East African Medical Journal

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Clinical Features and Patterns of Imaging in Cerebral Venous Sinus Thrombosis at Kenyatta National Hospital

CK Onyambu, EO Amayo, JM Kitonyi


Background: Cerebral venous sinus thrombosis (CVST) is an uncommon neurological deficit. It shows a wide range of clinical manifestations that may mimic many other neurological disorders and lead to misdiagnosis. Imaging plays a key role in the diagnosis.
Objective: To evaluate the clinical characteristics and patterns of  neuroimaging findings in patients with radiologically confirmed CVST.
Design: A retrospective study.
Setting: Kenyatta National Hospital, a tertiary referral and teaching hospital in Nairobi Kenya.
Subjects: Fifty one patients treated for CVST in the hospital were studied.
Results: Fifty one patients with CVST were seen over the last five years. The median age of 30 years. The most common age group affected was 25-34 years. Females were more affected (n=38, 74.5%) than males (n=13, 25.5%). The most common presenting clinical features documented were headache, seizures and neurological deficits. Aetiological factors commonly seen included infection (n=20, 39.2%), pregnancy and  puerperium (n=7, 13.7%) and oral contraceptive use (n=2, 3.9%). The most common NECT scan findings were hyperdense sinus and  parenchymalchanges. MRI showed loss of signal void in the sinus, gyral swelling and parenchymal signal change.
Conclusion: CVST is most commonly seen in young adult females due to infection, pregnancy, puerperium and oral contraceptive use. The most common clinical finding in patients with CVST is headache, followed by seizures, neck pain, neurological deficits and visual disturbance. Infective cause is much more common in our population and other developed countries compared to the developed world.

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