Abstract
CEREBRAL VENOUS SINUS THROMBOSIS AMONG SUDANESE PATIENTS IN THE TERM OF CLINICAL PRESENTATION, RISK FACTOR & OUTCOME

Dr. Motwakil Imam Awadelkareim Imam* and Dr. Osheik Abu Asha Seidi

ABSTRACT

Back ground: The cerebral venous sinus thrombosis (CVST) is a rare origin of stroke worldwide. However, the mode of presentation and aetiology are various. The prognosis is better than arterial thrombosis. The age of the onset is early than arterial. Magnetic resonance imaging (MRI), MR venography (MRV) CT venography is currently the key diagnostic. Objectives: To estimate the incidence, risk factor, clinical presentation, and outcome, of patients with CVT during a period of the study. Also to study other parameters related to disease. Methods:We studied 70 cases collected in the department of neurology of the university hospital of Khartoum (Sudan). This study lasted 42 months. The cerebral-CT scan was performed in 32 cases (45.7%) while MRI examination was done in 68 cases (97.1%) and most patients (75.7%) received anticoagulation therapy. Results:The mean age of our patients was of26 years old, ranging between 13 years old and60 years old. Predominance of female was noticed (80%). The clinical presentations of the patients were dominated by the following profile: Headache in 60 cases 85.7%, Seizure in 37 cases 52.9%, Paresis in 31cases 44.3%, and Papilledema in 27 cases 38.6%. Diplopia in 26 cases 37.1%, disturbance of the level of consciousness in 22 cases 31.4%, Nausea/vomiting in 15 cases 21.4%, neck pain in 15 cases 21.4%, fever in 11 cases 15.4%, aphasia in 11 case 15.4%, sensory symptoms in 5 cases 7.1%, visual loss in 2 cases 2.9%, and mental disorder in one case 1.4% CVT associated to gynecological causes in 35 cases 50%, drugs used in 13 cases 18.6%, infection origin in 10 cases 14.3%, prothrombotic causes in 10 cases 14.3%, 3 cases 2.9% with vasculitis, 2 cases 2.9% with thyroid disease, and one case 1.4% for the following nephrotic syndrome, malignancy-solid tumor,and polycythemia. Optic nerve is the most cranial nerve involved in 25 cases 33.3% Followed by Abducent nerve in 19 cases 27.4%. The superior sagital sinus affected in 47 patients 67.1%, Lt Transverse sinus affected in 40 patients 57.1%, Rt transverse sinus affected in 29 patients 41.4%. The evolution was good in 43 cases 61.4% minor squeals were observed in 14 patients 20% , while major squeals were observed in one cases1.4% and death of 12 cases 17.1% was also registered. Conclusion: CVT is pathology of good prognosis once the diagnosis is promptly performed early and anticoagulation treatments initiated with close monitoring and follow up and early surgical intervention if needed.

Keywords: Cerebral Venous Sinus Thrombosis, Clinical Presentation, Risk Factor, Outcome and Sudan.


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