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Puerperal superior sagittal sinus thrombosis

V J Ojeda, J M Hilton, E G Stewart-Wynne

The Medical Journal of Australia

|December 11, 1982

Summary

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A postpartum woman experienced seizures and coma after a stillbirth. Necropsy revealed superior sagittal sinus thrombosis and cerebral infarction, indicating a fatal neurological complication.

Area of Science:

Obstetrics and Gynecology
Neurology
Pathology

Background:

Postpartum complications can present with severe neurological symptoms.
Stillbirth delivery can precipitate maternal critical events.
Cerebral venous thrombosis is a rare but serious postpartum condition.

Observation:

A 31-year-old woman lost consciousness post-delivery of a 36-week stillborn fetus.
She developed tonic-clonic seizures and a deepening coma.
Intensive supportive therapy was initiated but ultimately unsuccessful.

Findings:

The patient expired three days after delivery.
Necropsy identified superior sagittal sinus thrombosis.
Extensive bilateral cerebral infarction was confirmed as the cause of death.

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Implications:

This case highlights the critical need for vigilant neurological monitoring in postpartum patients, especially after stillbirth.
Superior sagittal sinus thrombosis should be considered in the differential diagnosis of postpartum neurological emergencies.
Prompt diagnosis and management of cerebral venous thrombosis are crucial for improving maternal outcomes.