Headache Patterns in Cerebral Venous Sinus Thrombosis

Abstract

Objectives:The objective of this study was to assess the clinical characteristics, patterns, and factors associated with headache in patients with cerebral venous sinus thrombosis (CVT).Methods:In this prospective cohort study, we recruited conscious CVT patients who were able to give reliable history after consent. Institutional ethics approval was obtained. The diagnosis of CVT was based on the clinical and imaging parameters. Data regarding headache characteristic, severity (visual analog scale [VAS]), imaging findings and outcome was recorded.Results:Forty-seven patients (19 males and 28 females) with mean age 29.7 ± 8.7 years were recruited. The mean duration of headache was 12.6 ± 26.8 days, and VAS was 79.38 ± 13.41. Headache onset was acute in 51.1%, subacute in 42.6%, thunderclap in 4.3%, and chronic in 2.1%; location was holocranial in 36.2%, frontal in 27.7% patients; description was throbbing in 44.7% and aching in 25.5% patients. Superior sagittal sinus and transverse sinus were involved in 63.8% cases each. The prothrombotic factors were anemia in 55.3%, puerperal in 38.3%, hyperhomocysteinemia in 29.8%, and polycythemia in 19.1%.Conclusion:Holocranial and bifrontal headache of increasing severity may be a marker of CVT. This may be useful in clinical judgment in identifying conscious patients with CVT.

Clinical characteristics of cerebral venous sinus thrombosis patients with new-onset of headache

“…Headache may occur at the acute, subacute, or chronic stages of CVT. Botta et al found that headache onset was acute in 51.1%, subacute in 42.6%, thunderclap in 4.3%, and chronic in 2.1% of the CVT patients and the mean VAS was 76.4 ± 18.8 [10] , which was consistent with our ndings.…”

“…Different types of headaches have been observed in CVT patients, including exploding headache, migraine-like headache, chronic tension headache, and chronic thunderclap headache 10,11 . In this study, we analyzed the clinical characteristics of CVT patients with or without headache and identi ed the risk factors for headache in this population.…”

Eclampsia and postpartum onset of subarachnoid hemorrhage in dual setting of cerebral venous thrombosis and posterior reversible encephalopathy syndrome: A case report

“…Our case did not present with the classical acute onset headache of aneurysmal SAH nor did she have risk factors such as chronic hypertension, smoking, drug abuse, or alcohol use. Her initial headache was subacute onset, fronto‐parietal, and throbbing in nature which favor more toward CVT as found out by Botta et al 11 Probably, sepsis as shown by neutrophil leucocytosis and worsening thrombocytopenia might have played a synergistic role in pathogenesis of PRES in our case 12 . The concomitant development of postpartum PRES in our case might have synergistic effect on SAH as reported by Sharma et al 12 The possible mechanisms explained in their study were either vasogenic or cytotoxic in nature.…”

Evaluation of Diagnostic Values in NCCT and MRI of the Patients With Cerebral Venous or Sinus Thrombosis in Loghman Hakim Hospital in Tehran 2014-2018

“…The most common presentation was a headache, compatible with other studies. [19][20][21] Our results demonstrated that the sensitivity of CT scan in the diagnosis of CVT is 60.5% and the specificity of CT is 66.7%. These amounts are lower than the study by Linn et al, indicating sensitivity of 64.6% and specificity of 97.2% only for the cord sign.…”