Clinical profile of cerebral venous thrombosis in atertiary care center and utility of D-dimer in itsdiagnosis

[摘要] Background & Objectives: Cerebral venous thrombosis (CVT) is a rare cause of stroke, occurringcommonly in young adults. The variability in the clinical scenario from patient to patient and the lackof specificity of the presenting symptoms of CVT poses a diagnostic challenge. This study aims toanalyze the clinical characteristics of patients diagnosed with CVT in comparison to the global profileand explore the diagnostic utility of D-dimer levels as a screening tool in patients with clinical featuressuspicious of underlying CVT. Methods: This was a hospital-based case-controlled study, included 50imaging proven patients with CVT and age and sex matched healthy controls. Demographic detailswere collected, detailed neurological examination done at presentation and d- dimer levels wereevaluated. Results: Among our study group a male preponderance was noted (60%) in discordance withthe global pattern of CVT. Headache was the most common presenting feature and papilledema wasnoted in 98% of our patients. Additional clinical signs noted at presentation were nausea and vomiting(78%), seizures (28%), limb weakness (24%) and alteration in sensorium at presentation (14%). Riskfactors were alcohol dependency (36%), postpartum period (12%) and anaemia (12%). Additionallythe sensitivity of D-dimer was noted to be 90.74% with a specificity of 100% in predicting the disease.Conclusion: Our study differs from the global pattern of CVT in terms of male preponderance,higher detection of papilledema, lesser occurrence of anaemia, and a large proportion of patients withd-dimer positivity. The limitation of the study is the sample size as we cannot extrapolate our resultsto the population at large. However our data is in concordance with the current concept of CVT, thatdiagnosis is the key challenge in management.

[学科分类] 精神健康和精神病学

[关键词] CVT;headache;D-dimer