Diagnosis of cerebral venous thrombosis: a single centre experience

Petr Mikulenka1, Tomas Peisker1, Peter Vasko1

  • 1Department of Neurology, Third Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic.

Neuro Endocrinology Letters
|February 24, 2019
PubMed

Insights

Delayed diagnosis of cerebral venous thrombosis (CVT) is common due to varied symptoms. Identifying risk factors and atypical headaches prompts timely diagnosis via imaging, improving patient outcomes.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Cerebral venous thrombosis (CVT) is a critical cerebrovascular condition often presenting with non-specific symptoms, leading to diagnostic delays.
  • The variability in clinical presentation and rarity of CVT contribute to challenges in early identification.

Purpose of the Study:

  • To elucidate the risk factors associated with cerebral venous thrombosis.
  • To characterize the initial clinical manifestations and diagnostic findings of CVT.
  • To evaluate the role of imaging modalities in confirming CVT diagnoses.

Main Methods:

  • Retrospective analysis of 34 patients diagnosed with CVT between 2004 and 2016.
  • Review of demographic data, clinical symptoms, D-dimer levels, risk factors, and Magnetic Resonance (MR) findings.
  • Assessment of time from symptom onset to diagnosis.

Main Results:

  • Headache was the most frequent initial symptom (82.4%).
  • Focal neurological deficits or encephalopathy occurred in 64.7% of patients.
  • Risk factors were identified in 76.5% of patients, including hormonal contraceptive use (68% in women of childbearing potential) and recent inflammation.
  • MR venography confirmed CVT in all cases.
  • Hereditary thrombophilia was present in 68% of tested patients.
  • Elevated D-dimer levels were observed in 86% of cases.
  • The average diagnostic delay was 6.9 days.

Conclusions:

  • Cerebral venous thrombosis exhibits a diverse clinical course, frequently resulting in delayed diagnosis.
  • Atypical headaches and the presence of risk factors are crucial indicators for initiating diagnostic imaging for CVT.
  • Prompt recognition and appropriate imaging are essential for timely CVT diagnosis and management.
Abstract

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