Cerebral venous sinus thrombosis: Clinical profile and surgical outcome
Journal Title: Indian Journal of Neurosciences - Year 2018, Vol 4, Issue 3
Abstract
Thrombosis of the cerebral venous sinuses CVST is common cause of acute neurological deficit and altered sensorium Most of the patients are young and can suffer severe morbidity and mortality if not treated aggressively Early diagnosis and management is necessary for good outcome in case of CVSTMaterial and Methods Retrospective observational study over a period of 4 year 3 months from oct39 2013 to feb392018 in our institute CVST was affirmed by MRI brain venogram of 84 patients were included in this study Decompressive craniectomy done in case of mass effect or herniation All patients were treated according to standard guideline and protocolResultThis study include 51 607 females and 33 392 males with the age of 39 10 years and 29 7 years respectively Out of which 25 patients 297 had hemiparesishemiplegia vomiting and headache was manifested in 79 94 patients seizures in 1315 and fever in 30357 38452 out of 84 patients were presented with sagittal sinus thrombosis 10119 of 84 with multiple sinus thrombosis and 35416 of 84 patients with transversesigmoid sinus thrombosis On funduscopic examination papilledema in 25297 patients Patients had diagnosis of CVST during peripartum period altogether 8156 out of 51 female 1 patient had bilateral cavernous sinus thrombosis Signs of infection seen in patients in the study as Chronic supportive otitis media CSOM fever 111309 patients had paranasal sinus PNS infections 10 119 patients had evidence and history of lack of hydration 8 95 patients of the total deceased during the course of treatment and 79 94 out of 84 patients were discharged with partial orand total recovery Three 25297 required decompressive craniectomy Multiple sinus thrombosis had poor prognosisConclusionMost commonly involved sinus is superior sagittal sinus while transverse or sigmoid sinus and bilateral cavernous sinus thrombosis follows it being uncommon fondness in CVST Third part of the female population was influenced because of oral contraceptive pills and the peripartum period has high risk for CVST39 The lack of hydration andor infection was the most commonly related accelerating event for the advancement of CVST and hyper homocysteinemia which is seen in more than one fourth of the population Mortality and morbidity was more in patients of multiple sinus involvement The treatment must be aggressive as mortality and morbidity is relatively minimal compared with the arterial strokeKeywords Cerebral venous sinuses thrombosis Decompressive craniectomy Thrombosis of sagittal sinus
Authors and Affiliations
Bhagwati Salgotra, Dhruv Patel
Keywords
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