Clinical presentation, risk factors and factors affecting short term outcome in patients with cerebral venous thrombosis
Keywords:Clinical presentation, Cerebral venous thrombosis, Patients, Risk factors, Short term outcome
Background: Cerebral venous thrombosis is a rare cause of stroke, with a predilection to females. Since the past two decades its morbidity and mortality had decreased because of the new effective diagnostic and therapeutic interventions. This study mainly intends to assess, the clinical and aetiological factors of cerebral venous thrombosis and the factors predicting its short-term outcome. Objective was to study the factors influencing the short-term outcome of CVT and to study the pattern of clinical presentation and risk factors for CVT.
Methods: It was a cross-sectional study done at a tertiary care Centre in Tamil Nadu, in adult CVT patients from august 2018 to august 2019. Clinical, aetiological and radiological data were collected from patients and assessed and factors influencing the short-term outcome at discharge and at 15 days after discharge were studied. Data was analysed using SPSS16 software. Analysis of the descriptive data was performed and independent factors influencing the short-term outcome were analysed subsequently.
Results: Males predominated in the study with a mean age of 38yrs. Most common presentation was headache. Infarct was present in 61 (56.5%). The most common site of venous involvement was superior sagittal sinus 81 (75%). Short term outcome had shown a significant association with hypertension (p value -0.019 and odds ratio-65.439) and baseline MRS (p value- 0.000, OR - 0.004) only.
Conclusions: Nowadays, the mortality and morbidity of CVT has decreased. Hypertension has emerged as an independent predictive factor in the short -term outcome of CVT.
Srinivas G. Clinical profile, natural history and factors determining prognosis/outcome study of cerebral venous sinus thrombosis (Doctoral dissertation, SCTIMST).
Panagariya A, Maru A. Cerebral venous thrombosis in pregnancy and puerperium-a prospective study. J Assoc Physicians India. 1997;45:857-9.
Wasay M, Kamal A, Khealani B, International Advisory Committee, Roach S, Stam J, et al. Asian cerebral venous thrombosis registry: study protocol. J Vasc Interv Neurol. 2009 Apr;2(2):169-71.
Luo Y, Tian X, Wang X. Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review. Front Aging Neurosci. 2018 Jan 30;10:2.
Sasikala R, Aishwarya J, Dilshath S. Clinical profile of cerebral venous thrombosis in pregnancy and puerperium in South India. Int J Reprod Contracept Obstet Gynecol. 2017;6:3124-8.
Silvis SM, Middeldorp S, Zuurbier SM, Cannegieter SC, Coutinho JM. Risk factors for cerebral venous thrombosis. Semin Thromb Hemost. 2016;42:622- 31.
Tufano A, Guida A, Coppola A, Nardo A, Di Capua M, Quintavalle G, et al. Risk factors and recurrent thrombotic episodes in patients with cerebral venous thrombosis. Blood Transfus. 2014 Jan;12 Suppl 1(Suppl 1):s337-42.
Lee SK, Kim BS, Terbrugge KG. Clinical Presentation, Imaging and Treatment of Cerebral Venous Thrombosis (CVT). Interv Neuroradiol. 2002 Mar 30;8(1):5-14.
Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007 Feb 1;6(2):162-70.
Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral venous sinus thrombosis incidence is higher than previously thought: a retrospective population-based study. Stroke. 2016 Sep;47(9):2180-2.
Nagpal RD. Dural sinus and cerebral venous thrombosis. Neurosurg Rev. 1983;6:155-60.
Srinivasan K, Natarajan M. Cerebral venous and arterial thrombosis in pregnancy and puerperium. Neurol India. 1974; 22:131-40.
Nagaraja D, Taly AB. Cerebral Venous sinus thrombosis. J Assoc Physician India. 2004;52:18-20.
Ferro JM, Canhao P, Stam J. Prognosis of cerebral vein and dural sinus thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004;35:664-70.
Narayan D, Kaul S, Ravishankar K, Suryaprabha T, Bandaru VS, Mridula KR, et al. Risk factors, clinical profile, and long-term outcome of 428 patients of cerebral sinus venous thrombosis: Insights from Nizam's Institute Venous Stroke Registry, Hyderabad (India). Neurol India. 2012 Mar 1;60(2):154.
Bose P, Joshua PJ, Thandavarayan M. A clinical study of cerebral venous thrombosis. Int J Adv Med. 2017;4:1236-40.
Pai N, Ghosh K, Shetty S. Hereditary thrombophilia in cerebral venous thrombosis: A study from India. Blood Coagul Fibrinolysis. 2013; 24:540-3.
Ramrakhiani N, Sharma DK, Dubey R, Gupta P, Sharma A, Sharma KK. Clinical Profile, Risk Factors and Outcomes in Patients with Cerebral Venous Sinus Thrombosis: A Study from Western India. J Assoc Physicians India. 2019;67(9):49‐53.
Saroja AO, Tapsi C, Naik KR. Cerebral venous thrombosis in women from Indian subcontinent. J Sci Soc. 2017;44:20-5.
Bushnaq SA, Qeadan F, Thacker T, Abbas M, Carlson AP. High-risk features of delayed clinical progression in cerebral venous thrombosis: a proposed prediction score for early intervention. Intervent Neurol. 2018;7(6):297-307.
Khosya S. A Study of Clinical Pro le, Risk Factors and Outcome of the Cerebral Venous SinusThrombosis (CVST): An Experience at a Tertiary Care Center, INDIA. Austin J Neurol Disord Epilepsy. 2018;5(2):1041.
Rajendran A, Bose JA, Ponnu S DCH, Jayasankar V R, Shameer P. Clinical and etiological pro le of cerebral venous sinus thrombosis. International J Contempor Med Res. 2020;7(1):A1‐A4.
Ravikumar T, Vasanthakumar JA, Govindarajan K, Bharadwaj C, Prasannakumar P, Shankar R. Association of Hypertension and Cerebral Venous Thrombosis among the Women in the Puerperal Period – A Prospective Study. Indian J Basic Applied Medical Res. 2016;5(2):472-80.