Cerebral Venous Sinus Thrombosis in an Adult Patient Presenting as Headache and Acute Subdural Hematoma

Takahashi, Satoshi; Shinoda, Jun; Hayashi, Takuro

doi:10.1016/j.jstrokecerebrovasdis.2009.12.011

Cited by 18 publications

(12 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our opinion is that the patient’s headache was a symptom of CVT and SDH due to peripartum pathophysiology, possibly coincidentally observed with regional analgesia, and that the patient unnecessarily received an epidural blood patch. This suggestion is in agreement with the case report by Takahashi et al (13), who described severe persistent headache as a single symptom of CVT followed by acute SDHs in a previously healthy male patient without spinal/epidural anesthesia or analgesia. In our patient, the systemic diseases, as well as specific coagulation disorders were excluded by using immunological, serological, and specific laboratory tests.…”

Section: Discussionsupporting

confidence: 93%

Simultaneous appearance of cerebral venous thrombosis and subdural hematomas as rare cause of headache in puerperium following epidural analgesia: a case report

et al. 2012

View full text Add to dashboard Cite

The aim of this study is to report the first case of simultaneous appearance of cerebral venous thrombosis (CVT) and bilateral subdural hematomas (SDHs) following epidural analgesia for labor and delivery and to point out the difficulty of establishing such a diagnosis in the presence of postpartum headache. A 26-year old primigravida with a history of epilepsy received epidural analgesia for delivery. Three days after the uneventful spontaneous vaginal delivery she complained about the headache. Patient responded very well to the pain medication and oral hydration, and the headache was relieved. Ten days after the delivery, the headache reoccurred, and an epidural blood patch was performed that successfully relieved her symptom. Stronger progressive headache with nausea reappeared two days later and the parturient was readmitted to hospital. Urgent neuroimaging examinations detected CVT of right the transverse sinus, ipsilateral cortical veins, and partially occluded superior sagittal sinus, as well as bilateral subacute/chronic SDHs. The treatment of the patient with low molecular weight heparin and antiaggregation therapy was effective. In this case, the diagnosis was delayed because of atypical clinical presentation and potentially confounding events (epidural analgesia and assumption that it was a case of PDPH). It is important to carefully observe patients in such conditions and promptly conduct suitable diagnostic tests. Otherwise, unrecognized intracranial complications and delay of appropriate therapy could be life-threatening.

show abstract

Section: Discussionsupporting

confidence: 93%

Simultaneous appearance of cerebral venous thrombosis and subdural hematomas as rare cause of headache in puerperium following epidural analgesia: a case report

et al. 2012

View full text Add to dashboard Cite

show abstract

“…They proposed that hemodynamic stress caused by cerebral venous sinus thrombosis resulted in the collapse of a bridging vein and caused an acute subdural hematoma. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Acute subdural hematoma secondary to cerebral venous sinus thrombosis: Case report and review of literature

et al. 2016

View full text Add to dashboard Cite

Cerebral venous sinus thrombosis is a rare type of stroke primarily affecting young women. Diagnosis is generally delayed or overlooked due to a wide spectrum of clinical symptoms. Subdural hematoma secondary to cerebral venous sinus thrombosis is very rare. We report a case of 40-year-old female with cerebral venous sinus thrombosis who presented to us with an acute subdural hematoma and subarachnoid hemorrhage besides venous infarct. Management of such patients is complicated due to the rarity of the condition and contraindication for the use of anticoagulation. We conducted a thorough literature search through PubMed and could find only nine cases of spontaneous subdural hematoma secondary to cerebral venous sinus thrombosis.

show abstract

“…Many CVST patients in the postpartum period were first presumed to have headache secondary to dural puncture and treated with an epidural blood patch. Therefore, potentially fatal cranial peripartum complications can easily be delayed or misdiagnosed, especially in parturients with regional analgesia 1 19. On the other hand, if the headache persists, changes in character recur despite treatment, or when additional neurological findings develop; brain imaging is necessary and venous thrombosis may be diagnosed 12…”

Section: Discussionmentioning

confidence: 99%

Persistent headache in a postpartum patient: the investigation and management

et al. 2013

View full text Add to dashboard Cite

Postdural puncture headache (PDPH) is the most common complication of obstetric regional anaesthesia and the most likely cause of headache in a woman who underwent epidural anaesthesia during delivery. Cerebral venous sinus thrombosis (CVST) is an uncommon cause of postpartum headache. Anaesthesia in obstetrics may lead to long-lasting intracranial hypotension resulting in CVST. CVST is a serious pathology with high mortality if misdiagnosed, but its correct and rapid diagnosis offers the opportunity for early treatment. Cranial magnetic resonance imaging (MRI) is an important modality in the diagnosis of both CVST and intracranial hypotension. The latter condition may be treated either by an epidural blood patch or bed rest and hydration. We report a case of a 36-year-old woman who developed CVST and multiple venous infarcts after an attempted epidural procedure during delivery. She was treated conservatively with bed rest, hydration and low-molecular-weight heparin and the patient recovered completely.

show abstract

Cerebral Venous Sinus Thrombosis in an Adult Patient Presenting as Headache and Acute Subdural Hematoma

Cited by 18 publications

References 8 publications

Simultaneous appearance of cerebral venous thrombosis and subdural hematomas as rare cause of headache in puerperium following epidural analgesia: a case report

Simultaneous appearance of cerebral venous thrombosis and subdural hematomas as rare cause of headache in puerperium following epidural analgesia: a case report

Acute subdural hematoma secondary to cerebral venous sinus thrombosis: Case report and review of literature

Persistent headache in a postpartum patient: the investigation and management

Contact Info

Product

Resources

About