Clinical Profile, Outcome, and Prognostic Factors of Cortical Venous Thrombosis in a Tertiary Care Hospital, India

Abstract

Background:Cortical venous thrombosis (CVT) is a rare condition, compared to arterial stroke and often occurs in young individuals presenting with varying clinical features.Aim:The aim is to study clinical profile and assess the outcome and prognostic factors of CVT patients.Methodology:A case series study was done for 2 years. CVT cases confirmed by magnetic resonance imaging were included in this study. Clinical presentation and risk factors were noted then patients were assessed at the time of discharge for their physical and mental status. Modified Rankin scale was used to group patients, accordingly scores 0–2 were considered as good and 3–6 as poor outcome, respectively. Data were analyzed using Chi-square test to know the association between prognostic factors and outcome.Results:Out of 81 patients, more than half of the patients were in the age group of <35 years (55.6%), and majority of patients were females (79%). Most common symptom was headache (82.7%) and least was fever (14.8%). Superior sagittal sinus was most commonly involved (74.1%). Nearly half of the patients were in puerperal period (44.1%). Patients aged more than 35 years (odds ratio [OR]: 9.1, confidence interval [CI]: 4.463–19.750) presenting with symptoms such as fever (OR: 3.442, CI: 1.088–12.140), impaired consciousness (OR: 5.467, CI: 2.064–15.330) and having clinical signs such as coma (OR: 23.99, CI, 3.844–544.1), papilledema (OR: 25.15, CI: 7.565–101.5), and with focal neurological deficit (OR: 9.366, CI: 2.693–3.41) had statistically significant poor outcome.Conclusion:Females formed a major bulk of patients. Higher number patients showed poor outcome. Study showed association between age, headache, impaired consciousness, coma, papilledema, and neurological deficit to poor outcome.

A study of clinical, radiological and etiological profile of cerebral venous sinus thrombosis at a tertiary care center

“…In the present study transverse sinus was most frequently involved (40/54) 74% followed by superior sagittal sinus in (29/54) 52%, sigmoid sinus in (27/54) 50%, Straight sinus in (4/54) 7%, cortical veins alone in (2/54) 4% and deep veins in (1/50) 2% which is comparable with Bousser et al 15 The most common MRI finding was hemorrhagic venous infarction accounting for 30% of cases. Similar observations were noted in a recent study by Banakar et al 16 Table 5 compares the clinical, radiological and etiological profile of this study, with other large Indian cohort studies on CVT.…”

Clinical Profile and Prognosis of Cerebral Venous Sinus Thrombosis

“…These results were comparable with those of Bousser et al [ 23 ]. Similar results were noted in a recent study by Banakar et al [ 24 ]. One patient had a normal MRV.…”

Essential thrombocytosis: review of literature with a rare presentation of cerebral thrombosis treated with endovascular therapy

“…40,41 There was no definitive data regarding India as there were no multi-center hospital-based studies, but it was estimated to be higher than the average global incidence. 42 The management of CVST had always been complex because of the variety of underlying risk factors and the absence of a standardised treatment approach. Given the diversity of causes and presenting scenarios, CVST may commonly be encountered by neurologists, neurosurgeons, emergency physicians, internists, oncologists, haematologists, obstetricians, paediatricians and family practitioners.…”