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一名产后女性的脑静脉窦血栓形成:早期诊断与治疗的病例报告

Cerebral venous sinus thrombosis in a postpartum woman: a case report on early diagnosis and management.

作者信息

Ali Masab, Ahmad Muhammad Husnain, Babar Ilsa, Javeriya Sana, Ochani Teesha, Katyara Sakshi, Hassan Muhammad, Saeed Humza

机构信息

Department of Internal Medicine, Punjab Medical College, Faisalabad, Punjab, Pakistan.

Department of Medicine, Tentishev Satkynbai Memorial Asian Medical Institute, Kant, Kyrgyzstan.

出版信息

Ann Med Surg (Lond). 2025 Feb 7;87(3):1705-1709. doi: 10.1097/MS9.0000000000003025. eCollection 2025 Mar.

Abstract

INTRODUCTION AND IMPORTANCE

Cerebral venous sinus thrombosis (CVST) is a rare but serious condition that can cause permanent neurological impairments if not promptly diagnosed and treated. Its nonspecific presentation, such as headache and altered awareness, often delays diagnosis. Postpartum women are at heightened risk for CVST, necessitating vigilance.

CASE PRESENTATION

We describe a 25-year-old woman diagnosed with CVST 2 weeks postpartum. She presented with fever, severe headache, impaired vision, expressive dysphasia, and disturbed mental status. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) confirmed multiple thrombosed cerebral sinuses. The patient was treated with low-molecular-weight heparin (LMWH), followed by rivaroxaban, and demonstrated significant clinical improvement. She was subsequently discharged on oral anticoagulation therapy.

CLINICAL DISCUSSION

This case emphasizes the significance of maintaining a high level of suspicion for CVST in postpartum women who exhibit neurological symptoms. Early detection and intervention are essential to stop the disease's course and reduce its long-term effects. The use of anticoagulation medication, commencing with LMWH followed by oral anticoagulants like Rivaroxaban, was beneficial in this patient, illustrating the typical approach to CVST management.

CONCLUSION

CVST in postpartum women requires prompt diagnosis and anticoagulation therapy to prevent severe complications. High clinical suspicion and early intervention can mitigate long-term neurological sequelae. Further research is needed to explore intensive treatment strategies for high-risk populations.

摘要

引言与重要性

脑静脉窦血栓形成(CVST)是一种罕见但严重的疾病,如果不及时诊断和治疗,可能会导致永久性神经功能障碍。其非特异性表现,如头痛和意识改变,常常会延误诊断。产后女性患CVST的风险增加,需要保持警惕。

病例介绍

我们描述了一名25岁产后2周被诊断为CVST的女性。她出现发热、严重头痛、视力受损、表达性失语和精神状态紊乱。磁共振成像(MRI)和磁共振静脉血管造影(MRV)证实多个脑静脉窦血栓形成。患者接受了低分子量肝素(LMWH)治疗,随后使用利伐沙班,临床症状有显著改善。她随后出院并接受口服抗凝治疗。

临床讨论

该病例强调了对出现神经症状的产后女性保持高度怀疑CVST的重要性。早期发现和干预对于阻止疾病进程和减少其长期影响至关重要。在该患者中,从LMWH开始,随后使用利伐沙班等口服抗凝剂的抗凝药物治疗是有益的,这说明了CVST管理的典型方法。

结论

产后女性的CVST需要及时诊断和抗凝治疗以预防严重并发症。高度的临床怀疑和早期干预可以减轻长期神经后遗症。需要进一步研究探索高危人群的强化治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1719/11981357/b98cdb0fb546/ms9-87-1705-g001.jpg

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