Postpartum Cerebral Venous Sinus Thrombosis: A Case Report

Abstract

Introduction

Cerebral venous thrombosis (CVT) remains one of the most frequent cause of stroke in young adults although it is a rare disorder. It has a serious emergency manifestation during pregnancy and postpartum. It is frequently under diagnosed and limited publications in developing countries especially sub-Saharan Africa.

Case Presentation

Here, we report the case of a 35-year-old female, para 8 and gravida 8, brought to emergency department on her ninth day postpartum, having severe headaches and confusion; during her admission to emergency, she suffered two episodes of generalized seizure. On admission, the patient's blood pressure was 200/120 mmHg. The patient was firstly diagnosed with postpartum eclampsia and managed with magnesium sulfate for seizures and hydralazine for blood pressure control. On ward admission, she continued having seizures and her level of consciousness decreased with left side weakness. An urgent MRI of head and MR venography performed immediately revealed acute thrombosis involving the anterior aspect of superior sagittal sinus and the left transverse sinus. The patient was moved to the ICU. Anti-coagulant LMW enoxaparin and anticonvulsant were started. After improving on clinical and biochemical tests, the patient was transferred to the inpatient ward on fifth day. Another two days later in the ward, she improved significantly, and then a head CT (contrast) angiography/venography was performed before she was discharge and showed no evidence of filling defect in cortical/dural venous sinuses.

Conclusion

Cerebral venous sinus thrombosis (CVST) and postpartum eclampsia may have similar manifestations in young women of reproductive age. Early prompt diagnosing and therapeutic intervention of CVST can prevent further neurological deterioration and immediately improve the patient.

Keywords:

• cerebral venous thrombosis
• postpartum eclampsia
• severe headache
• CVT

Informed Consent

A Written consent form was attained from the patient for publication of this case report and the attaching images. In our institution, ethical approval is not required for case reports.

Acknowledgments

We would like to express our sincere gratitude and deep appreciation to Dr. Bashiru Garba for his guidance and recommendations in this case report. We also express our deep gratitude to Dr. Omar Hassan Badawi for his support on imaging interpretations.

Disclosure

The authors report no any financial or conflicts of interest in this case report.