Study of Cerebral Venous Sinus Thrombosis at Tertiary Care Center

Abstract

: Objective: Present study has been undertaken to describe the etiologies, clinical features, diagnosis and prognosis of cerebral venous sinus thrombosis (CVST). Study Design: Prospective observational study at a tertiary care hospital in patients with a confirmed diagnosis of Cerebral venous sinus thrombosis. Results: We studied 30 patients, with mean age as 37.6 years. Majority of them were in the age group of 18-30 years contributing to 50%. Majority ot the patients (86.7%) belong to nonpuerperal CVST. Hyperhomocystinemia and protein S deficiency were the most common risk factors identified in males whereas anemia and puerperum were the most common risk factors identified in females. Majority of the patients had subacute presentation. Headache was the most common presenting symptom (73.33%) followed by convulsions(46.67%) and focal deficits(46.67%). Hemiparesis (40%) was the most common neurological sign followed by papilloedema (30%). Radiologically most common sinus involved was transverse sinus in 66.67% cases followed by superior sagittal sinus in 43.37% of the cases. Overall outcome is good with 67.86% of the patients having complete recovery at the time of discharge and a mortality rate of 6.67%. Conclusion: Neuroimaging plays a pivotal role in diagnosis. MRI with MRV is the current diagnostic modality of choice. Evaluation for an underlying procoagulant state may be rewarding for further prevention with long term anti coagulation. Management with unfractionated heparin or LMWH and oral anticoagulants is appropriate. Surgical decompression is helpful in the case of continuing deterioration, inspite of maximum medical management.