Cerebral venous thrombosis. Clinical presentation and outcome in a prospective series from Sudan

OBJECTIVE: To describe the presentation and outcome of treatment of cerebral venous thrombosis (CVT) in patients from Sudan, an example of a developing country.

METHODS: In a prospective study, we described the clinical features, risk factors, and outcome of CVT in patients admitted to the National Center for Neurological Diseases, Khartoum, Sudan, the only specialized neurological hospital in the country, during the period from February 2001-October 2006. Patients were referred from other hospitals in the town or from nearby hospitals in Khartoum state.

RESULTS: We recruited only adult and adolescent patients aging >/=15 years. We reviewed 15 patients (12 females and 3 males) with a mean (+/-SD) age of 33.9+/-11.8 years. Headache (n=15), papilledema (n=13), paresis (n=3), and generalized seizures (n=3) were the most common symptoms, and signs encountered. A prothrombotic risk factor was often identified (n=12). At the time of the first visit namely, 12 weeks after discharge, 7 patients (46.7%) attained complete neurological recovery, 4 (26.7%) developed optic atrophy, and 2 (13.3%) died of pulmonary embolism.

CONCLUSION: The clinical features and risk factors of CVT in Sudan are not different from elsewhere, but the outcome is less favorable. Places with less privileged health service resources, late presentation or delayed accessibility to appropriate diagnostic tools may negatively influence the final outcome.