Profile of 26 HIV Seropositive individuals with Cerebral Venous Thrombosis

J Neurol Sci. 2017 Jul 15;378:69-74. doi: 10.1016/j.jns.2017.04.034. Epub 2017 Apr 21.

Abstract

Background: HIV infection has been found to be prothrombotic condition. However, venous thromboembolism associated with HIV is restricted to peripheral vasculature with few reports of cerebral venous thrombosis (CVT).

Objective: To examine the clinical manifestations of CVT among HIV seropositive individuals and explore the possible etiological factors.

Methods and results: It is a prospective study of 26 (M:F-18:8) patients of CVT associated with HIV seropositive status. Their age and duration of illness was 33.8±6.8years and 11.3±8.5days respectively. Headache and vomiting was the most common symptom followed by seizures. Drowsiness with GCS (Glasgow coma score) ranging from 9-14 was present in two-thirds of the patients. Serum homocysteine was elevated in 70% of patients. Vitamin B12 was low in 12.5% and insufficient levels in 25%. 88.5% of the patients recovered completely to GCS 15/15 in 2-7days during follow up; 11.5% patients expired during the acute state.

Conclusion: This study represents the largest series of CVT in HIV seropositive individuals. There is increased risk of thrombosis due to elevated homocysteine and low Vitamin B12. They have better sensorium inspite of extensive radiological involvement.

Keywords: CVT; Cerebral venous thrombosis; HIV; Human immunodeficiency virus; Hyperhomocysteinemia; Vitamin B12.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Brain / diagnostic imaging
  • Cerebral Veins*
  • Female
  • HIV Seropositivity / complications*
  • HIV Seropositivity / diagnostic imaging
  • HIV Seropositivity / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Venous Thrombosis / complications*
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / physiopathology
  • Young Adult

Substances

  • Biomarkers