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An assessment of cerebral venous thrombosis risk factors and associated clinical outcomes in Jazan region, Saudi Arabia

Hasan M. Daghriri, Alwaleed A. Alrajhi, Khadijah S. Aburasain, Ebtisam A. Ateya, Mohammed A. Hakami and Ibrahim M. Gosadi
Neurosciences Journal January 2021, 26 (1) 15-20; DOI: https://doi.org/10.17712/nsj.2021.1.20200098

Article Figures & Data

Tables

  • Table 1

    Demographic characteristics of 51 patients diagnosed with CVT in King Fahad Central Hospital, in Jazan region between 2010 and 2019.

    Demographic characteristicsGender – Frequency (%)Total
    Male16 (31.4)51 (100)
    Female35 (68.6)
    Age
     Mean±SD31.25±14.5534.29±9.6933.33±11.38
     Minimum5185
     Maximum555757
    Nationality
     Saudi11 (68.8)28 (80)39 (76.5)
     Non-Saudi5 (32.3)7 (20)12 (23.5)
    Chronic disease
     Hypertension1 (6.3)3 (8.6)4 (7.8)
     Diabetes0 (0)2 (5.7)2 (3.9)
     Asthma1 (6.3)2 (5.7)3 (5.9)
    BMI
     Normal4 (25)12 (34.3)16 (31.4)
     Underweight2 (12.5)0 (0)2 (3.9)
     Overweight9 (56.3)9 (25.7)18 (35.3)
     Obese1 (6.3)13 (37.1)14 (27.5)
     Previous history of CVT1 (6.3)3 (8.6)4 (7.8)
     Family history of CVT0 (0)0 (0)0 (0)
  • Table 2

    Clinical features, complications and prognosis of 51 patients diagnosed with CVT in King Fahad Central Hospital, in Jazan region between 2010 and 2019.

    Variablesn(%)
    Signs and symptoms
     Headache39(76.5)
     Seizure23(45.1)
     Vomiting17(33.3)
     Visual symptom9(17.6)
     Weakness10(19.6)
     Numbness2(3.9)
     Altered sensorium1(2.0)
     Speech difficulty4(7.8)
     Decreased level of consciousness7(13.7)
     Coma2(3.9)
     Cranial nerve palsy3(5.9)
     Papilledema7(13.7)
    *Mode of onset
     Acute2(3.9)
     Subacute23(45.1)
     Chronic5(9.8)
    Findings on clinical examination
     Upper limb weakness9(17.6)
     Lower limb weakness6(11.8)
     Upper limb numbness/loss of sensation3(5.9)
     Lower limb numbness/loss of sensation4(7.8)
     Cranial nerve palsy2(3.9)
     Normal37(72.5)
     Duration of symptoms and signs (Days):25.63±53.53 Mean±SDMedian= 5
    Acute complications
     Venous infarction & hemorrhage7(13.7)
     Coma2(3.9)
     Subarachnoid hemorrhage1(2)
     Ophthalmoplagia1(2)
     No acute complications39(76.5)
    Chronic complications
     Epilepsy13(25.5)
     Focal neurological deficit8(15.7)
     No chronic complications35(68.6)
    Prognosis
     Complete recovery34(66.7)
     Recovery with disability14(27.5)
     Death1(2)

    • ↵* Acute - within 48 hours, Subacute - more than 48 hours and less than 1 month, Chronic - More than one month

  • Table 3

    Recorded CVT risk factors of 51 patients diagnosed with CVT in King Fahad Central Hospital, in Jazan region between 2010 and 2019:

    Risk factorsn(%)
    Infection of head and neck1(2)
    Head trauma1(2)
    Anemia26(50.98)
    Dehydration1(2)
    Obesity14(27.5)
    Hypercoagulapathy status:
     Hereditary thrombophilia2(3.9)
     Protein C deficiency8(15.7)
     Protein S deficiency29(56.9)
     Anti-thrombin III deficiency7(13.7)
     Factor V Leiden mutation1(2)
     Anti-phospholipid syndrome11(21.7)
    Systemic diseases:
     Inflammatory bowel disease1(2)
     Thyroid disease2(3.9)
     Systematic Lupus Erythematosus (SLE)1(2)
    Female-specific risk factors:
     Pregnancy2(3.9)
     Puerperium15(29.4)
     Oral contraceptive pills (OCP)8(15.7)
     Hormonal Replacement Therapy (HRT)1(2)
     Unknown risk factors8(15.7)

    • CVT - Cerebral Venous Thrombosis

  • Table 4

    Radiological features of 51 patients diagnosed with CVT in King Fahad Central Hospital, in Jazan region between 2010 and 2019.

    Radiological featuresn(%)
    Used modalities
     CT scan3160.8
     MRI2156.9
     CT venogram2549
     MR venogram59.8
    Parenchymal lesion
     Hemorrhagic lesion1529.4
     Non-hemorrhagic lesion2447.1
     Subarachnoid hemorrhage23.9
     No parenchymal lesion1019.6
    Involved sinuses/veins
     Superior sagittal sinus3364.7
     Inferior sagittal sinus47.8
     Transverse sinus3976.5
     Sigmoid sinus2752.9
     Straight sinus1019.6
     Deep cerebral vein12
     Internal jugular vein1835.3
     Cortical vein23.9
    Number of involved sinuses/veins
     One1427.5
     Two713.7
     More than 22956.9
  • Table 5

    Comparison between different studies conducted in Saudi Arabia to investigate clinical features of CVT.

    City: period of records review [Reference]Jazan: 2010 -2019 Current studyKhobar: 2008-201813Jeddah & Al-Baha 1990-20107Riyadh: 2005-200814
    Number of patients512611122
    Mean age of patients33.3329.429.538.3
    Most common clinical presentation1-Headache
    2-Seizure
    3-Vomiting    		1-Headache
    2-Unilateral weakness
    3-CN palsy    		1-Headache
    2-Focal neurological deficit
    3-Seizure    		1-Headache
    2-Seizure
    3-Focal neurological deficit
    Most common risk factors1-Protein S deficiency
    2-Anemia
    3-Puerperium    		1-OCP/postpartum
    2-Infection
    3-Trauma and hereditary thrombophilia    		1-Pregnancy /puerperium
    2- antiphospholipid antibody syndrome
    3-OCP    		1-OCP
    2-Protein S deficiency
    3-Unkown
    Most common involved sinuses1-Transverse sinus
    2-Superior sagittal sinus
    3-Sigmoid sinus    		1-Transverse sinus
    2-Superior sagittal sinus
    3-Sigmoid sinus    		Superior sagittal sinus1-Transverse sinus
    2-Sigmoid sinus
    3-Superior sagittal sinus
    Most common type of parenchymal lesion on imagingNon-hemorrhagic lesionHemorrhagic lesionNot mentionedHemorrhagic lesion
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