Etiological associations of cerebral venous sinus thrombosis among adult sudanese patients: a multicenter cross-sectional study

Abstract

Cerebral venous sinus thrombosis (CVST) is a common condition that, if not detected and treated promptly, carries a high risk of morbidity and mortality. CVST's most common aetiological associations are post-partum, pregnancy, and oral contraceptive pills. The purpose of this study was to look into the aetiology of CVST in Sudanese patients in neurological centres in Khartoum state.

Methodology: This was a cross-sectional hospital bases study conducted on CVST patients at four neurological centres in Khartoum state in the period from March to October 2020. Patients were studied for the aetiological association of CVST using a standardized questionnaire including medical history, clinical examination, investigation, and treatment.

Results: The study included about 60 patients, 50 of whom were female (83.3%) and 10 of whom were male (16.7%). In terms of clinical presentation, almost all patients had headache, followed by visual disturbances in 49 (81.7%), seizures in 46 (76%), disturbed consciousness in 12 (20%), and weakness in 12 (20%). The most common sign was abnormal speech, which was found in eight patients (13.3%), memory disturbances in eight patients (13.3%), evidence of CN VI lesion in three (5%), papilledema in 49 (81.7%), and hemiparesis in 46 (76.7%), while abnormal sensory signs were found in only one patient. The most common aetiological association were pregnancy in 15 (25%), oral contraceptive pills in 11(18.3%), and being in the post-partum period in 23(38.3%). All of the patients' magnetic resonant imaging/magnetic resonant venography results were abnormal. Six patients had extensive sinus involvement, 35 had superior sagittal sinus involvement, and 19 had transverse sinus involvement. After treatment, 45 patients (75%) fully recovered, 11 (18.3%) partially recovered, and 4 (6.7%) died.

Conclusion: Post-partum, pregnancy, and oral contraceptive pills were the most common aetiological associations of CVST compared with other populations.

Keywords: CVST; cerebral venous sinus thrombosis; cerebral venous thrombosis; stroke.

Figure 1

The distribution of the study participants according to the risk factors (n=60). IBD, inflammatory bowel diseases; NS, nephrotic syndrome; OCP, oral contraceptive pills.