Early Diagnosis of a Cerebral Venous Thrombosis in the Emergency Department
Journal of the Korean Society of Emergency Medicine
;
: 605-612, 2005.
Article
in Korean
| WPRIM
| ID: wpr-26493
ABSTRACT
PURPOSE:
Early diagnosis and heparin therapy have contributed to a decreased mortality in patients with a cerebral venous thrombosis (CVT). The aim of this study is to evaluate the clinical and the radiologic features of a CVT and to develop an algorithm for diagnosis and treatment.METHODS:
Twenty (20) patients who were diagnosed at Asan Medical Center from 1997 to June 2004 as having a CVT were included in this study. The data in their medical records, including clinical features, predisposing factors, and diagnostic modalities, were reviewed. The cranial computed tomography findings of a CVT were investigated in 18 patients.RESULTS:
Headache was the most common symptom, followed by seizure and focal neurologic deficits. Initially, 14 patients were misdiagnosed by the emergency physician as having another neurologic disease, though 5 patients had pathognomic CT signs of a CVT. CT signs, such as cord signs and empty delta signs, were present in 10 cases. Among them, the cord sign was positive in eight (8) cases (44.4%), the empty delta sign was positive in six (6) cases (46.2%), and both signs were positive in four (4) cases. The presence of CT signs correlated with the presence of seizure at onset, and the Modified Rankin Scale (MRS) was 1 or 2 at discharge (p<0.05). Parenchymal changes correlated with headache at discharge (p<0.05).CONCLUSION:
Emergency physicians should consider CVT and look for pathognomic signs of a CVT when patients complain of sub-acute headaches or when the clinical features do not correlate with the neuroimage findings.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Seizures
/
Heparin
/
Medical Records
/
Causality
/
Mortality
/
Venous Thrombosis
/
Early Diagnosis
/
Diagnosis
/
Emergencies
/
Emergency Service, Hospital
Type of study:
Diagnostic study
/
Prognostic study
/
Screening study
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Society of Emergency Medicine
Year:
2005
Type:
Article
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