Clinical profile and Outcome of Cortical Venous Sinus Thrombosis at a tertiary care centre
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
Background: Cortical Venous Sinus Thrombosis (CVST) is known to be a cause of stroke especially in the young population. It has a multifactorial etiology with a varied presentation. Given the increasing burden of this disease and availability of magnetic resonance imaging for definitive diagnosis, a high level of clinical suspicion must be kept in mind while evaluating such patients. Materials and Methods:This study was a retrospective observational study conducted over a period of 1 year (1 stAugust 2017 to 31st September 2018) in the medicine department of aTertiary care teaching and research center. 36 patients admitted with varying complaints and diagnosed to have CVST on magnetic resonance venography were included. Patients were treated according to standard protocols and guidelines. Results:Of the total of 36 patients, 31(86.11%) were males and 5(13.89%) were females. The average age of the patients was 35.28 ± 14.31 years, the maximum being in the age group of 21-30 years [10 patients (27.28%)]. 12 (33.33%) patients were farmers by occupation. The months of April and May had higher number of patients [5(13.89%) each]. Headache was the most common presenting complaint [33 (91.67%) patients], followed by seizures [24 (66.67%) patients] followed by vomiting [17(47.22%)] and hemiparesis [15(41.67%)]. 10 (27.78%) patients had papilloedema on presentation. Most common sinus involved was transverse sinus [35 (97.22%)] followed by sigmoid sinus [22 (61.11%)], and sagittal sinus [19 (52.78)]. Multiple sinus involvement was seen in 29(80.56%) patients. Midline shift due to mass effect was seen in 11(30.56%) patients. The average midline shift was 5.2 ± 2.2 mm. 2(5.56%) patients underwent surgery i.e. decompression craniectomy. Total of 2(5.56%) patients died during this study. The average duration of hospital stay was 8.9 ± 3.07 days. 23(63.89%) patients were alcoholic; 13(36.11%) patients had history of dehydration in the form of working more than 6 hours in the sun, noon travelling, acute gastroenteritis, significantly decreased oral fluid intake. 10(27.78%) patients were anemic. 3 (8.33%) patients had evidence of infection in the form of CSOM or fever. Of the 7 patients that did serum homocysteine levels, 5(71.43%) had increased levels. Of the 5 female patients, 2(40%) had recent history of consumption of oral contraceptive pills(OCPs) and 1(20%) was peripartum. Conclusion:The present study was a retrospective observational study conducted at a tertiary care center. It showed a male predominance for disease at our centre with an average age of 35.3 years. Most of the populations were farmers, alcoholics, mostly affected during the summer months of April and May. In females, OCPs were an important risk factor. Headache and seizures were the most common presenting features. Transverse sinus involvement was commoner as was multiple sinus involvement. Overall mortality was 5.56% affecting persons with multiple sinus thrombosis. CVST is a treatable cause of acute stroke having a better prognosis than arterial strokes and therefore, a high index of clinical suspicion must be kept while dealing with such patients.
Authors and Affiliations
Dr. Sandip Chaudhari, Dr. KrithiKrishna Koduri, Dr. Neelima Chafekar
Keywords
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- EP ID EP467725
- DOI 10.9790/0853-1802135864.
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