Abstract

Objectives: Cerebral venous sinus thrombosis (CVST) is a rare but serious condition characterized by thrombosis in the cerebral veins and dural sinuses. This study aimed to evaluate the diagnostic accuracy and practicality of imaging modalities, emphasizing computed tomography (CT) scans for emergency use due to their speed, accessibility, and cost-effectiveness, compared to advanced techniques such as magnetic resonance venography (MRV), CT venography (CTV), and cerebral digital subtraction angiography (C-DSA). Materials and Methods: This analytical observational study used a retrospective case-control design, including a minimum sample size of 30 patients diagnosed with CVST. Diagnoses were confirmed through neuroimaging modalities such as MRV, CTV, or C-DSA at Wahidin Sudirohusodo General Hospital in Makassar. Data collection took place from August to December 2024, utilizing secondary data from patients treated between January 2022 and August 2024. Variables analyzed included hematocrit (Hct), platelet count (Plt), Hounsfield units (HU), and the HU/Hct ratio. Results: Thirty-five CVST patients (mean age: 40 ± 12.69 years) and 25 control subjects (mean age: 30.4 ± 15.07 years) were evaluated. Males represented 24% of CVST patients and 76% of control subjects, while females accounted for 65.1% and 34.9%, respectively ( P = 0.558). There were no significant differences observed in Hct levels (CVST: 39.19 ± 4.36%, controls: 37.5 ± 5.37%, P = 0.188) or Plt levels (CVST: 304 ± 54.52 ×10 9 /L, controls: 290 ± 99.49 × 10 9 /L, P = 0.474). However, HU values were significantly higher among CVST patients (68.67 ± 8.05) compared to controls (42.79 ± 4.93, P = 0.001). Similarly, the HU/Hct ratio was significantly elevated in CVST patients (1.75 ± 1.15) compared to controls (1.15 ± 1.75, P = 0.001). At an HU cut-off value of 60.5, sensitivity and specificity were 82.4% and 100%, respectively (Youden index: 0.824). For the HU/Hct ratio (cut-off: 1.41), sensitivity and specificity were 91.2% and 94.1%, respectively (Youden index: 0.853). Conclusion: This study strongly supports the use of Hct and platelet levels, alongside HU values, for the effective estimation and diagnosis of CVST.

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