Venkatesh Thammishetti1, Subrahmanyam Dharanipragada2, Debdatta Basu3, Ramesh Ananthakrishnan4, Deepanjali Surendiran5. 1. Senior Resident, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India . 2. Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India . 3. Professor, Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India . 4. Associate Professor, Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India . 5. Assistant Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India .
Abstract
INTRODUCTION: Cerebral Venous Thrombosis (CVT) is a well known disease with diverse clinical presentation and causes. With advances in neuroimaging and changing lifestyles, the clinical profile and causes of CVT are changing. D-dimer has been studied in early diagnosis of CVT with variable results. This prospective study was carried out to assess the clinical profile of CVT and role of D-dimer in diagnosis of CVT. AIM: To study various aspects of CVT and role of D-dimer. MATERIALS AND METHODS: The study period was September 2012 to July 2014 and included 80 imaging proven patients of CVT. We also included 39 controls for assessing D-dimer. Data was collected according to a preformed format. D-dimer was assessed by a rapid semi-quantitative latex agglutination assay. Discharged patients were followed up to six months. RESULTS: Of the total 44 were women and 36 were men (F: M=1.2:1). The mean age of the patients was 29.5±9.68 years. Most common clinical features were headache 77 (96.25%), papilloedema (67.5%) and seizures 51 (63.75%). Pregnancy was the most common cause of CVT. Superior sagittal and transverse sinuses were the most common sinuses to be affected. The sensitivity and specificity of D-dimer for diagnosing CVT was 84.62% and 80% respectively. The risk factors for poor prognosis were altered sensorium, presence of sepsis, increased sinus involvement and deep sinus thrombosis. CONCLUSION: CVT affects both sexes equally. Puerperium still contributes to majority of the cases. Iron deficiency anaemia needs to be evaluated as a contributing factor for incidence of CVT. D-dimer is not useful in puerperal female with CVT. Positive D-dimer will strengthen the suspicion of CVT in patients with acute headache followed by a neurological deficit.
INTRODUCTION:Cerebral Venous Thrombosis (CVT) is a well known disease with diverse clinical presentation and causes. With advances in neuroimaging and changing lifestyles, the clinical profile and causes of CVT are changing. D-dimer has been studied in early diagnosis of CVT with variable results. This prospective study was carried out to assess the clinical profile of CVT and role of D-dimer in diagnosis of CVT. AIM: To study various aspects of CVT and role of D-dimer. MATERIALS AND METHODS: The study period was September 2012 to July 2014 and included 80 imaging proven patients of CVT. We also included 39 controls for assessing D-dimer. Data was collected according to a preformed format. D-dimer was assessed by a rapid semi-quantitative latex agglutination assay. Discharged patients were followed up to six months. RESULTS: Of the total 44 were women and 36 were men (F: M=1.2:1). The mean age of the patients was 29.5±9.68 years. Most common clinical features were headache 77 (96.25%), papilloedema (67.5%) and seizures 51 (63.75%). Pregnancy was the most common cause of CVT. Superior sagittal and transverse sinuses were the most common sinuses to be affected. The sensitivity and specificity of D-dimer for diagnosing CVT was 84.62% and 80% respectively. The risk factors for poor prognosis were altered sensorium, presence of sepsis, increased sinus involvement and deep sinus thrombosis. CONCLUSION: CVT affects both sexes equally. Puerperium still contributes to majority of the cases. Iron deficiency anaemia needs to be evaluated as a contributing factor for incidence of CVT. D-dimer is not useful in puerperal female with CVT. Positive D-dimer will strengthen the suspicion of CVT in patients with acute headache followed by a neurological deficit.
Authors: Christoph M Kosinski; Michael Mull; Michael Schwarz; Benno Koch; Rolf Biniek; Joachim Schläfer; Eva Milkereit; Klaus Willmes; Johannes Schiefer Journal: Stroke Date: 2004-10-28 Impact factor: 7.914
Authors: José M Ferro; Patrícia Canhão; Jan Stam; Marie-Germaine Bousser; Fernando Barinagarrementeria Journal: Stroke Date: 2004-02-19 Impact factor: 7.914