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Superior sagittal sinus thrombosis after spinal anesthesia.

Tareef S Daqqaq1, Abdulelah A Naqshabandi, Emad S Rajih

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Superior sagittal sinus thrombosis is rare, especially without risk factors. This case highlights a young man developing this condition after spinal anesthesia, emphasizing the need for vigilance.

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Anesthesiology

Background:

  • Superior sagittal sinus thrombosis (SSST) is an uncommon condition often associated with thrombotic risk factors.
  • SSST has been previously reported following spinal anesthesia, particularly with persistent cerebrospinal fluid leaks.
  • No prior cases of SSST in individuals without a prothrombotic risk have been documented.

Observation:

  • A 29-year-old male presented with persistent headache and blurred vision post-varicocelectomy under spinal anesthesia.
  • Clinical examination revealed papilledema, suggesting increased intracranial pressure.

Findings:

  • Magnetic resonance imaging confirmed the diagnosis of superior sagittal sinus thrombosis.
  • The patient had no known prothrombotic risk factors, making this case unique.

Implications:

  • This case underscores the possibility of SSST following spinal anesthesia, even in individuals without predisposing thrombotic conditions.
  • Early diagnosis and anticoagulant therapy are crucial for favorable outcomes in SSST.
  • Further research may be warranted to explore the mechanisms linking spinal anesthesia to SSST in at-risk and non-at-risk populations.