Cerebral Venous Sinus Thrombosis in a Tertiary Care Center in Nepal
Journal Title: Nepal Journal of Neuroscience - Year 2013, Vol 10, Issue 2
Abstract
The advent of sensitive diagnostic techniques along with widespread treatment of Cerebral Venous Sinus Thrombosis (CVST) with anticoagulation has transformed this once dreaded disease to a benign entity. Prompt diagnosis on hospital visit and effective therapeutic interventions are likely to improve the outcome of the CVST patients and we employed this good clinical practice in our study. From 2007 to 2011, 32 adult patients with CVST confirmed by radiography and investigated for prothrombotic states were retrospectively studied. All patients were followed up for 6 months after hospitalization and the outcome at last follow- up visit was assessed by modified Rankin Scale (mRS). Primary outcome was mRS <=2 at the end of follow-up signifying good outcome. Of the 32 patients, 18(56.3%) were men and the mean age was 37.8 years (range 18-66). The most common symptoms were headaches (84.4%), vomiting (37.5%) and seizures (21.9%). Papilledema (31.3%) and isolated intracranial hypertension (IIH) (31.3%) were the most common sign and clinical syndrome respectively. The most common risk factors were oral contraceptive pills (28.1%) and dehydration (18.7%). Good outcome (mRS<=2) and poor outcome (mRS 3-6) at the end of follow-up were observed in 28(87.5%) and 4(12.5%) patients respectively with mortality (mRS=6) of 3(9.4%) patients. We had higher prevalence of CVST in men than previously reported. We had excellent prognosis with 87.5% of patients exhibiting good outcome (mRS<=2) at the final follow-up. We attribute this remarkable patient’s outcome to increased awareness of this entity, prompt diagnosis on hospital visit and timely intervention with effective therapies.
Authors and Affiliations
Upendra P Devkota, MBBS, FRCS
Keywords
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