Clinico-radiological Spectrum of Patients Presenting with Cerebral Venous Thrombosis in Western Nepal

Abstract

Cerebral venous thrombosis is a rare condition characterized by occlusion of venous channels in the brain. It includes thrombosis of dural venous sinus, cortical vein and deep cerebral vein. It is often underdiagnosed because of nonspecific signs and symptoms. Imaging plays an important role in its diagnosis. Present study was done to evaluate the clinical presentation, predisposing conditions, MR venography findings and outcome of patients with cerebral venous thrombosis in western region of Nepal. Fourteen patients who were diagnosed as cerebral venous thrombosis between August 2013 and August 2015 were included in the study. Of the 14 patients, 8 were female with female to male ratio of 1.2:1. Mean age of the patients was 36.7 ± 18.3 years. Most of the patients were in the age group 21 to 40. Headache, nausea and vomiting were the commonest presenting symptoms. Mean Glasgow Coma Scale (GCS) during presentation was 14. Infection which may be local or systemic was the most common risk factor (28.4%). Parenchymal abnormalities were seen in 85.71% of the patients. Two or more sinuses were involved in 7 patients (50%) of which transverse and superior sagittal sinus were more frequently involved. There was 14% mortality, which was higher for deep cerebral vein thrombosis. In conclusion, cerebral venous thrombosis is a rare condition with varying presentations and imaging findings.