title: Cortical venous thrombosis presenting with subarachnoid haemorrhage.
abstract: BACKGROUND
  Our study retrospectively reviewed the presentation, neuro-radiological findings, and outcomes of eight adult patients presenting at our institution with subarachnoid haemorrhage (SAH), which was subsequently proven to be due to cortical venous thrombosis (CVT).
  
  
  METHODS
  We reviewed the case records and neuroimaging findings of eight patients diagnosed with SAH and CVT over a span of two years at our institution, a tertiary care centre in Western India. All details pertaining to their presentation, clinical findings, neuroimaging, management, and outcome following therapy with anticoagulants were collected until patient discharge.
  
  
  RESULTS
  There were a total of eight patients, with the average age being 34 years (range 25-42). Only one patient was female. Six patients had a history of recent binge drinking. None of the patients had a past or family history of common risk factors for thrombosis. All patients presented acutely, with headache (n=6) and seizures (n=6) being the most common presenting features, occurring in three-quarters of the patients examined. Non-contrast computed tomography (NCCT) was the initial imaging study for all but one of the patients and showed cortical SAH (cSAH) without basilar haemorrhage. Magnetic resonance imaging/magnetic resonance venography (MRI/MRV) confirmed the underlying CVT. Unfractionated heparin was used in all cases. Seven patients improved and were discharged on oral anticoagulation. The eighth patient died.
  
  
  CONCLUSIONS
  Localised cSAH with sparing of basal cisterns can be a presentation for CVT. In patients with cSAH, MRI/MRV can be useful to make a diagnosis of CVT. Anticoagulation for CVT, even in the presence of SAH was related to seven out of eight patients being discharged.
authors.affiliation: Department of Medicine, Government Medical College & S.S.G. Hospital, Vadodara, Gujarat, India.
authors.forename: Minal
authors.initials: M
authors.lastname: Shastri
authors.affiliation: Department of Medicine, Government Medical College & S.S.G. Hospital, Vadodara, Gujarat, India.
authors.forename: Smita
authors.initials: S
authors.lastname: Trivedi
authors.affiliation: Department of Medicine, Government Medical College & S.S.G. Hospital, Vadodara, Gujarat, India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Rana
authors.affiliation: GMERS Medical College, Gotri, Vadodara, Gujarat India.
authors.forename: Dwijal
authors.initials: D
authors.lastname: Patel
authors.affiliation: Seth G.S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Rishi
authors.initials: R
authors.lastname: Tripathi
authors.affiliation: Department of Medicine, Government Medical College & S.S.G. Hospital, Vadodara, Gujarat, India.
authors.forename: Rushad
authors.initials: R
authors.lastname: Patell
keywords: Cortical venous thrombosis; non-contrast CT; subarachnoid haemorrhage