Clinic and aetiology of cases with cerebral venous thrombosis; survey of 13 cases

Abstract

GİRİŞSerebral venöz tromboz (SVT) sık görülmey-en ancak ciddi sonuçlara neden olabilen bir hastalıktır. Tüm inme nedenlerinin yaklaşık % 0.5'ini oluşturmaktadır (1). Her yaşta görülebilirse de sıklıkla genç erişkin yaş grubunu etkilemektedir. Genç kadınlarda doğum kontrol haplarının kullanılması ve lohusalık dönemi nedeni ile 20-35 yaşları arasında sıklığı daha fazladır (2,3). En sık sü-perior sagittal sinüs, transvers ve sigmoid sinüsler, kavernöz sinüs ve sinüs rectus etkilenmektedir (4). Klinik başlıca 4 farklı tabloda incelenebilir; izole kafa içi basınç artış sendromu, fokal defisit ve/veya epileptik nöbetler, subakut ensefalopati tablosu, kavernöz sinüs trombozu tablosu (5,6). SVT'un sebebi sıklıkla multifaktoriyeldir, % 20-25 olguda risk faktörü tanımlanamamaktadır (7). SEREBRAL VENÖZ TROMBOZ CLINIC AND AETIOLOGY OF CASES WITH CEREBRAL VENOUS THROMBOSIS; SURVEY OF 13 CASES SUMMARYCerebral venous thrombosis (CVT) is seen in all ages. It is mostly presented as increased intracranial pressure. The most affected dural sinuse is superior sagittal sinuse. The aetiology is often identified. 13 CVT cases were examined in Neurology Clinic of Şişli Etfal Hospital between April and December 2010 about clinical presentations and aetiology. Cranial MRI venougraphy was performed for diagnosis, genetic and acquired prothrombotic conditions for aetiology. The gender of cases were similar. The symptoms of the patients were as follows; headache in 5 patients, diplopia in 4, weakness in 1, sensory disturbance in 3 and seizure in 1 patient. In their neurological examinations, 6th cranial nerve palsy was found in 4 patients, papil edema in 2 patients, hemiparesis in 2 and hemihypoestesia in 1 patient. They all had transvers sinus occlusion. The predisposan factors were; oral contraseptive usage, 20 week pregnancy, otitis media infection and nasal operation. Genetic prothrombotic conditions were positive lupus anticoagulant test and Factor 5 leiden heterozigot gene mutation. In conclusion; Many clinical presentations have been described in CVT patients; but the most seen clinical presentation is intracranial hypertension. Although the disease is rarely seen, the cases of unknown causes are still frequent.