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Published on: June 2, 2015
D-dimer is useful in the diagnosis of cortical venous sinus thrombosis
Usha K Misra1, Jayantee Kalita, Vikas Bansal
1Department of Neurology, Sanjay Gandhi PGIMS, Lucknow, India. ukmisra@sgpgi.ac.in
Insights
D-dimer testing is a useful diagnostic marker for suspected cerebral venous sinus thrombosis (CVST). A positive D-dimer result in patients with CVST symptoms warrants urgent magnetic resonance imaging.
Area of Science:
- Neurology
- Radiology
- Hematology
Background:
- D-dimer levels correlate with deep vein thrombosis and pulmonary embolism.
- D-dimer may serve as a potential marker for cerebral venous sinus thrombosis (CVST).
Purpose of the Study:
- To evaluate the diagnostic utility of D-dimer in identifying CVST.
Main Methods:
- Twenty-six patients diagnosed with CVST underwent neurological evaluation and cranial MRI.
- D-dimer levels were measured using a rapid latex agglutination slide test.
Main Results:
- D-dimer was positive in 20 out of 26 patients.
- A positive D-dimer test correlated with symptom duration but not with thrombosis extent or patient outcome.
- Commonly affected sinuses included the superior sagittal and transverse sinuses.
Conclusions:
- D-dimer is a valuable tool for diagnosing suspected cases of CVST.
- Patients with a positive D-dimer test should undergo prompt MR imaging for definitive diagnosis.
Background:
Estimations of D-dimer correlate with deep vein thrombosis and pulmonary thromboembolism and may serve as a marker of cortical venous sinus thrombosis (CVST).
Aim:
To study the usefulness of D-dimer in the diagnosis of CVST.
Materials And Methods:
A total of 26 patients with CVST were subjected to a detailed medical history and neurological evaluation. A cranial MRI was carried out on a 1.5T scanner using T1, T2, and DWI sequences and two-dimensional time of flight MR venography. D-dimer was estimated using a rapid latex agglutination slide test using monoclonal antibodies.
Results:
The age of patients ranged between 16 and 70 years old (median 31 years old); 8 were males and were examined after a mean duration of 22 days of symptoms. Cortical venous thrombosis was attributed to puerperium in 4 patients, infection in 5 patients, and pregnancy, dehydration, insect bite, and migraine in 1 patient each. Superior sagittal sinus was involved in 15 patients, transverse sinus in 16 patients, straight sinus in 3 patients, sigmoid sinus in 7 patients, and cavernous and deep system in 1 patient each. A total of 12 patients had more than one sinus involvement. D-dimer was positive in 20 patients and correlated with the duration of symptoms but not with the extent of sinus thrombosis and the outcome.
Conclusion:
D-dimer is useful in patients suspected of CVST and patients with positive test results should be urgently sent for MR imaging.
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