ABSTRACT
OBJECTIVES: The objective of this study was to assess the clinical characteristics, patterns, and factors associated with headache in patients with cerebral venous sinus thrombosis (CVT). METHODS: In this prospective cohort study, we recruited conscious CVT patients who were able to give reliable history after consent. Institutional ethics approval was obtained. The diagnosis of CVT was based on the clinical and imaging parameters. Data regarding headache characteristic, severity (visual analog scale [VAS]), imaging findings and outcome was recorded. RESULTS: Forty-seven patients (19 males and 28 females) with mean age 29.7 ± 8.7 years were recruited. The mean duration of headache was 12.6 ± 26.8 days, and VAS was 79.38 ± 13.41. Headache onset was acute in 51.1%, subacute in 42.6%, thunderclap in 4.3%, and chronic in 2.1%; location was holocranial in 36.2%, frontal in 27.7% patients; description was throbbing in 44.7% and aching in 25.5% patients. Superior sagittal sinus and transverse sinus were involved in 63.8% cases each. The prothrombotic factors were anemia in 55.3%, puerperal in 38.3%, hyperhomocysteinemia in 29.8%, and polycythemia in 19.1%. CONCLUSION: Holocranial and bifrontal headache of increasing severity may be a marker of CVT. This may be useful in clinical judgment in identifying conscious patients with CVT.
ABSTRACT
With advances in the neuro-imaging modalities, diverse manifestations of the cerebral venous sinus thrombosis (CVT) are being recognized. There are very few reports of isolated cranial nerve palsies in CVT. In this case report, we describe a patient of lower motor neuron facial palsy with CVT who was successfully treated with anticoagulation, highlighting the atypical manifestation of the disease.
