Niazi Azfar K, Minko Paul, Elliott Kavita K, Ghaly Tamer R, Ayad Sabry
Outcomes Research, Cleveland Clinic, Cleveland, USA.
Anesthesiology, Cleveland Clinic Fairview Hospital, Cleveland, USA.
Cureus. 2019 Jun 4;11(6):e4822. doi: 10.7759/cureus.4822.
Pregnancy is a hypercoagulable state that increases the risk of thrombotic complications. A 32-year-old gravida 4 para 3 (G4P3) had a dural puncture during epidural catheter placement for labor analgesia. A positional headache started after delivery and continued for several days. A week after the delivery, she developed non-positional headaches along with seizures. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) lead to the diagnosis of cerebral venous thrombosis (CVT). A factor V Leiden mutation was also found; that was suspected to contribute to the development of CVT along with dural puncture and pregnancy. CVT can present with non-positional headaches a week after the dural puncture.
妊娠是一种高凝状态，会增加血栓形成并发症的风险。一名32岁、孕4产3（G4P3）的孕妇在硬膜外导管置入用于分娩镇痛时发生了硬膜穿刺。产后出现体位性头痛，并持续了几天。分娩一周后，她出现了非体位性头痛并伴有癫痫发作。磁共振成像（MRI）和磁共振静脉血管造影（MRV）诊断为脑静脉血栓形成（CVT）。还发现了凝血因子V莱顿突变；怀疑其与硬膜穿刺和妊娠一起促成了CVT的发生。CVT可在硬膜穿刺一周后出现非体位性头痛。
