Author(s): G. Anitha1, N. K. Senthilnathan2, M. Rajasekaran3, R. Elanchezian4, L. Muthumani5
CVT is a rare type of cerebrovascular disease that can occur at any age. The widespread use of neuroimaging now allows for early diagnosis and has completely modified our knowledge on this disorder. CVT is more common than previously thought and it is recognised as a disorder with a wide spectrum of clinical presentations.
AIMS & OBJECTIVE ??? To establish the clinical spectrum of the disease. ??? To determine the relationship between clinical findings, lab investigations and magnetic resonance imaging with venogram findings in CVT.
MATERIALS AND METHODS
The purpose of the study was explained to the patients and an informed written consent was obtained. Patients presenting with signs and symptoms suggestive of cerebral venous sinus thrombosis were evaluated. The diagnosis of cerebral sinus venous thrombosis is to be confirmed by MRI combined with MR venogram. The patients were analysed for clinical presentations, signs and symptoms, imaging findings, location and extent of the thrombus, and parenchymal lesions and based on the data to establish the correlation between clinical and MRI/MRV findings. Unpaired ‘t’ test and Chi square test were used to analyse the significance.
47% of the cases had a sub-acute onset while 40% had acute onset of symptoms. Headache is the most common presentation followed by seizures and focal neurological deficits and 21% of the cases presented with altered sensorium. Superficial sinuses were involved in 79% of cases. Most common site is superior sagittal sinus and superficial cortical veins. Deep sinus was involved in 21% of cases. 62% of patients had a haemorrhagic infarct or an associated finding. 13.2% succumbed to the illness. MRI/MRV proved to be better investigation to confirm the diagnosis than CT brain.
DISCUSSION AND CONCLUSION
The spectrum of the disease includes headache, seizures, focal neurological deficits, altered sensorium and other neurological signs. Most commonly superficial cortical veins, superior sagittal sinus are involved. Patients with deep CVT/IJV involvement had a poor prognosis.