PREVALENCE OF CEREBRAL VENOUS SINUS THROMBOSIS IN PATIENTS PRESENTED WITH SECONDARY HEADACHE

Abstract

Background: Cerebral venous sinus thrombosis (CVST) is a rare but life-threatening secondary headache disorder. Sometimes it is difficult to diagnose because its clinical picture is variable, especially if no local neurological signs are present. The authors in this study found, from a hospital-based perspective, the prevalence of CVST in patients with clinically suspected secondary headache and described the clinical, radiological, treatment and short-term outcome characteristics. Methods: This was a cross-sectional study with 100 patients between 18-60 years coming to the Department of Neurology, Ziauddin University Hospital, Karachi. Convenience sampling was used to recruit the participants. Eligible patients were those with clinically suspected secondary headache who underwent MRI as a part of usual care. Demographic data, characteristics of headache, neurologic manifestations, imaging results, treatment, and discharge outcomes were documented. SPSS 25 was used for data analysis. P ≤ 0.05 considered significant. Results: Mean age was 36.8±11.4 years, females were 62%. Prevalence of CVST was 15.0% in 15 patients. CVST was significantly related to severe headache (p=0.008). Visual loss (p=0.021), loss of consciousness (p=0.020), loss of movement control (p=0.005), and seizures (p<0.001) were also significantly associated with CVST. The most frequent involvement was with the superior sagittal sinus. 93.3% received anticoagulation, 80% improved at discharge. Conclusions: CVST was an important cause of secondary headache. CVST was strongly associated with severe headache and neurological red flags which can help to prompt timely clinical suspicion and suitable neuroimaging.