A descriptive monocentric study in Algeria of adults with cerebral venous thrombosis

Introduction. - Patients with cerebral venous thrombosis (CVT) often present with slowly progressive symptoms, leading to delay in diagnosis. The aim of our single-center study was to highlight the clinical patterns and etiological features of CVT, and to show the impact of diagnostic delay on prognosis in Algerian adults. Methods. - Retrospective and prospective data of patients with radiologically confirmed CVT were collected over a 10-year period at the neurovascular emergency unit of the Salim Zemirli hospital in Algiers. Manifestations were classified by clinical syndrome. All patients received immediate unfractionated heparin at a hypocoagulant dose. Systematic targeted etiological research for CVT was performed with identification of acquired and genetic risks. Results. - The study included 28 patients, median age 32 years. Median time to diagnosis was 11 days. The most common clinical features were headache (79%), focal neurological deficit (48%), seizures (33%), and mental status changes (26%). The superior sagittal and transverse sinuses were most commonly involved. Important predisposing factors included local infection (31%), puerperium (14%), oral contraceptive pill use (11%), Behcet disease (11%) and thrombophilia (18%). Short-term outcome was favorable in a majority of patients, but vision lost was noted in three because of delayed diagnosis. Conclusions. - In a single center in Algiers, CVT occurred essentially in young women. Most patients presented acute intracranial hypertension with headache as the cardinal sign. The most common sites of thrombosis were the transverse and the superior sagittal sinuses. Predominantly, acquired causes were infection, puerperium and oral contraceptives. Protein S deficiency was notable. Outcome was favorable in most patients, without sequelae. The prognosis of CVT is decisively dependent on early diagnosis and immediate anticoagulant treatment with heparin. (C) 2020 Elsevier Masson SAS. All rights reserved.