Browsing by Author "Kanchana Poochaneeyapan"

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    Influence of CT/MRI findings on outcome and prognosis of patients with cerebral venous sinus thrombosis
    (2018-06-01) Dittapong Songsaeng; Kanchana Poochaneeyapan; Faculty of Medicine, Siriraj Hospital, Mahidol University
    © 2018, Medical Association of Thailand. All rights reserved. Objective: To study influence of CT/MR imaging findings in cerebral venous sinus thrombosis (CVST), regarding patient treatment outcome and prognosis. Materials and Methods: The authors collected forty-two patients (n = 42) whose diagnosis of cerebral venous sinus thrombosis between 2005-2011, underwent cranial CT with contrast medium administration/CTV in all patients and contrast-MRV in 12 patients from database of Siriraj Hospital. The radiographic findings were retrospectively included in the study by one experienced radiologist. Baseline data collected included dermographic, clinical sign and presentation, vascular risk factors, treatment and outcome. Results: From the 42 patients; 32 female (76.2%), 10 male (23,8%); mean age was 39.8 years (range 14-85 years) were identified. Symptoms included headache, vomiting, seizure, neurological deficit and blurred vision, risk factors, Glasgow coma scale (GCS), blood pressure on arrival, papilledema, hemiparesis, location of occluded venous sinuses, hemorrhagic infarction, treatment options and length of stay were analyzed to determine the outcome by using modified Rankin Scale (mRS). Poor prognosis (defined as mRS of 3-6) was determined on the discharge date. Diagnosis of venous sinus thrombosis was considered on cranial CT with contrast medium administration in 30 patients and contrast MRV in 12 patients. Radiographic findings were abnormal in all patients by thrombus location in superficial vein location: Superior sagittal sinus [SSS] (62%), Transverse sinus [TS] (64%), sigmoid sinus (69%), internal jugular vein (50%), cortical vein (31%) and deep vein location: internal cerebral vein (5%). Those with deep vein involvement (5%) and parenchymal involvement (55%) had poor outcome 100% and 88.9% after heparin treatment, respectively. Conclusion: Although, overall prognosis was good outcome in 78% of patients, patients with parenchymal involvement (Hemorrhage, infarction, midline structure shifting, brain swelling, brain herniation, hydrocephalus) were more likely to present in poor outcome.