Clinical Profile of Cerebral Sinus Venous Thrombosis: A Prospective Observational Study in South India

Cerebral sinus venous thrombosis (CSVT) is a thrombosis of the cerebral veins and dural sinuses. It is a challenging condition for a physician due to varied symptoms. We aimed to study the clinical, radiological, etiology, and outcome of CSVT in a rural population.

Patients with suspected symptoms of CSVT and positive neuroimaging by MRI with MRV were enrolled in the study. Patients with normal neuroimaging, arterial stroke, space-occupying lesions, and unwillingness to participate were excluded from the study. The patient's demographic data and clinical presentation were noted. Protein C and S, anti-thrombin III, ANA, anti-phospholipid antibodies (APLA), and homocysteine were analyzed.

The incidence of CSVT was most common in the age group of 21-40 years (44.3%) and in males. The presentation was mostly subacute (61.4%). Headache was the most common presentation (80%), followed by seizures. The most common site of the thrombus is the superior sagittal sinus (51.4%), the next being the transverse sinus (25.7%). CSVT was attributed to hyperhomocysteinemia in 40% of patients, and protein C and S deficiency was seen in 14.3%. Almost all of them recovered completely (93%).

Cerebral sinus venous thrombosis primarily afflicts adults in their middle age, marked by notable manifestations such as headaches and seizures. The prognosis is good with early diagnosis and management.