Zeynep ÖZÖZEN AYAŞ, Ruhsen ÖNCEL ÖCAL, Ayhan BÖLÜK

Cerebral Sinus Venous Thrombosis: Evaluation of Nineteen Patients

Objective: Cerebral sinus venous thrombosis (CSVT) is a disease that can be seen in all age groups with various clinical findings and usually a good prognosis. In this study, evaluation of the complaints on admission, the possible risk factors, localization, findings and treatment approaches, and discussion of these findings with comparison to the literature were aimed. Materials and Methods: The demographic, clinical, laboratory and the radiological characteristics of 19 patients with diagnosed with CSVT and followed at the Sakarya University Training and Research Hospital Clinic of Neurology. Results: Nineteen patients (15 female, 4 male) with the diagnosis of CSVT were included. The mean age of the patients was determined as 31.3±11.2. Headache was determined to be the first symptom on admission in 17 patients. Nauseavomiting (n=10), blurred vision (n=4) and epileptic seizures (n=3) had accompanied headache. Altered state of consciousness (n=2), papilledema (n=4), dysarthria (n=1), and cerebellar disorder (n=1) were determined. Two of the patients were pregnant and 6 patients were in the postpartum period. CSVT due to infection was determined in 2 patients. No reason for etiological investigation was found in 4 of the cases. In 11 patients, more than one etiology were detected. Two patients had been diagnosed with Behçet’s disease. MTHFR A1298C gene heterozygous mutation was most detected. Fourteen patients were determined to have a single sinus venous thrombosis and 5 patients had more than one sinus venous thrombosis on magnetic resonance venography. Six patients had venous infarction. Conclusion: Pregnancy and postpartum period are significant risk factors for CSVT. The association of more than one reason in the etiological investigations of patients despite the presence of one significant risk factor has been emphasized.

Serebral Sinüs Ven Trombozu: On Dokuz Hastanın Değerlendirilmesi

Amaç: Serebral sinüs venöz trombozu (SSVT) her yaş grubunda rastlanılabilen, çok çeşitli klinik bulgulara ve genellikle iyi prognoza sahip bir hastalıktır. Bu çalışmada hastaların başvuru şikayetleri, olası risk faktörleri, lokalizasyonu, bulguları ve tedavi yaklaşımlarımızın ortaya konulması ve bulgularımızın literatürle tartışılması amaçlanmıştır. Gereç ve Yöntemler: Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi Nöroloji Kliniği’nde SSVT tanısı alarak izlenmiş olan 19 hastanın demografik, klinik, laboratuvar ve radyolojik özellikleri değerlendirilmiştir. Bulgular: SSVT tanısı alan 19 hasta (15 kadın, 4 erkek) alındı. Hastaların yaş ortalamaları 31,3±11,2 idi. Baş ağrısı 17 hastada ilk başvuru şikayeti olarak saptandı. Baş ağrısına bulantı-kusma (n=10), bulanık görme (n=4), epileptik nöbet geçirme (n=3) eşlik ediyordu. Bilinç bulanıklığı (n=2), papil ödem (n=4), dizartri (n=1), serebellar bozukluk (n=1) tespit edildi. Hastalardan 2’si gebe, 6’sı postpartum dönemde idi. İki hastada enfeksiyona bağlı SSVT saptandı. Dört hastada etiyolojik araştırmada bir neden bulunamadı. On bir hastada birden fazla etiyoloji saptandı. İki hastaya Behçet hastalığı tanısı kondu. En fazla MTHFR A1298C heterozigot gen mutasyonu saptandı. Manyetik rezonans venografide 14 hastada tek, 5 hastada birden fazla sinüste venöz tromboz saptandı. Altı hastada venöz enfarkt saptandı. Sonuç: Gebelik ve postpartum dönem SSVT için önemli risk faktörleridir. Hastaların etiyolojik araştırmasında belirgin risk faktörü varlığında bile birden çok nedenin birlikteliği vurgulanmıştır.

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