 22 patients) followed by idiopathic which were 15% (n = 4). In magnetic resonance imaging venography (MRV), 74% of patients (n = 28) had thrombosis of transverse sinus, 53% of patients (n = 20) had thrombosis of the sigmoid sinus and 42% patients (n = 16) of patients had saggital sinus thrombosis. Conclusion: Clinical presentation is variable, etiology must be determined, and diagnostic method of choice is MRV. Headache was most the common clinical presentation and the most common etiological factor is puerperium. Provoked CVST is more common than unprovoked CVST and transverse sinus thrombosis frequently involved.

F1000posters, 2012

Objectives: Cerebral venous and sinus thrombosis (CVST) is a rare condition, which accounts for <1% of all strokes. It may present with a wide spectrum of clinical symptoms and may lead to severe morbidity and mortality, in case of delayed diagnosis and treatment. The aim of this study is to investigate the clinical, etiological, diagnostic features and risk of recurrence of CVST in a cohort of patients diagnosed at our hospital. Methods: The retrospective and prospective data of patients with radiologically confirmed CVST during the years 2002-2012 were collected from the clinical records and the electronic database of Papageorgiou General Hospital in northern Greece. Results: 60 patients (41 females), median age of 37.3 years (range: 7-77), were studied. In most cases (45) the primary clinical symptom was acute cephalalgia. The first neurological exam revealed pathological findings in 61.2 %. Epileptic seizures occurred in 15 %. The most common known predisposing factors were postpartum condition (31.2 %) and treatment with prothrombotic drugs-including substitutive hormones and oral contraceptives (15.6 %). Superior sagittal sinus (58.3 %) was most commonly involved. Concomitant complications were observed in 23.3 % (e.g. emergency admission to the intensive care unit, persistent epileptical seizures, chronic cephalalgia). Mortality rate was 1.6 % (1 patient with congestive heart failure, dysregulated diabetes mellitus and arterial hypertension). Until today, two CVST have recurred during the follow-up period. Conclusion: CVST can be a life-threatening condition with various complications. Diagnosis is still frequently overlooked or delayed as a result of the variety of initial neurologic symptoms and the often subacute onset. Clinical awareness of this multi-factorial condition is very important, in order to suspect and recognize it before major stroke symptoms. The follow-up of these patients is mandatory in order to determine the duration of anticoagulation treatment after CVST and prevent recurrence.

Journal of Neurosciences in Rural Practice, 2014

Cerebral venous sinus thrombosis (CVST) is one of the common causes of stroke in young people. CVST is a disease with potentially serious consequences and usually affecting young to middle-aged people. Strokes in the young account for nearly 30% of all cases of stroke in India and cerebral venous thrombosis (CVT) accounts for 10-20% of these cases. Two-thirds of them develop the same in the postpartum period. There has been a drastic reduction of infection as a causative agent for CVST in recent years. Primary or idiopathic CVST are mainly caused by hypercoagulable state commonly from puerperium or from dehydration. Puerperal CVST may

Journal of Neurosciences in Rural Practice, 2013

Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

The advent of sensitive diagnostic techniques along with widespread treatment of Cerebral Venous Sinus Thrombosis (CVST) with anticoagulation has transformed this once dreaded disease to a benign entity. Prompt diagnosis on hospital visit and effective therapeutic interventions are likely to improve the outcome of the CVST patients and we employed this good clinical practice in our study. From 2007 to 2011, 32 adult patients with CVST confirmed by radiography and investigated for prothrombotic states were retrospectively studied. All patients were followed up for 6 months after hospitalization and the outcome at last follow- up visit was assessed by modified Rankin Scale (mRS). Primary outcome was mRS <=2 at the end of follow-up signifying good outcome. Of the 32 patients, 18(56.3%) were men and the mean age was 37.8 years (range 18-66). The most common symptoms were headaches (84.4%), vomiting (37.5%) and seizures (21.9%). Papilledema (31.3%) and isolated intracranial hypertension (IIH) (31.3%) were the most common sign and clinical syndrome respectively. The most common risk factors were oral contraceptive pills (28.1%) and dehydration (18.7%). Good outcome (mRS<=2) and poor outcome (mRS 3-6) at the end of follow-up were observed in 28(87.5%) and 4(12.5%) patients respectively with mortality (mRS=6) of 3(9.4%) patients. We had higher prevalence of CVST in men than previously reported. We had excellent prognosis with 87.5% of patients exhibiting good outcome (mRS<=2) at the final follow-up. We attribute this remarkable patient’s outcome to increased awareness of this entity, prompt diagnosis on hospital visit and timely intervention with effective therapies. Key Words: cerebral venous sinus thrombosis, diagnosis, effective therapies, patient’s outcome

Bangladesh Journal of Neuroscience, 2017

Cerebral venous sinus thrombosis is an uncommon but important cause of stroke, especially in young-aged woman. Clinical presentation is variable, usually in the form of focal neurological deficit, seizure, headache and other features of raised intracranial pressure, leading to misdiagnosis or delay in treatment. Here we report 4 cases of venous sinus thrombosis with variable presentation. Diagnosis is confirmed by neuroimaging including magnetic resonance imaging with magnetic resonance venography of brain. Treatment consists of anticoagulation along with supportive management. Bangladesh Journal of Neuroscience 2017; Vol. 33 (1): 30-33

… Journal of Stroke, 2009

Cerebral venous sinus thrombosis is an uncommon disease marked by clotting of blood in cerebral venous, or dural sinuses, and, in rare cases, cortical veins. It is a rare but potentially fatal cause of acute neurological deterioration previously related to otomastoid, orbit, and central face cutaneous infections. After the advent of antibiotics, it is more often related to neoplasm, pregnancy, puerperium, systemic diseases, dehydration, intracranial tumors, oral contraceptives, and coagulopathies are the most common causes, but in 30% of cases no underlying etiology can be identified. It has been found in association with fibrous thyroiditis, jugular thrombosis after catheterization, or idiopathic jugular vein stenosis. Other factors include surgery, head trauma, arteriovenous malformations, infection, paraneoplastic, and autoimmune disease. This article presents a comprehensive review of cerebral venous sinus thrombosis etiologies.