Headache as the sole presenting symptom of cerebral venous sinuses

Abstract

Objectives: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes be the only symptom in these patients. This retrospective and prospective study was an investigation of any differences in terms of clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) and cases with other concomitant findings (non-isolated headache [NIH]).

Methods: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis ( VENOST study) were enrolled in this research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared.

Results: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated by age group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IH group, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH group during follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group than in the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in the NIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group.

Conclusion: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an important role in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.

C1 [Duman, Taskin; Colakoglu, Sena] Mustafa Kemal Univ, Dept Neurol, Antakya, Turkey.

[Cinar, Nilgun; Sahin, Sevki] Maltepe Univ, Dept Neurol, Istanbul, Turkey.

[Uluduz, Derya; Goksan, Baki; Ince, Birsen] Istanbul Cerrahpasa Univ, Dept Neurol, Istanbul, Turkey.

[Domac, Fusun Mayda] Erenkoy Training & Res Hosp Neurol & Psychiat Dis, Dept Neurol & Psychiat Dis, Istanbul, Turkey.

[Ozturk, Serefnur; Ekmekci, Hakan] Selcuk Univ, Dept Neurol, Konya, Turkey.

[Yayla, Vildan; Baybas, Sevim; Cabalar, Murat] Bakirkoy Training & Res Hosp Neurol & Psychiat Di, Dept Neurol, Istanbul, Turkey.

[Karahan, Ali Yavuz] Usak Univ, Dept Phys Med & Rehabil, Usak, Turkey.

[Afsar, Nazire] Acibadem Univ, Dept Neurol, Istanbul, Turkey.

[Sungur, Mehmet Ali] Duzce Univ, Dept Biostat, Duzce, Turkey.

[Goksu, Eylem Ozaydin; Tokuc, Firdevs Ezgi] Antalya Training & Res Hosp, Dept Neurol, Antalya, Turkey.

[Yurekli, Vedat Ali; Demirci, Seden] Suleyman Demirel Univ, Dept Neurol, Isparta, Turkey.

[Genc, Hamit; Yilmaz, Arda] Mersin Univ, Dept Neurol, Mersin, Turkey.

[Utku, Uygar; Gokce, Mustafa] Kahramanmaras Sutcu Imam Univ, Dept Neurol, Kahramanmaras, Turkey.

[Tekeli, Hakan; Senol, Mehmet Guney; Ozdag, Mehmet Fatih] Sultan Abdulhamid Han Training & Res Hosp, Dept Neurol, Istanbul, Turkey.

[Uzuner, Nevzat; Uzuner, Gulnur Tekgol] Osmangazi Univ, Dept Neurol, Fac Med, Eskisehir, Turkey.

[Kusbeci, Ozge Yilmaz] Bozyaka Educ Res & Training Hosp, Dept Neurol, Izmir, Turkey.

[Caglayan, Hale Zeynep Batur; Nazliel, Bijen] Gazi Univ, Dept Neurol, Fac Med, Ankara, Turkey.

[Acikgoz, Mustafa; Tascilar, Nida] Bulent Ecevit Univ, Dept Neurol, Fac Med, Zonguldak, Turkey.

[Kurucu, Hatice] Univ Edinburgh, Ctr Discovery Brain Sci, Dementia Res Inst, Edinburgh W1T 7NF, Midlothian, Scotland.

[Yaman, Mehmet; Oruc, Serdar] Afyon Kocatepe Univ, Dept Neurol, Fac Med, Afyon, Turkey.

[Bektas, Hesna] Ataturk Training & Res Hosp, Dept Neurol, Ankara, Turkey.

[Kaplan, Yuksel] Inonu Univ, Dept Neurol, Fac Med, Malatya, Turkey.

[Goksel, Basak Karakurum] Baskent Univ, Dept Neurol, Fac Med, Adana, Turkey.

[Milanlioglu, Aysel] Yuzuncli Yil Univ, Dept Neurol, Fac Med, Van, Turkey.

[Orken, Dilek Necioglu] Istanbul Bilim Univ, Dept Neurol, Fac Med, Istanbul, Turkey.

[Aluclu, Mehmet Ufuk] Dicle Univ, Dept Neurol, Fac Med, Diyarbakir, Turkey.

[Tufekci, Ahmet] Recep Tayyip Erdogan Univ, Dept Neurol, Fac Med, Rize, Turkey.

[Bakar, Mustafa] Uludag Univ, Dept Neurol, Fac Med, Bursa, Turkey.

[Kozak, Hasan Huseyin] Necmettin Erbakan Univ, Dept Neurol, Fac Med, Konya, Turkey.

[Misirli, Cemile Handan] Hlth Sci Univ, Dept Neurol, Haydarpa Training & Res Hosp, Istanbul, Turkey.

[Midi, Ipek] Marmara Univ, Dept Neurol, Fac Med, Istanbul, Turkey.

[Mengulluoglu, Necdet] Eskisehir State Hosp, Dept Neurol, Eskisehir, Turkey.

[Aytac, Emrah] Ankara Numune Training & Res Hosp, Dept Neurol, Ankara, Turkey.

[Yesilot, Nilufer] Istanbul Univ, Istanbul Fac Med, Dept Neurol, Istanbul, Turkey.

[Yalin, Osman Ozgur] Hlth Sci Univ, Istanbul Training & Res Hosp, Dept Neurol, Istanbul, Turkey.

[Gunes, Taskin] Maltepe State Hosp, Dept Neurol, Istanbul, Turkey.

[Demir, Serkan] Sancaktepe Sehit Prof Dr Ilhan Varank Training &, Dept Neurol, Istanbul, Turkey.