The clinical profile in male CVT patients admitted to the Institute of Neurology, Madras Medical College, India

Background: Cerebral venous thrombosis (CVT) is an important cause of stroke in young. The Exact etiology and prevalence of the disease are yet to be fully understood. However various risk factors that predispose to the development of CVT have been identified. Cerebral venous thrombosis is most commonly seen in females, now there is no gender disparity. Objective: To study the clinical profile in male CVT patients admitted to the Institute of Neurology, Madras Medical College, India Materials and method: Clinical characteristics of 203 consecutive male patients diagnosed to have CVT and proven by MRI were analyzed who were admitted in the Institute of Neurology, Madras medical college, India. Data obtained a s an Asian CVT registry questionnaire. Clinical profile and risk factors are studied. Results: The mean age of male patients with CVT was (38 + 6.9 years). Out of 203 patients, 147 patients (72.4%) were aged less than 40 years. The most common clinical feature encountered is Headache (93.5%). Papilledema was observed in 101 patients (50.2%). Trans-Venous Aphasia was observed in 21 patients (10.3%). Cranial nerve abnormality was observed in 70 patients (34.7%). Seizures developed in 101 patients (49. 7%) and the majority of them had 2 or fewer episodes (59%). The generalized tonic-clonic seizure was the most common semiology observed (82 patients). Focal seizures were observed in 17 patients and 2 had status epilepticus .61 patients (30%) had motor weakness on examination. Ataxia and vertigo noted in 8 patients (3.9%). All patients had evidence of venous sinus thrombosis in MR venography. The most common venous system is the superficial venous system (98.7%). The most common vein affected is superior sagittal sinus (68.3%) followed by Transverse sagittal sinus (53.6%). Iatrogenic antithrombotic therapy-related hemorrhage was seen in 6 patients (4 GI bleed and 2 Hematuria) and was not severe warranting transfusion. The nosocomial infection developed in 4 patients (2 UTI and 2 Aspiration Pneumonia).Malignancy is noted in one patient.4 patient expired in spite of therapy (2 due to aspiration pneumonia, 1 due to a rapid worsening of neurological status and 1 due to the development of pulmonary embolism). Conclusion: Compare to previous International study, Incidence of CVT in Male's are higher. Alcoholism is a major risk factor. Compared with previous Indian studies there is no significant difference in gender disparity, clinical profile and risk factors.