ABSTRACT
To study the clinical and radiological features of cerebral venous thrombosis [CVT], the response to treatment with anticoagulation, and the outcome. A five year prospective study was performed from Febraary 2000 to January 2005. Diagnosis of cerebral venous thrombosis was confirmed by magnetic resonance venography [MRV] or CT venography [CTV]. All patients were treated with unfractionated heparin [UFH] for 7-10 days followed by treatment with warfarin for 6 months. The outcome in each case was assessed by modified Rankin Scale [mRS] score at the end of six months from the time of presentation. A total of 20 cases were identified, 14 were female [70%] and 6 male [30%] with F: M ratio of 2.3: 1. Mean age was 34.5 years [range 10-65 years]. The most common symptoms were headache [90%], vomiting [65%], seizures [40%], and impairment in conscious level [35%]. Most common signs were bilateral papilloedema [45%], hemiparesis or hemiplegia [30%], quadriparesis [25%], and cranial nerve palsies [20%]. Neuroimaging features on pre and post contrast CT scan and/or MRI were variable among all patients and revealed features like ischemic infarctions and/or intracerebral hemorrhages in various locations, sulcal sub-arachnoid hemorrhages, and intraluminal signal abnormalities due to presence of thrombus inside the dural sinuses. The most frequently involved dural sinus [85%] was one of the lateral sinuses [transverse and sigmoid dural sinus], followed by superior sagittal sinus [75%], and straight sinus [20%]. At the end of six months, 16 [80%] cases recovered completely while 2 [10%] were moderately impaired [mRS = 3], and one [5%] had mild impairment [mRS = 2]. Only one [5%] patient died. Cerebral venous thrombosis is a rare condition with variable clinical and radiological features at presentation making the diagnosis difficult. Early diagnosis and prompt treatment with anticoagulation resulted in better outcome even in the presence of hemorrhagic lesions