Radiological Spectrum of Cerebral Venous Sinus Thrombosis in Soldiers at High Altitude: A Four-Year Analysis

Abstract

Objective: To assess the spectrum of radiological findings of cerebral venous sinus thrombosis (CVST) in soldiers serving at high altitudes.

Study Design: Retrospective longitudinal study.

Place and Duration of Study: Combined Military Hospital, Skardu Pakistan, from Jan 2016 to Jan 2020.

Methodology: Thirty-three consecutive soldiers evacuated to Combined Military Hospital, Skardu, with radiologically proven cerebral venous sinus thrombosis on CTV brain were enrolled in the study. Plasma D-dimer levels of all the patients were sent to the laboratory, and clinical data were noted.

Results: Mean age of patients was 28.88 years ± 5.189 (range 20 to 40 years) with a mean duration of stay at high altitude of 59.8 ± 39.3 days and the average height of deployment as 17094 ± 3285 feet. Left transverse sinus was the most commonly involved sinus in 21 (63.6%) patients, followed by left sigmoid sinus 18 (54.5%) and superior sagittal sinus 16 (48.5%). Sixteen cases demonstrated associated findings of venous infarction on CT brain (48.5%). Headache was the most common clinical presentation 13 (93.9%), followed by vomiting 12 (36.4%).

Conclusion: Prolonged stay at high altitude is a key risk factor for cerebral venous sinus thrombosis in young individuals showing a predilection for posteriorly and inferiorly located venous sinuses.