Devan, R (2013) Study on Clinical Profile of Cerebral Venous Thrombosis. Masters thesis, Thanjavur Medical College, Thanjavur.
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Abstract
BACKGROUND : Cerebral venous thrombosis (CVT) refers to the thrombosis of dural venous sinuses or the cerebral veins. Once considered a rare disease, CVT is now being recognized with increasing frequency especially in South Asian countries including India. It is an important cause of young strokes in India especially among woman. Though the prognosis is good in majority of patients, it is a potentially life threatening disease requiring early clinical suspicion and prompt diagnosis. However the diagnosis may be challenging in certain cases due to varied clinical presentation and there is a substantial difference in predisposing factors, presentations, therapeutic options, and outcome between developed and developing countries. The objective of our study was to study the demographic, clinical, etiological, radiological and prognostic characteristics of the disease in patients admitted with CVT in our hospital. METHODS : This was a cross sectional study conducted on 45 patients admitted with CVT in Thanjavur medical college hospital, Thanjavur satisfying the inclusion and exclusion criteria. Detailed history, neurological examination, brain imaging with CT and MRI with MRV, routine and specific laboratory investigations as required were done in all patients and we analysed the demographic factors, clinical presentation, etiology, radiological features and outcome in these patients. Factors associated with good and poor outcome were also analysed. RESULTS : In our study, CVT was 3 times more common in females than in males especially those between the age group of 21 to 30 years. Majority of patients presented subacutely. Headache was the most common symptom and papilledema was the most common sign. 28% of patients presented with headache as an isolated symptom. Other common presentations were altered sensorium, focal motor deficit, generalized seizures and delirium. Puerperium was the leading cause of CVT in our study. Superior sagittal sinus and right transverse sinus were the most common sinuses involved by MRI with MRV. Most common finding in CT Brain was haemorrhagic infarct though CT Brain was normal in about 26 to 27 % of patients. In our study, the mortality rate was 11% and the morbidity rate was 17%. Presentation with Isolated intracranial hypertension syndrome was associated with good outcome. Age ≥35 years, GCS score of <9 and coma at presentation were associated with poor prognosis. CONCLUSION : 1. CVT has a wide range of clinical presentation. 2. CVT should be suspected, i) Whenever a young adult presents with symptoms and signs of raised intracranial tension with or without other neurological symptoms. Examination of the fundus to rule out papilledema is an important tool in arriving at a diagnosis in such cases of CVT. ii) Whenever a young adult presents with stroke especially in the absence of vascular risk factors. iii) Whenever a peripartum female presents with neurological symptoms in our setting. iV) Whenever imaging of the brain shows haemorrhagic infarct especially in non arterial territories. 3. Diagnosis should be confirmed by MRI with MRV whenever possible. 4. In general, the prognosis is good in CVT; however extravigilance may be required in patients who present with poor prognostic factors.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Cerebral venous thrombosis, Young peripartum females, Wide clinical presentation, Most common- Isolated intracranial hypertension, Haemorrhagic infarct in CT brain, Confirm diagnosis by MRI with MRV, Prognosis good in general. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 06 Mar 2018 05:44 |
| Last Modified: | 06 Mar 2018 05:44 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6049 |
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