CEREBRAL VENOUS SINUS THROMBOSIS – A REVIEW OF 90 CASES

Rajesh Uddandam; Shijith KP; Rajneesh Joshi; Dalbara Singh; Dr J Sai Kiran

Volume : VII, Issue : I, January - 2018

CEREBRAL VENOUS SINUS THROMBOSIS – A REVIEW OF 90 CASES

Rajesh Uddandam, Shijith Kp, Rajneesh Joshi, Dalbara Singh, Dr J Sai Kiran

Abstract :

INTRODUCTION : Cereal venous sinus thrombosis is a life threatening and rare condition, responsible for less than 1% of strokes. It is an under–diagnosed condition and prompt diagnosis requires a high degree of suspicion and use of relevant neuroimaging modalities.

OBJECTIVES : To evaluate patients with Cereal venous sinus thrombosis (CVST) and characterize the risk factors, clinical manifestations, treatment and clinical course.

METHODS : In a retrospective cross–sectional study, 90 patients with proven diagnosis of CVST admitted in a tertiary care hospital from 2014 to 2017 were evaluated. The diagnosis of CVST was based on MRI, MRV, CT, CTV and conventional angiography. Statistical analysis was performed using R software.

RESULTS : The most common presenting complaint was headache, followed by vomiting and focal neurological deficit. In most of the patients the diagnosis of CVST was made on MRI and MRV. The mean time to diagnosis was 6 days. The most affected cereal venous sinus was transverse sinus followed by superior sagittal sinus and sigmoid sinus. All patients were treated with low molecular weight heparin (LMWH) followed by warfarin. Most of the patients had complete recovery.

CONCLUSION: Strong clinical suspicion and appropriate imaging plays a key role in the diagnosis of CVST. MRI along with MRV is the diagnostic modality of choice with CT Venography a good alternative to MRI in case of non–availability of the same. The mainstay of treatment is systemic anticoagulation with LMWH in the acute phase followed by oral anticoagulation.