Study of Clinical Profile of Cerebral Venous Sinus Thrombosis

Abstract

The syndrome of intracranial venous sinus thrombosis termed as cerebral venous thrombosis is a distinctive cause of cerebrovascular disease in the young. CVT has been diagnosed almost exclusively at autopsy. However, with the advent of modern neuroimaging techniques, the quantum of CVT cases being diagnosed has increased significantly when compared to previous years. The annual incidence is currently estimated to be 3-4 cases for one million people. It accounts for 10% to 20% of the etiology of young stroke in India. 1 CVT is now typically recognized as a disorder with various clinical presentations and usually favorable outcome. Magnetic resonance imaging and magnetic resonance angiography are the best diagnostic methods available for diagnosis of CVT, and heparin is the first line treatment. But as the symptoms, modes of onset, and neuroimaging methods are diverse, the diagnosis of CVT is commonly overlooked. Pathological hallmark of CVT is hemorrhagic infarction. CVT is primarily a disease of a young man, can present in protean ways with a wide spectrum of clinical manifestations. These include headache, altered sensorium, seizures, focal neurological deficits, papilledema and cranial nerve palsies. The commonest dural venous sinuses involved are superior sagittal sinus and transverse sinus. Nearly 20% of cases of CVT are idiopathic in origin. However, in the Asian Studies, infectious puerperium seems to be the commonest cause of CVST. Though stroke due to arterial thrombosis is more common, cerebral venous sinus thrombosis especially in young strokes. The clinical and neurological presentation can be variable, hence there needs to be a high index of suspicion for venous sinus thrombosis in order to diagnose this entity clinically. There is a wide spectrum of underlying causes of this condition. The prognosis is good, especially when the diagnosis is prompt and treatment initiated. The aim of this study is to study the clinical profile of cerebral venous sinus thrombosis, to study the etiology factors of cerebral venous sinus thrombosis, to correlate the severity and clinical presentation with imaging studies to study the outcome at discharge and at follow-up if possible.