Background: Cerebral venous thrombosis (CVT) with its highly variable clinical presentations needs to be considered in the differential diagnosis of all patients presenting with acute headache. Because measurement of D-dimer “a marker of endogenous fibrinolysis" has been demonstrated to be helpful in excluding deep vein thrombosis and pulmonary thromboembolism. Objective: The aim of this study is to investigate whether D-dimers would be also sensitive enough to diagnose or exclude CVT. Patients and Methods: CVT was diagnosed in 21 consecutive patients based on the classical neuroimaging signs using MRI/MR venography. Measurement of D-dimer was performed using Liatest in all   patients with CVT within 30 days of symptoms onset and before starting any anticoagulant therapy. Results: Of all 21 patients with CVT, only three patients (14.3%) had negative D-dimer assay. Isolated headache was the only variable significantly associated with a negative D-dimer assay (p<0.05). Positive D-dimer values were detected in 18 patients (85.7%) (P<0.05). Conclusion: D-dimer measurement is a useful guide within the diagnostic dilemma of patients with suspected CVT. Normal D-dimers makes the presence of CVT very unlikely. However, in patients presenting with isolated headache, negative D-dimer assay does not reliably exclude diagnosis of CVT. Future larger and multicenter studies are recommended before confidential approval of D-dimer assay as a useful biomarker in the diagnostic approach of acute CVT. (Egypt J Neurol Psychiat Neurosurg.  2010; 47(2): 331-336)

Key Words: Cerebral venous thrombosis, D-dimmer, Magnetic resonance venography

Correspondence to Ahmad M. Alshereef, Department of neurology,  Minoufiya University; Egypt. Tel.: 0020109818581, Email: alshereef1969 @ hotmail.com