Murugaiyan Sivaji, Sivaji Akshaya Rathin, Julin Asir
Neurology, Tamil Nadu Government Multi Super Specialty Hospital, Chennai, IND.
Internal Medicine, Panimalar Medical College Hospital & Research Institute, Chennai, IND.
Cureus. 2024 Jul 27;16(7):e65528. doi: 10.7759/cureus.65528. eCollection 2024 Jul.
Objective and aim Cerebral venous thrombosis (CVT) is a rare condition with significant morbidity and mortality risk involving the thrombosis of cerebral veins and dural sinuses. Its symptoms vary widely, ranging from headaches to focal neurological deficits, posing significant challenges to its diagnosis. Various contributing factors are involved in its etiology, some of which are gender specific. The clinical presentation varies widely and differs based on geographic distribution. This diversity makes CSVT challenging to diagnose, as it manifests in different ways and requires keen medical observation. Early detection is crucial for prognosis, as addressing the underlying cause can prevent further complications. This study aims to identify various causative factors and clinical presentations observed in individuals diagnosed with cerebral venous sinus thrombosis (CVST). Material and methods This prospective observational study was conducted at the Department of Neurology for a year, involving 55 patients admitted to the Neurology OPD/ER. Sample selection was done using non-probability convenience sampling. Patients aged 18 years or older presenting with symptoms indicative of CVST, confirmed by neuroimaging, were included in the study. Patients with arterial stroke, space-occupying lesions, and CVST related to pregnancy or puerperium were excluded. A detailed and structured medical history was obtained, and relevant blood investigations were conducted to find the underlying etiology. Results The study population had a mean age of 33 ± 2.04 years. The gender distribution is inclined towards 78.1% males due to the exclusion of pregnancy- or puerperium-related CVST to identify other predominant risk factors. 87.2% of the patients presented acutely, primarily with headaches (94.54%), and 67.2% had seizures within a week of admission. Prothrombotic conditions (45.4%) were the prevalent risk factor in the study group. Second, infections accounted for 21.8%. Alcoholism was seen in 52.7% of the study population, but its correlation with CVST remains unclear. The superior sagittal sinus (34.5%) and transverse sinus (20%) were commonly involved in neuroimaging, with multiple sinus involvement observed in some cases. Conclusion Cerebral venous sinus thrombosis (CVST) presents with a wide range of symptoms, making diagnosis challenging. However, with modern imaging and lab tests, we can detect and treat it effectively, often with positive outcomes and minimal long-term effects. This study seeks to understand the risk factors associated with CVST, contributing to its diagnosis and management.
目的和目标 脑静脉血栓形成(CVT)是一种罕见疾病,具有较高的发病和死亡风险,涉及脑静脉和硬脑膜窦的血栓形成。其症状差异很大,从头痛到局灶性神经功能缺损不等,给诊断带来重大挑战。其病因涉及多种促成因素,其中一些具有性别特异性。临床表现差异很大,且因地域分布而异。这种多样性使得脑静脉窦血栓形成(CSVT)难以诊断,因为它以不同方式表现,需要敏锐的医学观察。早期发现对预后至关重要,因为解决潜在病因可预防进一步并发症。本研究旨在确定在被诊断为脑静脉窦血栓形成(CVST)的个体中观察到的各种致病因素和临床表现。
材料和方法 这项前瞻性观察性研究在神经科进行了一年,涉及55名入住神经科门诊/急诊室的患者。样本选择采用非概率便利抽样。纳入年龄在18岁及以上、有神经影像学证实的提示CVST症状的患者。排除患有动脉性卒中、占位性病变以及与妊娠或产褥期相关的CVST患者。获取详细且结构化的病史,并进行相关血液检查以找出潜在病因。
结果 研究人群的平均年龄为33±2.04岁。由于排除了与妊娠或产褥期相关的CVST以确定其他主要危险因素,性别分布倾向于男性,占78.1%。87.2%的患者急性起病,主要表现为头痛(94.54%),67.2%的患者在入院一周内出现癫痫发作。血栓前状态(45.4%)是研究组中普遍的危险因素。其次,感染占21.8%。52.7%的研究人群存在酗酒情况,但其与CVST的相关性仍不明确。神经影像学检查显示,上矢状窦(34.5%)和横窦(20%)是常见受累部位,部分病例可见多个窦受累。
结论 脑静脉窦血栓形成(CVST)症状多样,诊断具有挑战性。然而,借助现代影像学和实验室检查,我们能够有效检测和治疗它,通常会取得良好效果且长期影响最小。本研究旨在了解与CVST相关的危险因素,有助于其诊断和管理。