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一例来自索马里的产后脑静脉血栓形成和出血性梗死罕见病例。

A Rare Case of Postpartum Cerebral Venous Thrombosis and Hemorrhagic Infarction From Somalia.

作者信息

Adem Mustafa Mumin, Ali Abdirahman Omer, Abdi Muhiadin Ismail, Hirsi Jama Osman, Aw Egge Ahmed Abdi, Abdi Mohamoud Hashi, Muhumed Mohamed Abubakar, Moumin Hassan Elmi, Abdilahi Hodo Abdi

机构信息

College of Health Sciences, School of Medicine and Surgery, Amoud University, Borama, Somalia.

Borama Regional Hospital, Psychiatric Department, Borama, Somalia.

出版信息

Int Med Case Rep J. 2025 Mar 19;18:355-365. doi: 10.2147/IMCRJ.S516258. eCollection 2025.

Abstract

INTRODUCTION

Cerebral venous thrombosis (CVT) is a rare but serious complication that can occur during pregnancy and the postpartum period. This case report discusses a unique instance of postpartum CVT complicated by hemorrhagic infarction in a patient from Somalia.

CASE PRESENTATION

We report the case of a 35-year-old woman, gravida 9, para 8, who presented on the 13th postpartum day with right-sided weakness, seizures, and severe headache. Initially misdiagnosed as impending eclampsia due to the absence of hypertension and proteinuria, she underwent CT and MRI scans, revealing a significant superior sagittal sinus thrombosis with hemorrhagic infarction. The patient was treated in the ICU with increased intracranial pressure management, seizure prophylaxis, and anticoagulation therapy, resulting in substantial clinical improvement.

DISCUSSION

This case emphasizes the necessity of maintaining a high index of suspicion for CVT in postpartum women displaying neurological symptoms. Misdiagnosis can impede timely intervention, highlighting the need for access to advanced imaging and a multidisciplinary approach. Increasing awareness and training for healthcare providers are essential for timely diagnosis.

CONCLUSION

The management of this case illustrates the importance of early recognition of CVT in the postpartum population. Enhancing diagnostic resources and treatment strategies, particularly in resource-limited settings, can significantly improve maternal health outcomes and reduce morbidity and mortality.

摘要

引言

脑静脉血栓形成(CVT)是一种罕见但严重的并发症,可发生在孕期和产后。本病例报告讨论了一名索马里患者产后CVT并发出血性梗死的独特病例。

病例介绍

我们报告一例35岁女性,孕9产8,产后第13天出现右侧肢体无力、癫痫发作和严重头痛。由于无高血压和蛋白尿,最初被误诊为先兆子痫,随后进行了CT和MRI扫描,显示上矢状窦有明显血栓形成并伴有出血性梗死。患者在重症监护病房接受治疗,包括控制颅内压、预防癫痫发作和抗凝治疗,临床症状有显著改善。

讨论

该病例强调了对出现神经系统症状的产后女性保持高度怀疑CVT的必要性。误诊会妨碍及时干预,凸显了获得先进影像学检查和多学科方法的必要性。提高医疗服务提供者的意识和培训对于及时诊断至关重要。

结论

该病例的处理说明了产后人群中早期识别CVT的重要性。加强诊断资源和治疗策略,特别是在资源有限的环境中,可以显著改善孕产妇健康结局,降低发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b743/11930266/f13c8cf50ae7/IMCRJ-18-355-g0001.jpg

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