Journal of Neurosciences in Rural Practice
Year : 2016  |  Volume : 7  |  Issue : 4  |  Page : 554-558

Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

1 Department of Neuro-ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences; Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Surgery, Institute of Cancer, Tehran University of Medical Sciences, Tehran, Iran
4 Research Center of Medical Students, Tehran University of Medical Sciences, Tehran, Iran

Correspondence Address:
Samira Yadegari
Farabi Eye Hospital, Ghazvin Avenue, Tehran 1336616351
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0976-3147.185512

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Introduction: Despite increasing the use of magnetic resonance imaging (MRI), cerebral venous sinus thrombosis (CVST) has remained an under-diagnosed condition. In this study, characteristics and frequency of various risk factors of CVST patients in a tertiary referral hospital were closely assessed. Methods: Patients with an unequivocal diagnosis of CVST confirmed by MRI and magnetic resonance venography during 6 years of the study were included. All data from the onset of symptoms regarding clinical signs and symptoms, hospital admission, seasonal distribution, medical and drug history, thrombophilic profile, D-dimer, neuroimaging, cerebrospinal fluid findings, mortality, and outcome were collected and closely analyzed. Result: A total of 53 patients with female to male ratio of 3.07 and mean age of 33.7 years were included in the study. Headache and papilledema were the most frequent clinical features (44 and 36 patients, respectively). An underlying disease (diagnosed previously or after admission) was the most common identified risk factor for CVST in both females and males (21 patients). A total of 15 women used the oral contraceptive pill (OCP) where 12 of them had simultaneously other predisposing factors. Overall, 19 patients (36%) had more than one contributing factor. D-dimer had a sensitivity of 71.4% in CVST patients. The mortality of patients in this study was 3.7% (n = 2). Focal neurologic deficit and multicranial nerve palsy were associated with poor outcome which defined as death, recurrence, and massive intracranial hemorrhage due to anticoagulation (P = 0.050 and 0.004, respectively). Conclusion: Unlike most of the CVST studies in which OCP was the main factor; in this study, an underlying disease was the most identified cause. Considering the high probability of multiple risk factors in CVST that was shown by this study, appropriate work up should be noted to uncover them.

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