DOI: http://dx.doi.org/10.18203/2349-3933.ijam20190110

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

Amruth Gujjar, Sudindra Babu, Kalinga B. E.

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.

Keywords


Cerebral venous thrombosis, Puerperal, Sinus, Thrombosis

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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.