D-dimer is useful in the diagnosis of cortical venous sinus thrombosis.
BACKGROUND
Estimations of D-dimer correlate with deep vein thrombosis and pulmonary thromboembolism and may serve as a marker of cortical venous sinus thrombosis (CVST).


OBJECTIVE
To study the usefulness of D-dimer in the diagnosis of CVST.


METHODS
A total of 26 patients with CVST were subjected to a detailed medical history and neurological evaluation. A cranial MRI was carried out on a 1.5T scanner using T1, T2, and DWI sequences and two-dimensional time of flight MR venography. D-dimer was estimated using a rapid latex agglutination slide test using monoclonal antibodies.


RESULTS
The age of patients ranged between 16 and 70 years old (median 31 years old); 8 were males and were examined after a mean duration of 22 days of symptoms. Cortical venous thrombosis was attributed to puerperium in 4 patients, infection in 5 patients, and pregnancy, dehydration, insect bite, and migraine in 1 patient each. Superior sagittal sinus was involved in 15 patients, transverse sinus in 16 patients, straight sinus in 3 patients, sigmoid sinus in 7 patients, and cavernous and deep system in 1 patient each. A total of 12 patients had more than one sinus involvement. D-dimer was positive in 20 patients and correlated with the duration of symptoms but not with the extent of sinus thrombosis and the outcome.


CONCLUSIONS
D-dimer is useful in patients suspected of CVST and patients with positive test results should be urgently sent for MR imaging.
Misra
Usha K
UK
Department of Neurology, Sanjay Gandhi PGIMS, Lucknow, India. ukmisra@sgpgi.ac.in
Kalita
Jayantee
J
Bansal
Vikas
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D002533:Cerebral Angiography; D002540:Cerebral Cortex / Q000473:pathology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D