Abstract
Introduction: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and the clinical presentation is variable. One of the more common acquired risk factors of venous sinus thrombosis is oral contraceptive medications. While the prognosis for CVST is favorable, it is important to identify and treat early to prevent neurologic deficits. CVST accounts for 0.5% of strokes and most commonly presents with headaches and in many cases focal neurologic deficits. Diagnosis is confirmed with neuroimaging including CT angiography or MR angiography. Treatment consists of anticoagulation and in some cases, thrombolytic therapy is beneficial. The overall prognosis of CVST is favorable.The objective of the study is to describe the features of a series of patient with CVST due to consumption of OCPs, treated in the department of Neurosurgery, Bir hospital and OM hospital, and to discuss the risk factors associated with consumption of OCPs, its presentation, and outcome.Methods: This is a retrospective case series carried out in the department of Neurosurgery, Bir hospital and OM hospital during the year September 2012 to September 2014. Demographic features like age, presenting symptoms, clinical findings and outcome were analyzed. All cases received heparin or LMWH followed by Warfarin.Results: Nine patients were identified over a period of 2 years. The presenting symptoms included headache, vomiting, loss of consciousness, focal neurological deficit, seizure and neck pain. Signs found included papilloedema, fever, slurring of speech and focal neurological signs.Conclusion: Dural sinus thrombosis is a rare and under-recognized cause of headache that should be considered in women with recent introduction of hormonal contraception. The absence of papilledema and a negative CT brain should not halt further workup. MRI/venogram is mandatory to confirm the diagnosis.Journal of Society of Surgeons of Nepal Vol.17(1) 2014: 2-5
Highlights
RI 2&3V DQG WR GLVFXVV WKH ULVN IDFWRUV DVVRFLDWHG with consumption of OCPs, its presentation, and early
GXULQJ WKH \HDU 6HSWHPEHU WR 6HSWHPEHU \HDUV$OOSDWLHQWVGLDJQRVHGDVGXUDOYHQRXVDQGVLQXVHV WKURPERVLV ZLWK FRQVXPSWLRQ RI RUDO FRQWUDFHSWLYHV ZHUH LQFOXGHG 7KH GLDJQRVLV ZDV EDVHG RQ &7 VFDQ DQG 05, 059 RI WKH EUDLQ +\SHUFRDJXODEOH VWDWHV GXH WR RWKHU IDFWRUV ZHUH H[FOXGHG E\ KLVWRU\ DQG KHPDWRORJLFDO LQYHVWLJDWLRQV 'HPRJUDSKLF IHDWXUHV OLNH DJH SUHVHQWLQJ V\PSWRPV FOLQLFDO ¿QGLQJV DQG RXWFRPH ZHUH DOVR analyzed and complications associated with anticoagulation
LV FKDUDFWHUL]HG E\ WKH SUHVHQFH RI VOLWOLNH YHQWULFOHV RQ WKH &7 EUDLQ DQG LQFUHDVHG FHUHEURVSLQDO ÀXLG SUHVVXUH JUHDWHUWKDQPP+J'XUDOVLQXVWKURPERVLVZKLFKKDV DZRUVHSURJQRVLVLVQRWHYLGHQWRQQRQFRQWUDVWEUDLQ&7 DQG05,YHQRJUDPZLWKDQGZLWKRXWFRQWUDVWLVQHFHVVDU\ WRFRQ¿UPWKHGLDJQRVLV$OWKRXJK&7FRQWUDVWYHQRJUDSK\ UHPDLQV SRSXODU LQ VRPH FHQWHUV DQG PD\ EH D VXSHULRU WHFKQLTXH LQ FHUWDLQ FDVHV WKH FODVVLF HPSW\ GHOWD VLJQ LV SUHVHQWLQRQO\RIWKHFDVHV
Summary
&HUHEUDO YHQRXV VLQXV WKURPERVLV &967 LV D UDUH DQG potentially deadly condition. Known conditions that LQFUHDVH WKH ULVN RI &967 LQFOXGH K\SHUFRDJXODEOH states, dehydration, adjacent infectious processes, ORZ FHUHEUDO EORRG ÀRZ RUDO FRQWUDFHSWLYHV KRUPRQH replacement therapy, pregnancy, and puerperium.1,2 $V WKH WKURPEXV HQODUJHV LW FDXVHV YHQRXV FRQJHVWLRQ DQG OHDGV WR FHUHEUDO HGHPD ZLWK PDVV HIIHFW DQG D UHVXOWDQW. LQFUHDVH RI LQWUDFUDQLDO SUHVVXUH ,I WKH WKURPEXV LV untreated, the intracranial pressure continues to rise and the vascular supply is compromised, leading to ischemia. RI 2&3V DQG WR GLVFXVV WKH ULVN IDFWRUV DVVRFLDWHG with consumption of OCPs, its presentation, and early
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have