RELATIONSHIP OF D-DIMERS WITH THE DURATION OF CEREBRAL VENOUS SINUS THROMBOSIS (CVST): A DESCRIPTIVE STUDY IN TERTIARY HEALTH CARE HOSPITAL OF DISTRICT PESHAWAR PAKISTAN.

Abstract

Purpose CVST is a serious condition with a recent incidence of 13 million persons per year. (1) It has a highly variable presentation and may manifest itself with no recognizable risk factor, Magnetic resonance venography (MRV) is the investigation of choice for its diagnosis. However, since MRV is not readily available and is costly, this study tried to find the relationship between the levels of D-dimers as marker and duration of CVST. D-dimers are degraded fibrin products which are found to be raised in pulmonary embolism and deep venous thrombosis.

Methods: Total 49 patients (male to female ratio 1:6) mean age 36.37 13years) with MRV proven CVST were included in the study. This descriptive cross-sectional study was conducted from January 2015-April 2017, on 49 confirmed patients of CVST, in Lady Reading Hospital. In patients suspected of CVST, magnetic resonance imaging of the brain with MRV was performed without delay on a 1.5 tesla MR scanner using T1, T2, flair, and diffusion weighted imaging sequences with a two-dimensional time of flight MRV. D-dimers were estimated by a rapid latex agglutination slide test technique using monoclonal antibodies. Data was analyzed using SPSS version 19.  Frequencies, mean were calculated for quantitative data while Chi-square test was used for qualitative data. Sensitivity and specificity were calculated.

 Result: The duration of symptoms was 3-60 days (mean 22 days). The mean value of D-dimers levels recorded in micrograms were recorded as 1456

Conclusion:  D-dimers levels were high in acute and subacute stage of CVST. However, there were cases in our study who despite having acute and subacute stage of CVST had normal D-dimers levels for unknown reasons.