Cerebral venous sinus thrombosis: an analyses of 47 patients.
OBJECTIVE: Cerebral venous sinus thrombosis (CVST) is an extremely rare disease and its early treatment is important for decreasing the morbidity and mortality. In present study, it was investigated to clinical and etiological factors, localization features, treatment, and prognosis of patients with CVST. PATIENTS AND METHODS: The study group included CVST cases who were followed up between January 2008 and June 2010. Demographical, clinical, radiological, etiological and prognostic characteristics of 47 patients with CVST were retrospectively investigated. RESULTS: Presentation complaints of the patients were as follows in order: acute and/or sub-acute headache (80.8%), impaired consciousness (25.5%), ear complaints (21.3%), paresis (19.1%) and epileptic seizures (14.9%). Chronic daily headache without any signs of neurological deficit was found in 10.6% of cases. Neurologic examinations of 40.4% of the CSVT patients were found to be normal. The most frequently found etiological factors were as follows: MTHFR gene mutation (25.5%), local infections due to chronic otitis complications (21.3%), puerperium (17%), pregnancy (12.8%), lupus anticoagulant positivity (12.8%). The sigmoid sinus was found to be involved in 35 patients (74.5%), the transverse sinus in 29 (61.7%) and superior sagittal sinus in 21 (44.7%). Impaired consciousness (p = 0.046), hemorrhagic infarct (p = 0.017), acute onset (p = 0.026), and presence of hemiparesis (p = 0.019) were found to be associated with increased mortality. CONCLUSIONS: New onset sub-acute or chronic headache may be the only neurologic complaint of CVST patients. Early diagnosis and anticoagulant treatment may decrease mortality and/or morbidity rates related with CVST in these patients.