IP Indian Journal of Neurosciences


Role of D- Dimer in aseptic cerebral venous sinus thrombosis


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Author Details: Dilip Maheshwari, Vijay Sardana, Parag Moon, Bharat Bhushan, Sankalp Mohan, Sumit Kamble, Piyush Ojh

Volume : 3

Issue : 1

Online ISSN : 2581-916X

Print ISSN : 2581-8236

Article First Page : 16

Article End Page : 20


Abstract

Introduction: Early diagnosis of cerebral venous sinus thrombosis (CVT) is essential because early treatment may prevent morbidity and may even be life-saving. Definite exclusion, however, needs advanced neuroradiologic diagnostics, which are not readily available in many hospitals. A biological marker like D-dimer can be used as a tool to help in diagnosis of CVT.
Aims: To evaluate patients with CVT with diverse clinical manifestations and assess the importance of D-dimer in the diagnosis.
Settings and Design: Prospective observational study carried out at Dept. of Neurology at a tertiary care hospital.
Methods and Material: A total of 56 patients with CVT were subjected to a detailed medical history and neurological evaluation. A MRI brain was carried out on a 1.5T scanner using T1, T2, and Diffusion weighted sequences and TOF MR venography. D-dimer was quantitatively estimated by immunoturbidimetry.
Statistical analysis used: SPSS 19 statistical software was used. Unpaired t test, ANOVA, Pearson chi square test was used to analyse different parameters. Significance level of 95% with p<0.05 was considered statistically significant.
Results: A total 56 patients were enrolled in this study. The mean age was 33.98 +/- 13.20 years. Female: male ratio was 2.3:1. Headache was the most common presentation (82.1%) followed by vomiting(48.2%). MRI brain showed infarct in 39(69.6%) patients, out of which 24 (42.8%) had hemorrhagic venous infarct. Most common sinus involved was superior saggital sinus (71.4%) followed by transverse (64.3%). Mean D-dimer concentration in patients with 1 vein involvement was 1.04, in 2 vein involvement it was 1.35, in 3 vein involvement it was 1.30, 1.96 in patients with 4 and 5.67 in patients with more than 6 vein involvement which was found to be significant statistically.
Conclusions: D-dimer might be not only suitable in the context of diagnosing CVT but also may be helpful in estimating severity of disease.

Keywords:
D-dimer, Cerebral venous sinus thrombosis, MR venograpghy