Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention.

Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome.

Correlation between peripheral arterial disease and coronary artery disease using ankle brachial index-a study in Indian population.

OBJECTIVE: To study the prevalence of peripheral arterial disease (PAD) of the lower limbs in a high-risk population and its correlation with coronary artery disease (CAD), using the ankle brachial index (ABI). METHODS: The present study was conducted in randomly selected indoor patients >45 years of age with one or more risk factors for PAD admitted in the cardiology and medicine wards in a tertiary care institute. RESULTS: Based on ABI <0.9, PAD was diagnosed in 32 of the 182 (18%) patients. Coronary artery disease was present in 15 cases of PAD which was statistically significant. CONCLUSION: There is a definite and strong correlation between PAD and CAD. Correct diagnosis and supervision of patients with PAD is important for preventing the local progression of the disease and effective secondary prevention of future coronary and cerebrovascular events.

Lipid profile in non-diabetic stroke--a study of 100 cases.

OBJECTIVE: To study serum lipid profile in patients with cerebrovascular disease and to determine significant correlation between them. To ascertain the effect of age and sex on serum lipid profile. DESIGN: Case Control study. SETTING: Single Tertiary care centre in Southern India. PARTICIPANTS: Total of 100 patients of which 80 were cases of completed stroke (ischaemic--50 and haemorrhagic --30) and the remaining 20 were controls. Males accounted for 71 cases. All subjects were adult patients. Patients with suspected emboli of cardiac origin and diabetics (Type 1 and 2) were excluded from the study. None of the patients were on diet or other modification that would lower plasma lipid levels. RESULTS: 32 patients had elevated serum total cholesterol levels, of which 81.3% had ischaemic stroke and the rest haemorrhagic stroke. 10 patients had elevated serum triglyceride levels, of which 80% had ischaemic stroke and the rest haemorrhagic stroke. 33 patients had elevated serum low density lipoprotein levels of which 75.8% had ischaemic stroke whereas the remaining had haemorrhagic stroke. CONCLUSION: A statistically positive correlation was found between serum Total cholesterol, Triglycerides, LDL levels and the risk of stroke.