Postpartum Cerebral Venous Thrombosis-A Single-Center Experience

Area of Science:

• Neurology
• Vascular Medicine
• Obstetrics & Gynecology

Background:

• Cerebral venous thrombosis (CVT) is a rare stroke variant, but a notable subtype in pregnancy and puerperium.
• Limited studies exist on CVT risk factors and clinical characteristics, particularly in relation to pregnancy.
• This study aims to elucidate these aspects and compare postpartum CVT with non-pregnancy-related cases.

Purpose of the Study:

• To identify risk factors and clinical characteristics of cerebral venous thrombosis (CVT) in the postpartum period.
• To compare postpartum CVT with CVT in non-pregnant women.
• To assess the short-term outcome of postpartum CVT.

Main Methods:

• Retrospective analysis of 88 consecutive CVT cases from a tertiary neurology clinic.
• Inclusion of 10 cases (11.3%) diagnosed during the postpartum period.
• Comparison of clinical characteristics and outcomes between postpartum and non-postpartum female CVT patients.

Main Results:

• Postpartum CVT cases averaged 26.5 years; risk factors included cesarean delivery (50%), preeclampsia (20%), and stillbirth (10%).
• Headache (90%) and seizures (60%) were common in postpartum CVT; onset occurred a mean of 9.6 days post-delivery.
• Postpartum CVT showed a significantly better short-term outcome (Rankin score 0.22 vs. 0.7, p=0.02) compared to non-postpartum cases.

Conclusions:

• The early postpartum period is a critical risk window for developing CVT.
• Cesarean delivery, preeclampsia, infection, smoking, and thrombophilia are significant risk factors for postpartum CVT.
• CVT related to puerperium demonstrates a more favorable short-term prognosis than CVT from other causes.