Clinical Profile of Patients with Cerebral Venous Sinus Thrombosis in Malwa Region.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 6
Abstract
Introduction Cerebral venous sinus thrombosis (CVT) has been recognized since the early 18th century but still remains a diagnostic and therapeutic challenge. Cerebral venous sinus thrombosis is rare as compared to arterial stroke which often occurs in young individuals2. CVT may occur at any time from infancy to old age, most of the reported cases involved women in association with puerperium3.Venous infarctions are often multifocal, bilateral, affecting both grey matter and sub cortical white matter. Patient of CVT usually presents with headache, seizure, papilledema, altered sensorium and focal deficits due to thrombosis of intracranial veins and sinuses resulting in hemorrhagic infarctions and raised intracranial tension2. The above features are present in various combinations ranging from syndrome of raised intracranial pressure without localization to deep altered sensorium and dense hemiparesis. CVT forms a distinct subgroup of cerebrovascular disease in India and is a leading cause of mortality in women of reproductive age group3.In India, most of the cases are seen in postpartum period in women, while alcoholism is a significant risk factor in males. Review of CVT cases from Asian countries is suggestive of differences in risk factors profile and outcome in these patients as compared to European studies. Largest cohort of CVT patients from Europe (n=624) reported that 50% of these cases were related to OCP pills, 6% were due to pregnancy and 14% were secondary to puerperium. A study of 182 adult patients with CVT from USA reported 7% due to pregnancy and puerperium and 5% related to OCP use4. A study from Pakistan (N=109) patients with CVT reported that 17% were due to pregnancy and puerperium and 5% related to OCP use. Cantu from Mexico reported 59% cases due to Pregnancy and puerperium.5,6,7. This study was undertaken to see the clinico etiological spectrum of patients with cerebral venous sinus thrombosis further to attempt correlation between site of venous occlusion and clinical parameters. The ability to accurately detect less clinically severe cases of CVT has modified the Natural history of this disorder. Thus, in contemporary series, the reported mortality rate ranges between 8% and 14%, Ferro JM in contrast to prior studies within which cause-specific mortality was as high as 30% to 50%. Although some patients with CVT present with catastrophic complications, such as stroke syndrome with focal neurologic signs or coma, many present with mild or nonspecific syndrome such as isolated intracranial hypertension, presenting with headache and papilledema.2,4 However, conversely to arterial stroke, scarce information exists on natural history and long-term prognosis of CVT.
Authors and Affiliations
Dr. Chetan Mathur
Keywords
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