Study of Clinical Profile, Radiological Findings and Risk Factors in Patients with Cerebral Venous Thrombosis in Tertiary Care Hospital

Abstract

Background: Cerebral venous thrombosis is a rare cause of stroke in adults especially in the young. It is a diagnostic and therapeutic challenge for the physician, given the wide spectrum of its clinical presentation. The purpose of the present study is to describe the clinical features, risk factors, radiological findings and outcome in a patient of Cerebral venous thrombosis. Objective: To study clinical profile, radiological findings and risk factors in patients with cerebral venous thrombosis amongst study participants. Material and Method: The prospective observational study was conducted on 60 patients admitted in department of General Medicine at tertiary health care institute at Nashik. Written informed consent was taken from all the study participants, and those who gave consent and satisfy eligibility criteria were enrolled in the present study between August 2017 to December 2019 with a radiologically confirmed diagnosis of cerebral venous thrombosis. Detailed history, clinical examination, laboratory investigations were carried out in all the cases and followed until discharge from the hospital or death. All the data will be analysed by applying appropriate statistical tests Microsoft Excel 2010. Results: Majority of incidence was seen in 18-30 age group comprising 50% of the cases, with equal sex distribution. Mean age of patient was found to be 37.3 years. Most patient had subacute onset with headache (76.67%) being the commonest presenting symptoms followed by convulsions and focal deficit in 46.67%. Hemiparesis 43.67% followed by papilloedema 33% were the most common neurological signs. Hyperhomocystinemia 33.67% and Protein S deficiency 20% were the most common risk factors identified in males whereas anemia 60% and puerperium 26.67% were most common in females. Transverse sinus (66.33%) was most common sinus involved radiologically followed by superior sagittal sinus in 43.67%. In 90% of the cases Low Molecular Weight Heparin [LMWH] was given and remaining 10% were given intravenous unfractionated heparin. 14% cases underwent decompressive surgery. Mortality was found to be 6.33% in the present study. Conclusion: High index of suspicion required for diagnosis of Cerebral venous thrombosis. The clinical presentation is nonspecific, can vary significantly and often makes the diagnosis of quite puzzling. MRI brain and MR Venogram are necessary for establishing a diagnosis. Patients are treated with anticoagulants, antiepileptics and antiedema measures and surgical decompression in case of continuing deterioration, in spite of maximum medical management. Cerebral venous thrombosis has a good prognosis unlike arterial ischemic stroke if the acute stage of illness has been survived.