Pattern and localization of headache in cerebral venous sinus thrombosis (CVST).

Abstract

Introduction: Cerebral Venous Sinus Thrombosis (CVST) is an underdiagnosed but not rare type of neurovascular disease. There is involvement of cerebral veins or dural sinuses instead of arteries. The vein or dural sinuses are blocked by thrombus resulting in increased pressure and leading to rupture of vessels and leakage of blood into the brain. Headache is the most frequent presenting symptom of CVST.
Methodology: This descriptive study was conducted at Sheikh Zayed Medical Col-lege and Hospital Rahim Yar Khan. All consecutive patients with confirmed diagno-ses of CVST were included in the study. Diagnosis of CVST confirmed by MRI/MR Venogram. An informed consent was taken and the data was collected on a ques-tionnaire. Ethical permission was taken from Institutional ethical review com-mittee.
Results: Headache was present in 51 (81%) of 63 confirmed CVST patients. Data regarding characteristics of headache from 51 patients was analyzed. The headache was associated with photophobia (4%), phonophobia (6%), loss of vision(6%), nau-sea (9%) and vomiting (42%) .The headache was not related with infarct and hem-orrhage on Computed Tomography scan and Magnetic Resonance Imaging. The site of headache was not linked with site of sinus thrombosis.
Conclusion: Headache is the common symptom in patients with CVST. Usually the headache in CVST is subacute, throbbing, unilateral or localized to some specific region i.e frontal, temporal and occipital. There is no relation between headache and site of sinus thrombosis. Also there is no link between headache and hemor-rhage or infarct on Computed Tomography scan (CT) and Magnetic Resonance Im-aging (MRI).
Key words: Cerebral Venous Sinus Thrombosis , Headache, MRI/MR Venogram.