Role of D- Dimer in aseptic cerebral venous sinus thrombosis
Journal Title: Indian Journal of Neurosciences - Year 2017, Vol 3, Issue 1
Abstract
Introduction: Early diagnosis of cerebral venous sinus thrombosis (CVT) is essential because early treatment may prevent morbidity and may even be life-saving. Definite exclusion, however, needs advanced neuroradiologic diagnostics, which are not readily available in many hospitals. A biological marker like D-dimer can be used as a tool to help in diagnosis of CVT. Aims: To evaluate patients with CVT with diverse clinical manifestations and assess the importance of D-dimer in the diagnosis. Settings and Design: Prospective observational study carried out at Dept. of Neurology at a tertiary care hospital. Methods and Material: A total of 56 patients with CVT were subjected to a detailed medical history and neurological evaluation. A MRI brain was carried out on a 1.5T scanner using T1, T2, and Diffusion weighted sequences and TOF MR venography. D-dimer was quantitatively estimated by immunoturbidimetry. Statistical analysis used: SPSS 19 statistical software was used. Unpaired t test, ANOVA, Pearson chi square test was used to analyse different parameters. Significance level of 95% with p<0.05 was considered statistically significant. Results: A total 56 patients were enrolled in this study. The mean age was 33.98 +/- 13.20 years. Female: male ratio was 2.3:1. Headache was the most common presentation (82.1%) followed by vomiting(48.2%). MRI brain showed infarct in 39(69.6%) patients, out of which 24 (42.8%) had hemorrhagic venous infarct. Most common sinus involved was superior saggital sinus (71.4%) followed by transverse (64.3%). Mean D-dimer concentration in patients with 1 vein involvement was 1.04, in 2 vein involvement it was 1.35, in 3 vein involvement it was 1.30, 1.96 in patients with 4 and 5.67 in patients with more than 6 vein involvement which was found to be significant statistically. Conclusions: D-dimer might be not only suitable in the context of diagnosing CVT but also may be helpful in estimating severity of disease.
Authors and Affiliations
Dilip Maheshwari, Vijay Sardana, Parag Moon, Bharat Bhushan, Sankalp Mohan, Sumit Kamble, Piyush Ojha
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