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Cerebral venous thrombosis: An Indian perspective Deepa Dash, Kameshwar Prasad, Leve Joseph1 Departments of Neurology and 1Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
ABSTRACT Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with extremely varied clinical presentations, predisposing factors, imaging findings, and outcomes, and thus can be extremely challenging to diagnose. Accurate and prompt diagnosis of CVT is crucial because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long‑term squel. In this article, we have reviewed the epidemiology, causative factors, clinical features, diagnosis and treatment of CVT from an Indian perspective. Over the last decade, a change in trends in the causative factors has been noted from India. Key words: Anticoagulation; causes; cerebral venous thrombosis; India; neuroimaging
Introduction Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with extremely varied clinical presentations, predisposing factors, imaging findings, and outcomes. The first description of CVT, appearing in the French literature in 1825, was by Ribes, in a 45‑year old man who died after a 6‑month history of severe headache, epilepsy, and delirium. In 1957, Padmavati et al., for the first time from India, reported 15 cases of CVT in puerperium in an epidemiological study evaluating the causes of hemiplegia in 44 women. It was at that time recognized as a diagnosis which was mostly made at autopsy and considered lethal. With the advent of newer and more sophisticated imaging techniques and increasing awareness of this entity, the incidence of this disease has increased and the prognosis has improved as compared to the older series. Accurate and prompt diagnosis of CVT is crucial because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long‑term sequel. The objective of this Access this article online Website: www.neurologyindia.com DOI: 10.4103/0028-3886.158191 PMID: xxxxx
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review was to assess the demographic profile, frequency of different clinical features, risk factors, and prognostic outcome in patients suffering from CVT from India. We conducted a literature search on the Medline database to identify the published studies from India that evaluated the demographic profile, clinical features, risk factor profile, and prognostic outcome of patients with CVT. The following keywords were used: Cerebral vein thrombosis, India, CVT, intracranial embolism or thrombosis, cerebral veins, intracranial thrombosis, sinus thrombosis intracranial.
What is the Magnitude of the Problem in India? The literature search yielded no population‑based study from India exploring the exact incidence of the disease. Most of the studies published from India are hospital‑based studies. In the late 1970’s, hospital‑based series from Northern India documented CVT in a frequency of 4.5/1000 obstetric admissions. Another population‑based study from Southern India in the late 1960’s found that 25% of stroke patients were less than (