Dural Sinus Thrombosis in Rwanda: An Observational Descriptive Study

BACKGROUND: Dural sinus thrombotic (DST) events are common emergencies globally, yet awareness, even among health professionals, is limited. DST is devastating when the diagnosis is missed and/or the patients are inadequately treated. If the diagnosis is made and the patient is correctly treated, the results are generally good.
METHODS: We performed a retrospective descriptive study of a prospectively compiled database documenting management and outcome of 20 adult patients treated with DST at King Faisal Hospital (KFH) and Centre Hospitalier Universitaire de Kigali (CHUK) from March 2012 to March 2017.
RESULTS: Headache was the most common presenting symptom occurring in 14 patients (70%). The mean duration from presentation to diagnosis was 6 days (range: 2 to 21 days). There was one death with the 13 remaining patients (95%) responding well to treatment.
CONCLUSION: The delay in diagnosis of five days suggests that awareness of this condition is still low in Rwanda and that the diagnostic tools necessary to confirm this diagnosis continue to not be available in most medical facilities in the country. In order to achieve optimal results referral of patients suspected of having DST to a hospital with the imaging modalities is needed to confirm the diagnosis along with specialists who can treat this condition.

Keywords
Dural Sinus Thrombosis; Anticoagulation; Stroke; Venous Infarction; Rwanda