Rohan Mahale1, Anish Mehta2, Aju Abraham John3, Kiran Buddaraju4, Abhinandan K Shankar5, Mahendra Javali6, Rangasetty Srinivasa7. 1. Department of Neurology, MS Ramaiah Medical College & Hospital, MSRIT Post, New BEL Road, Bangalore 560054, Karnataka, India. Electronic address: rohanmahale83@gmail.com. 2. Department of Neurology, MS Ramaiah Medical College & Hospital, MSRIT Post, New BEL Road, Bangalore 560054, Karnataka, India. Electronic address: anishmehta1302@gmail.com. 3. Department of Neurology, MS Ramaiah Medical College & Hospital, MSRIT Post, New BEL Road, Bangalore 560054, Karnataka, India. Electronic address: aaajohn99@gmail.com. 4. Department of Neurology, MS Ramaiah Medical College & Hospital, MSRIT Post, New BEL Road, Bangalore 560054, Karnataka, India. Electronic address: kiranb@gmail.com. 5. Department of Neurology, MS Ramaiah Medical College & Hospital, MSRIT Post, New BEL Road, Bangalore 560054, Karnataka, India. Electronic address: abhiks@yahoo.com. 6. Department of Neurology, MS Ramaiah Medical College & Hospital, MSRIT Post, New BEL Road, Bangalore 560054, Karnataka, India. Electronic address: jvmahend@gmail.com. 7. Department of Neurology, MS Ramaiah Medical College & Hospital, MSRIT Post, New BEL Road, Bangalore 560054, Karnataka, India. Electronic address: Srinivasa-drsrinivas@hotmail.com.
Abstract
BACKGROUND: Seizures are the presenting feature of cerebral venous sinus thrombosis (CVST) in 12-31.9% of patients. 44.3% of patients have seizures in the early stage of the disease. Acute seizures (AS), refers to seizures which take place before the diagnosis or during the first 2 weeks afterward. OBJECTIVE: To report the predictors of acute seizures in cerebral venous sinus thrombosis (CVST). METHODS: 100 patients with CVST were included in the study. The occurrence of acute seizures was noted. The predictors of acute seizure were evaluated by univariate analysis including the demographic (gender, age), clinical (headache, focal neurological deficit, papilloedema, GCS score), type and number of risk factors, MRI findings (Type of lesion: hemorrhagic infarction or hematoma, location of lesion) and MRV findings (superficial or deep sinus, cortical veins). RESULTS: A total of 46 patients had acute seizures. On univariate analysis, altered mental status (p<0.001), paresis (p=0.03), GCS score <8 (p=0.009), hemorrhagic infarct on imaging (p=0.04), involvement of frontal lobe (p=0.02), superior sagittal sinus (p=0.008), and high D-dimer levels (p=0.03) were significantly associated with acute seizure. On multivariate analysis, the hemorrhagic infarct on MRI and high D-dimer was independently predictive for early seizure. CONCLUSION: The predictive factors for the acute seizures are altered mental status (GCS<8), focal deficits, hemorrhagic infarct, involvement of frontal lobe and superior sagittal sinus with high D-dimer levels.
BACKGROUND:Seizures are the presenting feature of cerebral venous sinus thrombosis (CVST) in 12-31.9% of patients. 44.3% of patients have seizures in the early stage of the disease. Acute seizures (AS), refers to seizures which take place before the diagnosis or during the first 2 weeks afterward. OBJECTIVE: To report the predictors of acute seizures in cerebral venous sinus thrombosis (CVST). METHODS: 100 patients with CVST were included in the study. The occurrence of acute seizures was noted. The predictors of acute seizure were evaluated by univariate analysis including the demographic (gender, age), clinical (headache, focal neurological deficit, papilloedema, GCS score), type and number of risk factors, MRI findings (Type of lesion: hemorrhagic infarction or hematoma, location of lesion) and MRV findings (superficial or deep sinus, cortical veins). RESULTS: A total of 46 patients had acute seizures. On univariate analysis, altered mental status (p<0.001), paresis (p=0.03), GCS score <8 (p=0.009), hemorrhagic infarct on imaging (p=0.04), involvement of frontal lobe (p=0.02), superior sagittal sinus (p=0.008), and high D-dimer levels (p=0.03) were significantly associated with acute seizure. On multivariate analysis, the hemorrhagic infarct on MRI and high D-dimer was independently predictive for early seizure. CONCLUSION: The predictive factors for the acute seizures are altered mental status (GCS<8), focal deficits, hemorrhagic infarct, involvement of frontal lobe and superior sagittal sinus with high D-dimer levels.
Authors: Pritam Raja; Ravindranadh C Mundlamuri; Prathyusha P Vasuki; Girish B Kulkarni; Raghavendra Kenchaiah; Ajay Asranna; L G Viswanathan; Rohan Mahale; V H Ganaraja; Shamick Biswas; Karthik Kulanthaivelu; Sanjib Sinha Journal: Ann Indian Acad Neurol Date: 2022-06-24 Impact factor: 1.714