Cerebral Venous Thrombosis – Clinical Profile and Role of MRI in Diagnosis and Prognosis

Abstract

Inclusion Criteria All patients with Cerebral venous sinus/Cortical vein thrombosis confirmed by MRI. Exclusion Criteria Patients with normal Dural Sinuses/Cortical veins on MRI. Patients with MRI Incompatible Devices such as Cochlear Implants, Cardiac Pacemaker etc. Claustrophobic Patients. Proper Consent to include in the study was obtained from all the patients. The study was conducted after considering and following all the factors of Declaration of Helsinki. RESULTS Wide range of age groups were affected by cerebral venous thrombosis in our study from 2 nd decade to 7 th decade in A B S T R A C T Introduction: Cerebral Venous Thrombosis (CVT) is relatively a rare cause of stroke which is potentially treatable without any permanent neurological deficit if diagnosed early in time. The objective of this study was to describe the etiologies, clinical features and the importance of MRI in diagnosis and prognosis of Cerebral Venous Thrombosis. Material and Methods: This was a prospective study done in 50 consecutive patients diagnosed with cerebral venous thrombosis on MRI in Meenakshi Medical College Hospital and Research Institute, Kanchipuram between April 2016 and March 2018. Detailed history, proper clinical examination and necessary laboratory investigations were done in all the cases. Results: Among 50 patients, most of the cases were seen in 21-50 years of age comprising 92%. The most common presenting symptom was headache(82%) followed by Vomiting(52%), altered sensorium(44%) and seizures(42%). Superior sagittal sinus is the commonest one involved in our study. MRI is helpful to assess the prognosis. Venous infarct is seen in 48% of the cases and diffusion restriction is seen only in 8% of cases. Conclusion: Clinical presentation of Cerebral venous thrombosis(CVT) is vague and high degree of clinical suspicion should be there in young patients presenting with headache, seizures or papilledema. MRI plays a very vital role in the diagnosis and prognosis. Heparin, anticoagulants, antiepileptics and symptomatic treatment play the key role in management. Cerebral venous Thrombosis has very good prognosis provided early diagnosis is made and proper treatment started in time.