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Postpartum Superior Sagittal Sinus Thrombosis: A Case Report.

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PubMed
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Cerebral venous sinus thrombosis (CVST) is a rare but potentially fatal condition. This case highlights a patient experiencing superior sagittal sinus thrombosis post-delivery, emphasizing the need for prompt diagnosis and treatment to prevent severe outcomes.

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Cerebral infarctionCerebral venous sinus thrombosisPuerperium

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Area of Science:

  • Neurology
  • Obstetrics
  • Radiology

Background:

  • Cerebral venous sinus thrombosis (CVST) is a rare neurological condition.
  • Pregnancy and the postpartum period are recognized risk factors for CVST.
  • Early diagnosis and intervention are critical due to the potentially fatal nature of CVST.

Observation:

  • A 20-year-old woman presented with headache and seizures two days after a normal vaginal delivery.
  • Initial CT scans revealed subarachnoid hemorrhage and mild cerebral edema.
  • CT angiography confirmed superior sagittal sinus thrombosis, with diffusion-weighted MRI showing multiple micro-infarctions.

Findings:

  • The patient experienced neurological deterioration, including left-sided hemiplegia, despite initial treatment with heparin and mannitol.
  • Emergency decompressive craniectomy was performed, followed by re-administration of heparin.
  • While superior sagittal sinus thrombosis decreased on follow-up imaging, persistent hemiplegia indicated a significant neurological deficit.

Implications:

  • Superior sagittal sinus thrombosis is an uncommon but serious complication following delivery.
  • This case underscores the importance of timely diagnosis and aggressive management of CVST in the postpartum period.
  • Prompt recognition and treatment are crucial for mitigating neurological damage and improving patient outcomes in postpartum CVST.