ACUTE CEREBRAL VENOUS SINUS THROMBOSIS: PLAIN COMPUTED TOMOGRAPHY VERSUS MAGNETIC RESONANCE IMAGING

Abstract

INTRODUCTION: The most common cause of CSVT was septic process in preantibiotic era. Cerebral sinus venous thrombosis shows wide clinical spectrum and it is difficult to diagnose because of its variable aetiologies and prognosis. Clinical findings of CSVT can be due to Occlusion in cerebral veins or Occlusion of venous sinuses.  Most patients with CVST present with nonspecific signs and symptoms and are likely to undergo nonenhanced head computed tomography (NCT) and in these cases undergo nonenhanced head computed tomography may be normal in up to two-thirds of patients with venous sinus thrombosis. Magnetic resonance imaging (MRI) is considered as the choice of imaging but MRI may not be available in many of the setting or cannot be afforded by the patients. MATERIAL AND METHODS: In this study two groups two groups were formed, first in which sinus thrombosis confirmed by MR venography and second group consist of control had normal NCT study and having seizures and headache . In both the group 30 each patients were selected and included whose symptoms were < 3 days old. Measurement of Hounsfield unit (HU) verses haematocrit (H) was calculated. HU: H ratio of each patient was also calculated. The haemoglobin, haematocrit (HCT), and HU:H (HU to HCT) ratio of both groups were calculated and compared. RESULTS: 30 patients in MR venography were included in the study while 30 patients in control group were included. In MRI group in which thrombosis was observed mean age was 35.4 ± 14.2 while in control group it was 41.3±12.4. Average haemoglobin concentration in MR and control group was 14 ±2.6 and 11.6±3.4 respectively. In MR group HCT was 48.2±7.6 while in control group it was 37.5±8.4. HU in MR group was 74 ±2.9 and in control group it was 44.8±7.8. HU: H ratio was calculated in both the group in group MR it was 1.6±0.5 and in control group it was 1.2±0.3. CONCLUSION: Thus acute CVST can be diagnosed accurately in plain CT scan with the help of HU: H ratio and the treatment can be started early to reduce the future complications.
Keywords: HU to HCT