Clinical Outcome of Cortical Venous Thrombosis in Stroke Patients at a Tertiary Care Hospital of Southern Punjab
Objective: This study was determined to find out the clinical Outcome of Cortical Venous Thrombosis (CVT) in Stroke patients at a Tertiary Care Hospital of Southern Punjab.
Material & Methods: A total of 100 patients with cortical venous thrombosis were included in this descriptive case series study, which was conducted at Department of Neurology, Nishtar Hospital Multan. Outcome of patients in terms of partial recovery or complete recovery, any recurrence, any complication, indication for Surgery and any disability in terms of focal deficit, prolonged hospital stay and Mortality was followed.
Results: Our study included a total of 100 patients with cortical venous thrombosis (CVT), 35 (35%) were male and 65 (65%) were female patients with their mean age was 37.69 ± 16.52 years, ranging from 20 – 83 years (51.37 ± 17.44 in males versus 30.32 ± 10.15 years for females). Headache was noted in 80%, focal deficit in 57%, nerve palsy in 30%, coma in 22% and disability was noted in 35%. Partial recovery was noted in 65%, whereas complete recovery was noted in 35% while, complications were noted in 12 (12%) of these patients with CVT.
Conclusion: Cortical venous thrombosis was more prevalent in females in their younger age groups and it was associated with poor prognosis as high frequency of partial recovery was noted in our study.
Keywords: Cortical venous thrombosis, Stroke, headache, recovery, outcome.
2. Goyal G, Charan A, Singh R. Clinical Presentation, Neuroimaging Findings, and Predictors of Brain Parenchymal Lesions in Cerebral Vein and Dural Sinus Thrombosis: A Retrospective Study. Ann Indian Acad Neurol. 2018; 21 (3): 203-208.
3. Kalita J, Singh VK, Jain N, Misra UK, Kumar S. Cerebral Venous Sinus Thrombosis Score and its Correlation with Clinical and MRI Findings. J Stroke Cerebrovasc Dis. 2019; 28 (11): 104324.
4. Wang Y, Meng R, Duan J, Liu G, Chen J, Li S, Ji X. Nephrotic Syndrome May Be One of the Important Etiologies of Cerebral Venous Sinus Thrombosis. J Stroke Cerebrovasc Dis. 2016; 25 (10): 2415-22. Doi: 10.1016/j.jstrokecerebrovasdis.2016.06.013.
5. Gunes HN, Cokal BG, Guler SK, Yoldas TK, Malkan UY, Demircan CS, Yon MI, Yoldas Z, Gunes G, Haznedaroglu IC. Clinical associations, biological risk factors and outcomes of cerebral venous sinus thrombosis. J Int Med Res. 2016; 44 (6): 1454-1461. Doi: 10.1177/0300060516664807.
6. Lee DJ, Ahmadpour A, Binyamin T, Dahlin BC, Shahlaie K, Waldau B. Management and outcome of spontaneous cerebral venous sinus thrombosis in a 5-year consecutive single-institution cohort. J Neurointerv Surg. 2017; 9 (1): 34-38.
7. Jankowitz BT, Bodily LM, Jumaa M, Syed ZF, Jovin TG. Manual aspiration thrombectomy for cerebral venous sinus thrombosis. J Neurointerv Surg. 2013; 5 (6): 534-8. Doi: 10.1136/neurintsurg-2012-010476.
8. Adachi H, Mineharu Y, Ishikawa T, Imamura H, Yamamoto S, Todo K, Yamagami H, Sakai N. Stenting for acute cerebral venous sinus thrombosis in the superior sagittal sinus. Interv Neuroradiol. 2015; 21 (6): 719-23.
9. Zhang S, Hu Y, Li Z, Huang D, Zhang M, Wang C, Wang Z. Endovascular treatment for hemorrhagic cerebral venous sinus thrombosis: experience with 9 cases for 3 years. Am J Transl Res. 2018; 10 (6): 1611-1619.
10. Wang Y, Zhao C, Huang D, Sun B, Wang Z. Stent retriever thrombectomy combined with long-term local thrombolysis for severe hemorrhagic cerebral venous sinus thrombosis. Exp Ther Med. 2020; 20 (5): 66. Doi: 10.3892/etm.2020.9194.
11. Ilyas A, Chen CJ, Raper DM, Ding D, Buell T, Mastorakos P, Liu KC. Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a systematic review. J Neurointerv Surg. 2017; 9 (11): 1086-1092.
12. Cabral de Andrade G, Lesczynsky A, Clímaco VM, Pereira ER, Marcelino PO, Franco A, De Almeida DF. Cerebral venous sinuses thrombosis in both transverse sinus and torcula: Multistep endovascular treatment and stenting. Interv Neuroradiol. 2017; 23 (1): 84-89.
13. Sassi SB, Touati N, Baccouche H, Drissi C, Romdhane NB, Hentati F. Cerebral Venous Thrombosis: A Tunisian Monocenter Study on 160 Patients. Clin Appl Thromb Hemost. 2017; 23 (8): 1005-1009. Doi: 10.1177/1076029616665168.
14. Al Hashmi K, Al Wahaibi K, Al-Khabori M, Al Lamki S. Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis. Oman Med J. 2019; 34 (5): 434-437. Doi: 10.5001/omj.2019.79.
15. Bushnaq SA, Qeadan F, Thacker T, Abbas M, Carlson AP. High-Risk Features of Delayed Clinical Progression in Cerebral Venous Thrombosis: A Proposed Prediction Score for Early Intervention. Interv Neurol. 2018; 7 (6): 297-307.
16. Siddiqui FM, Weber MW, Dandapat S, Scaife S, Buhnerkempe M, Ortega-Gutierrez S, Aksan N, Elias A, Coutinho JM. Endovascular Thrombolysis or Thrombectomy for Cerebral Venous Thrombosis: Study of Nationwide Inpatient Sample 2004-2014. J Stroke Cerebrovasc Dis. 2019; 28 (6): 1440-47.
17. Nasr DM, Brinjikji W, Cloft HJ, Saposnik G, Rabinstein AA. Mortality in cerebral venous thrombosis: results from the national inpatient sample database. Cerebrovasc Dis. 2013; 35 (1): 40-4. Doi: 10.1159/000343653.
18. Korathanakhun P, Sathirapanya P, Geater SL, Petpichetchian W. Predictors of hospital outcome in patients with cerebral venous thrombosis. J Stroke Cerebrovasc Dis. 2014; 23 (10): 2725-2729. Doi: 10.1016/j.jstrokecerebrovasdis.2014.06.020.
19. Wasay M, Kojan S, Dai AI, Bobustuc G, Sheikh Z. Headache in cerebral venous thrombosis: incidence, pattern and location in 200 consecutive patients. J Headache Pain. 2010; 11: 137-39.
20 Khealani BA, Wasay M, Saadah M, Sultana E, Mustafa S, Khan FS, Kamal AK. Cerebral venous thrombosis: a descriptive multicenter study of patients in Pakistan and Middle East. Stroke, 2008; 39(10):2707-11.
21. Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral Venous Sinus Thrombosis Incidence Is Higher Than Previously Thought: A Retrospective Population-Based Study. Stroke, 2016; 47 (9): 2180-2.
22. Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke, 2012; 43 (12): 3375-7. Doi: 10.1161/STROKEAHA.112.671453.
23. Mehndiratta M, Garg S, Gurnani M. Cerebral venous thrombosis – clinical presentations. J Pak Med Assoc. 2006; 56 (11): 513-5.
Copyright (c) 2021 Pakistan Journal Of Neurological Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.