In-hospital Imaging Prevalence, Patterns of Neurological Involvement in Cerebral Venous Sinus Thrombosis: Analysis from Pakistan

Objective: The objective of the study was to calculate in-hospital imaging prevalence and report patterns of neurological involvement in cerebral venous sinus thrombosis patients presenting at a tertiary care hospital in a developing country.

Methods: A cross-sectional analytical study elicited data from the Department of Radiology at the Aga Khan University Hospital from January 2007 until December 2012. Patients of either sex were retrospectively recruited from medical record database. They were included if they presented with or were referred from clinical departments for evaluation of suspected cerebral venous sinus thrombosis. Diagnosis of cerebral venous sinus thrombosis was made on the basis of a combination of Magnetic resonance imaging with Magnetic resonance venogram imaging findings.

Results: A total of 597 scans were reviewed. Mean age was 37.46 ± SD 15.4 years, range: 72 years. Out of the total sample of 66, 28(46%) were males. Infarcts were more pronounced in females. Regarding clinical features, most commonly presenting symptom was a headache and weakness, 16 (26%) and 14 (23%) respectively. The 6 -year in-hospital imaging prevalence of cerebral venous sinus thrombosis was calculated as 11.055%, (66/597), 95% CI [8.54-13.56%] and true positive rate as 10.22%, (61/597), 95%CI [7.79-12.65%]). Patterns of sinus involvement were multi sinus involvement, and the major combination was superior sagittal, sigmoid and transverse 9(15%), sigmoid and transverse 8(13%), all sinuses 5 (8.2%).

Conclusion: There is increasing trend of multi sinus involvement in our population which can be detected early, by contrast, enhanced magnetic resonance venogram.