European Journal of Cardiovascular Medicine

Objective: To evaluate the surgical outcomes of decompressive craniectomy in patients with cerebral venous sinus thrombosis (CSVT) at our institution. Methods: We conducted a retrospective analysis of 396 CSVT cases admitted to our institution. Among these, 45 (11.3%) underwent decompressive craniectomy. We assessed demographic data, clinical presentation, risk factors, Glasgow Coma Scale (GCS) scores upon presentation, and radiologic findings in relation to venous sinus and cerebral lobe involvement. Results: Of the 45 patients who underwent decompressive craniectomy, 26 (57.7%) were female and 19 (42.3%) were male. The mean age of incidence was 34 years, with a notable predominance in patients below 40 years (69%). The predominant presenting symptoms were headache (93.3%), altered sensorium (88.8%), focal motor deficit (60%), and convulsion (48%). Identified risk factors included chronic alcohol intake (31%), smoking (37%), postpartum status (30%), dehydration (51%), anemia (26%), homocystinemia (17.7%), and oral contraceptive pill usage (15%). In terms of GCS, 57.7% presented with scores between 8-12, while 22.2% had scores below 8. Radiologic findings revealed involvement of two or more sinuses in 21 patients. Specific sinus involvements were: superior sagittal (11 patients), sigmoid (7 patients), and transverse (6 patients). Regarding lobe involvement, the distribution was: parietooccipital (13 patients), frontal (10 patients), frontoparietal (14 patients), and temporoparietal (8 patients). Conclusion: Decompressive craniectomy serves as a crucial intervention in selected CSVT cases. Our study presents an institutional experience emphasizing demographics, clinical presentations, risk factors, and radiologic findings in patients undergoing this surgical intervention for CSVT.