Risk factors and outcome variables of cerebral venous and sinus thrombosis in a tertiary care hospital

Introduction: Cerebral venous and sinus thrombosis (CVT) is one of the common causes of stroke in young people. It is a relatively uncommon neurologic disorder that is potentially reversible with prompt diagnosis and appropriate medical care. The purpose of this study is to identify the risk factors and outcome determinants. Methods: A prospective observational study was conducted at a tertiary care centre in coastal Karnataka from November 2015 to May 2017. Demographic details, symptomatology and history pertaining to risk factors were noted. Outcome and prognosis were assessed by Modified Rankin Scale (mRS) at the time of admission and follow-up after 4 to 6 weeks. Chi-square test was used to compare mRS score at admission and follow-up in relation to outcome variables. Results: A total of 45 adults with CVT were included. Males (53.3%) were more affected than females (46.7%), mostly in the 3rd decade. The most common risk factors were polycythaemia (31.1%) followed by oral contraceptive pill intake (17.7%). Based on mRS score at admission, 23 patients were functionally independent (mRS≤ 2) and 22 were functionally dependent (mRS > 2). At 6 weeks’ follow-up 73.3% of the patients were functionally independent. Nine patients (20%) underwent decompressive craniotomy, of which seven patients improved, one deteriorated and one expired. The mortality rate was 2.2 %. Two patients were lost to follow-up. Conclusion: The most common risk factors were polycythaemia followed by intake of oral contraceptive pills. Functional independence was achieved in 73.33% of patients at follow-up. The determinants of poor outcome were altered level of consciousness, presence of neurological deficits and intracerebral haemorrhage at the onset of illness.