Spectrum of Cerebral Venous Thrombosis in Uttarakhand

CVT is an uncommon but important cause of stroke that is often misdiagnosed delaying its treatment. High suspicion is essential in early recognition and treatment.

To study the clinical features and etiology of patients with Cerebral Venous Thrombosis (CVT) and relation between septic and non septic CVT if any.

A prospective study was done in SMIH that enrolled 40 patients of CVT in 2 years duration (Jan 2014 to Dec 2015). The patients were diagnosed as CVT according to Magnetic Resonance Venogram (MRV) and clinical status.

Forty (40) patients of CVT were enrolled during 2 years period, most were females (22/30) and aged between 18-50 years (mean age 30.2+4.9). Most common presentation was headache followed by seizures and focal deficit. Other symptoms encountered were cranial nerve palsies, meningeal signs, papilloedema. Most common headache type was tension type headache. Most common cranial nerve involvement was abduscens nerve. Superior Sinus Thrombosis (SSS) involvement was most commonly thrombosed followed by its involvement with other sinuses. Isolated lateral sinus involvement also seen. On screening for cause, non septic CVT outnumbered septic CVT (22/8) and the most common cause of non septic CVT was unknown followed by coagulation defect. Among septic CVT group puerperial sepsis in females and mastoiditis in males were the dominant cause.

Septic CVT prognosis had better than non septic CVT. Hence, CVT presents with wide range of presentations and anticoagulation is the treatment. Septic CVT if intervened timely with proper antibiotics have better prognosis. Antibiotics are the mainstay of therapy for septic CVT.