Clinical and Radiological Profile of Seven Patients with Cerebral Venous Thrombosis: A Case Series from Nepal

Background: Cerebral venous thrombosis (CVT) is an uncommon but potentially reversible cause of stroke, primarily affecting young adults and women. Despite global data, information from Nepal is limited. This study presents the first documented case series describing the clinical presentation, radiological characteristics, risk factors, management, and outcomes of CVT in a tertiary hospital setting in Nepal. Methods: A retrospective descriptive study was conducted at the Department of Neurology, Tribhuvan University Teaching Hospital, Kathmandu, from September 2020 to August 2021. Seven patients with radiologically confirmed CVT were included. Demographic, clinical, radiological, and treatment data were extracted from hospital records and analyzed descriptively. Results: The mean age of the patients was 41.7 years (range: 20–78 years), with a female predominance (5 females, 2 males). The most common presenting symptom was headache (85.7%), followed by seizures and focal neurological deficits (each in 71.4%). MRI and MRV were the primary diagnostic modalities, revealing the superior sagittal sinus as the most frequently involved site (71.4%). Parenchymal changes, mainly venous or hemorrhagic infarctions, were seen in 71.4% of cases. Major risk factors included infections, autoimmune diseases, pregnancy/postpartum state, and COVID-19 infection. All patients received anticoagulation, with LMWH transitioned to warfarin or direct oral anticoagulants. At discharge, all patients improved clinically, with one achieving complete recovery and no recorded mortality. Discussion: The findings align with global literature highlighting CVT as a condition with diverse clinical manifestations and generally favorable prognosis when promptly recognized. The high frequency of headache and seizures corresponds to patterns observed in international cohorts. MRI and MRV continue to be indispensable for diagnosis, especially in atypical stroke presentations. The identification of postpartum, autoimmune, and COVID-19–related cases reflects evolving risk profiles in developing countries. The good recovery rates in this series reinforce the effectiveness of early anticoagulation and multidisciplinary management. Conclusions: This first Nepalese case series underscores that cerebral venous thrombosis presents with variable symptoms but favorable outcomes when diagnosed early and treated with anticoagulation. Risk factors mirror global patterns, including autoimmune and pregnancy-related conditions. MRI and MRV remain the diagnostic gold standards. Early recognition and multidisciplinary management are key to optimizing outcomes