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)

Narayan, Deekshanti; Kaul, Subhash; Ravishankar, K.; Turaga, Suryaprabha; Bandaru, V C S Srinivasarao; Mridula, Kandadai Rukmini; Jabeen, Shaik Afshan; Alladi, Suvarna; Meena, A K; Borgohain, Rupam

doi:10.4103/0028-3886.96388

Cited by 90 publications

(44 citation statements)

References 17 publications

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“…In the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT), for instance, anemia was present in 9.2% of patients. 11 This discrepancy might be explained by the fact that the prevalence of anemia was not a specific research objective in ISCVT, and that measurement 10 We found a stronger association between CVT and anemia than a previous case-control study, despite a similar prevalence of anemia among cases. 13 Stolz et al 13 reported only a weak association with severe anemia (OR, 1.1) and no association with mild anemia.…”

Section: Discussioncontrasting

confidence: 56%

Association Between Anemia and Cerebral Venous Thrombosis

Coutinho

Zuurbier

Gaartman

et al. 2015

Stroke

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Background and Purpose— Anemia is often considered to be a risk factor for cerebral venous thrombosis (CVT), but this assumption is mostly based on case reports. We investigated the association between anemia and CVT in a controlled study. Methods— Unmatched case–control study: cases were adult patients with CVT included in a single-center, prospective database between July 2006 and December 2014. Controls were subjects from the control population of the Multiple Environmental and Genetic Assessment of Risk Factors for Venous Thrombosis (MEGA) study. Anemia was defined according to World Health Organization criteria: nonpregnant women hemoglobin <7.5 mmol/L, pregnant women <6.9 mmol/L, and men <8.1 mmol/L. We used logistic regression analysis, adjusting for age, sex, malignancy, oral contraceptive use, and pregnancy/puerperium. Results— We included 152 cases and 2916 controls. Patients with CVT were younger (mean age, 40 versus 48 years) and more often women (74% versus 53%) than controls. Anemia was more frequent in cases (27.0%) than in controls (6.5%; P <0.001). Anemia was associated with CVT, both in univariate analysis (odds ratio, 5.3; 95% confidence interval [CI], 3.6–7.9) and after adjustment for potential confounders (adjusted odds ratio, 4.4; 95% CI, 2.8–6.9). Hemoglobin as a continuous variable was inversely associated with CVT (adjusted odds ratio per 1 mmol/L change 0.53; 95% CI, 0.42–0.66). Stratification by sex showed a stronger association between anemia and CVT in men (adjusted odds ratio, 9.9; 95% CI, 4.1–23.8) than in women (3.6; 95% CI, 2.1–6.0). Conclusion— Our data suggest that anemia is a risk factor for CVT.

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Section: Discussioncontrasting

confidence: 56%

Association Between Anemia and Cerebral Venous Thrombosis

Coutinho

Zuurbier

Gaartman

et al. 2015

Stroke

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“…Similar results have been shown in different series. [ 11 12 13 14 15 ] Depending on the availability of collateral venous pathways, CVST can result in significant brain involvement or may be presented as nonspecific symptoms like headache. The mechanism of headache is postulated to be the stretching of nerve fibers in the walls of the occluded sinus and local inflammation, as suggested by the evidence of contrast enhancement of the sinus wall surrounding the clot.…”

Section: Discussionmentioning

confidence: 99%

Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

Goyal¹,

Charan²,

Singh³

2018

Ann Indian Acad Neurol

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Introduction:Cerebral venous sinus thrombosis (CVST) is an unusual cause of stroke with potentially serious consequences. This study was designed to investigate the clinical and neuroimaging features in patients with CVST and to analyze the predictors of brain parenchymal lesions.Materials and Methods:A retrospective study of 181 patients with CVST was conducted in a tertiary care hospital.Results:Of 181 patients (age range 14–96 years, mean age: 34.64 ± 14.66 years), 121 were female (66.9%). Most of the patients were in their third decade of life. Headache (47.51%) was the most common clinical presentation followed by seizures (24.31%). Transverse sinus (TS) (77.9%) was the most common site of venous sinus thrombosis. Brain parenchymal lesions were present in 63%, and each patient had subarachnoid and intraventricular hemorrhage. Hemorrhagic venous infarct was the most common brain parenchymal lesion (37.57%). Frontal region (25.4%) was the most common site of brain parenchymal lesions followed by frontoparietal region (21.9%). Women were more likely to have brain parenchymal lesions (72.4%, P = 0.034). Headache was the most common clinical presentation in patients without brain parenchymal lesions while seizures with brain parenchymal lesions. Straight sinus thrombosis was more likely to be associated with brain parenchymal lesions (P = 0.009).Conclusion:CVST presents in young and more commonly in females. TS was the most common site of venous sinus thrombosis. Female gender, seizures, altered sensorium and focal neurological deficit at presentation, and straight sinus thrombosis were more likely associated with the presence of brain parenchymal lesions.

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“…This is in conformity with most of the earlier studies by Ameri and Bousser[9] (61%), Daif et al .,[10] Deschiens et al .,[11] Nagaraja et al .,[12] and Narayan et al . [13] The present study showed a female preponderance with ratio of male to female patients being 1:3.76 because of influence of pregnancy, puerperium, and oral contraceptive pills, whereas ratio was 1:1.29 in study done by Ameri and Bousser[9] and 1:1 by Daif et al .,[10] and studies done in India showed higher number of female patients such as 1:1.38 by Patil et al . [14] and 1:1.4 by Mehta et al .…”

Section: Discussionmentioning

confidence: 99%

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

Banakar

Hiregoudar

2017

Journal of Neurosciences in Rural Practice

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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.

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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)

Abstract: Compared to the previous studies, prevalence of CSVT was higher in men. Anemia, hyperhomocysteinemia, alcoholism, oral contraceptive use, and postpartum state were the most common risk factors. Overall prognosis was good, but a small percentage of patients died or showed recurrence.

Cited by 90 publications

References 17 publications

Association Between Anemia and Cerebral Venous Thrombosis

Association Between Anemia and Cerebral Venous Thrombosis

Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

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

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