Cerebral venous thrombosis in pregnancy and puerperium--a prospective study

During a prospective study of cerebrovascular accidents we evaluated 64 cases of cerebral venous thrombosis (CVT) in pregnancy and puerperium. CVT made up approximately half of the young strokes and 40% of strokes occurring in females. Majority of them were below 25 years of age, multipara women from rural areas who were delivered at home by untrained dais. While 79.6% cases occurred during first two weeks after delivery, the incidence of antepartum CVT was also higher at 7.8%. Majority of the patients had meningoencephalitic (70.32%) presentation. Others in the spectrum had either acute fulminant type (18.7%), neuropsychiatric (6.25%) or pseudotumour cerebri like presentation (4.68%). Patients with neuropsychiatric and pseudotumour cerebri like presentation had a better prognosis while those with acute fulminant type had a poorer outcome. The patients with bilateral hemorrhagic infarcts and diffuse cerebral edema on CT scan had a poorer prognosis. A lower mortality rate (18.75%) could be achieved with early diagnosis and quick institution of planned therapy.