Cerebral Vein Thrombosis

thrombocytosis (both primary and secondary), leukocytosis, sicklecell disease, hyperhomocysteinemia, hemoconcentration due to a multitude of causes, hypereosinophilia and antiphospholipid antibody (APLA) syndromes.2 As mentioned already, almost always more than one cause coexists in each patient, which is found out only on good clinical evaluation and not by laboratory studies alone. To compound all this, the new generation doctors forget the importance of proper clinical evaluation and the correlation of important observations in the diet, lifestyle and environment of the patients. Many of them do not bother to find out such information and rather proceed prematurely to laboratory tests for diagnosis. After making a diagnosis of CVT, the clinician should apply clinical skills and common sense with which it is possible to arrive at one or more completely correctable common etiological factors contributing to the development of CVT, even if there is an underlying inherited disorder, which cannot be corrected. Recurrences can be avoided in future if all the other contributory factors are found out by good clinical evaluation. Therefore, CVT almost always has a good prognosis compared to other cerebrovascular accidents (CVAs). In many patients with the so called idiopathic CVT, nutritional deficiencies and lifestyle issues are more important basic etiological factors in pathogenesis, at least in some epidemiological settings such as strict vegetarians and those who consume an unbalanced diet. Study by observation of patients regarding their diet, lifestyle and environment might give the answer to the several etiological factors in cerebral CVT, as in all other clinical problems, rather than depending on the costly laboratory investigations alone.2