Jain Shruti, Bhushan Mehak, Talwar Vandana
Department of Anaesthesiology and Intensive Care, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India Email:
Qatar Med J. 2024 Mar 11;2024(1):13. doi: 10.5339/qmj.2024.13. eCollection 2024.
Cerebral venous sinus thrombosis (CVST) is a rare and life-threatening condition that may be encountered during pregnancy and puerperium. The diagnosis of CVST is a challenge because of its varied presentation.
A 28-year-old woman presented with headache, projectile vomiting, and generalized tonic-clonic seizures 10 days after delivery by cesarean section. She had an uneventful antenatal period of 38 weeks of gestation. High clinical suspicion and the availability of magnetic resonance venography helped in making a diagnosis of CVST. She was successfully managed with a low-molecular-weight heparin (LMWH) and anti-epileptic therapy with no residual complications.
Pregnancy induces several prothrombotic changes in the coagulation system that predispose to CVST. These changes persist for six to eight weeks after birth. Infection and cesarean section are the additional risk factors for CVST during puerperium. The symptoms of CVST depend on the sinuses and veins involved, raised intracranial pressure, and the extent of brain parenchymal injury.
Greater awareness of the disease and the availability of imaging modalities have contributed to the early diagnosis and favorable outcomes in these cases. LMWH is the main stay of treatment in this disease.
脑静脉窦血栓形成(CVST)是一种罕见且危及生命的疾病,在妊娠和产褥期可能会遇到。由于其表现多样,CVST的诊断具有挑战性。
一名28岁女性在剖宫产分娩10天后出现头痛、喷射性呕吐和全身性强直阵挛发作。她孕期38周,产前过程顺利。高度的临床怀疑以及磁共振静脉造影有助于诊断CVST。她通过低分子量肝素(LMWH)和抗癫痫治疗成功治愈,无残留并发症。
妊娠会在凝血系统中引发多种促血栓形成变化,易导致CVST。这些变化在产后持续六至八周。感染和剖宫产是产褥期CVST的额外危险因素。CVST的症状取决于受累的窦和静脉、颅内压升高以及脑实质损伤的程度。
对该疾病的更高认识以及成像方式的可用性有助于这些病例的早期诊断和良好预后。LMWH是该疾病治疗的主要手段。