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

Authors

  • Amruth Gujjar Department of Neurology, KIMS, Hubli, Karnataka, India
  • Sudindra Babu Department of General Medicine, KIMS, Hubli, Karnataka, India
  • Kalinga B. E. Department of General Medicine, KIMS, Hubli, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20190110

Keywords:

Cerebral venous thrombosis, Puerperal, Sinus, Thrombosis

Abstract

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.

References

Nagaraja D. Cerebral veno-sinus thrombosis. In: Shah SN, eds. API-Text Book of Medicine. 8th ed. Mumbai: The Association of Physicians of India; 2008:1165-1167.

Caplan LR. Cerebral Venous Thrombosis. Caplan's Stroke, 4th Edition; 2009:554-577.

Ehlers H, Courville CB. Thrombosis of internal cerebral veins in infancy and childhood: review of literature and report of five cases. J Pedia. 1936;8(5):600-23.

Towbin A. The syndrome of latent cerebral venous thrombosis: its frequency and relation to age and congestive heart failure. Stroke. 1973;4(3):419-30.

Cross JN, Castro PO, Jennett WB. Cerebral strokes associated with pregnancy and the puerperium. Brit Med J. 1968;3(5612):214-8.

Villringer A, Seiderer M, Bauer W, Laub G, Haberi R, Einhäupl K. Diagnosis of superior sagittal sinus thrombosis by three-dimensional magnetic resonance flow imaging. Lancet. 1989;333(8646):1086-7.

Mangshetty B, Reddy KN. Clinical and neuroimaging correlation in patients with cerebral sinus venous thrombosis. Al Ameen J Med Sci. 2015;8(1):64-71.

Vishwanath K, K P Balaraj, Dr. B D Chavan. A study of the clinical Profile of cerebral venous sinus thrombosis. IOSR J Dental Med Sci. 2014;13(2):61-6.

Souirti Z, Messouak O, Belahsen F. Cerebral venous thrombosis: a moroccan retrospective study of 30 cases. Pan Afric Med J. 2014;17:281.

Appenzeller S, Zeller CB, Annichino-Bizzachi JM, Costallat LT, Deus-Silva L, Voetsch B, et al. Cerebral venous thrombosis: influence of risk factors and imaging findings on prognosis. Clin Neurol Neurosurg. 2005;107(5):371-8.

Sidhom Y, Mansour M, Messelmani M, Derbali H, Fekih-Mrissa N, Zaouali J, et al. Cerebral venous thrombosis: clinical features, risk factors, and long-term outcome in a Tunisian cohort. J Stroke Cerebrovas Dis. 2014;23(6):1291-5.

Yii IY, Mitchell PJ, Dowling RJ, Yan B. Imaging predictors of clinical deterioration in cerebral venous thrombosis. J Clin Neurosci. 2012;19(11):1525-9.

Nagarajan E, Shankar V. Characteristics of cerebral venous thrombosis in a south Indian rural hospital. Int J Med Health Sci. 2013;2(3):298-304.

Patil VC, Choraria K, Desai N, Agrawal S. Clinical profile and outcome of cerebral venous sinus thrombosis at tertiary care center. J Neurosci Rural Prac. 2014;5(3):218-24.

Umesh G Rajoor, B N Seema. Cerebral venous thrombosis in women: a study from teaching hospital in north Karnataka. Int J Sci Study. 2015:179-82.

Christo PP, De Carvalho GM, Gomes Neto AP. Cerebral Venous Sinus Thrombosis: Study of fifteen cases and literature review. Rev Assoc Med Bras. 2010;56(3):288-92.

Wasay M, Bakshi R, Bobustuc G, Kojan S, Sheikh Z, Dai A, et al. Cerebral venous thrombosis: analysis of a multicenter cohort from the United States. J Stroke Cerebrovas Dis. 2008:49-54.

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Published

2019-01-23

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Original Research Articles