title: A Prospective Study of the Clinical Profile, Outcome and Evaluation of D-dimer in Cerebral Venous Thrombosis.
abstract: BACKGROUND
  Cerebral Venous Thrombosis (CVT) is a well known disease with diverse clinical presentation and causes. With advances in neuroimaging and changing lifestyles, the clinical profile and causes of CVT are changing. D-dimer has been studied in early diagnosis of CVT with variable results. This prospective study was carried out to assess the clinical profile of CVT and role of D-dimer in diagnosis of CVT.
  
  
  OBJECTIVE
  To study various aspects of CVT and role of D-dimer.
  
  
  METHODS
  The study period was September 2012 to July 2014 and included 80 imaging proven patients of CVT. We also included 39 controls for assessing D-dimer. Data was collected according to a preformed format. D-dimer was assessed by a rapid semi-quantitative latex agglutination assay. Discharged patients were followed up to six months.
  
  
  RESULTS
  Of the total 44 were women and 36 were men (F: M=1.2:1). The mean age of the patients was 29.5±9.68 years. Most common clinical features were headache 77 (96.25%), papilloedema (67.5%) and seizures 51 (63.75%). Pregnancy was the most common cause of CVT. Superior sagittal and transverse sinuses were the most common sinuses to be affected. The sensitivity and specificity of D-dimer for diagnosing CVT was 84.62% and 80% respectively. The risk factors for poor prognosis were altered sensorium, presence of sepsis, increased sinus involvement and deep sinus thrombosis.
  
  
  CONCLUSIONS
  CVT affects both sexes equally. Puerperium still contributes to majority of the cases. Iron deficiency anaemia needs to be evaluated as a contributing factor for incidence of CVT. D-dimer is not useful in puerperal female with CVT. Positive D-dimer will strengthen the suspicion of CVT in patients with acute headache followed by a neurological deficit.
authors: Senior Resident, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India .
authors: Venkatesh
authors: V
authors: Thammishetti
authors: Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India .
authors: Subrahmanyam
authors: S
authors: Dharanipragada
authors: Professor, Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India .
authors: Debdatta
authors: D
authors: Basu
authors: Associate Professor, Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India .
authors: Ramesh
authors: R
authors: Ananthakrishnan
authors: Assistant Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research , Pondicherry, India .
authors: Deepanjali
authors: D
authors: Surendiran
keywords: Anticoagulation; Chicken Pox; Neuroimaging; Polycythemia; Risk Factors