Venous thrombosis of the brain. Retrospective review of 110 patients in Kuwait.
ABSTRACT To highlight the importance of neurological presentation and complications in the early diagnosis and management of cerebral venous thrombosis (CVT).
We performed a retrospective case analysis of 110 patients with CVT treated at the Neurology Center, Ibn Sina Hospital, in Kuwait from January 2000 to September 2013. The records of patients with CVT were retrieved and entered in a data sheet. The different neurological presenting signs and symptoms were analyzed based on their frequency, pathogenesis, and treatment.
One hundred and ten (110) patients were included in this study, with a male to female ratio of 1:1.7. Neurological signs and symptoms were headache (82%), seizures (42%), and focal neurological deficits (33%). Papilledema with raised intracranial pressure was recorded in 35 patients (32%). Venous and hemorrhagic venous infarctions were recorded in 27 patients, and multiple intracerebral or subarachnoid hemorrhages in 7 patients. The venous sinuses involved were the superior sagittal sinus in 54.5%, and transverse sigmoid sinuses in 52%.
Headache, seizures, and focal neurological deficits were the most common neurological presentation. Anticoagulants (systemic heparin) were used as first-line therapy, including patients with intracerebral hemorrhage. The use of steroids and osmotic diuretics as anti-edema measures were recorded in 25% of cases. Treating raised ICP by repeated lumbar puncture and CSF drain could prevent visual failure.
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ABSTRACT: Background: Plasma levels of D-dimer shown to be elevated and sensitive for the diagnosis of deep vein thrombosis including cerebral venous thrombosis (CVT). Objective: To assess the usefulness of serum D-dimer level, for the diagnosis of CVT. Subjects and Methods: This retrospective analysis included 65 patients who was diagnosed with cerebral venous thrombosis proved by magnetic resonance venography (MRV) or computed tomographic venography (CTV), from Jan. 2005 up to Dec. 2014. The patient’s files were collected and the data were extracted for the study. Based on these data, the usefulness of serum D-dimer level for the diagnosis of CVT, were analyzed. Results: The records of 23 male and 42 female were taken for this clinical review. The D-dimer level were elevated in 42 patients (64.6%) versus 23 patients (35.4%) with normal level; P <0.018. Eight patients had slight elevation of D-dimer level (200-500 ngm/ml), 18 patients had moderate elevation of D-dimer level (500-1000 ngm/ml) and 16 patients had very high level of D-dimer (1000-2000 ng/ml). The sensitivity and specificity of predicting cerebral venous sinus thrombosis using D-dimer were 64.6% and 71.5%. The pattern of venous sinuses involved, the neurological deficits were different and did not correlate with serum D-dimer levels (r=0.18, P<0.108). Conclusion: Raised D-dimer level are often helpful for early diagnosis of CVTOpen Access Emergency Medicine 07/2015; 4(4):1000265. DOI:10.4172/2165-7548.1000265