Intracranial venous thrombosis in the first trimester of pregnancy.

Lavin, P. J. M.; Bone, Ian; Lamb, J. T.; Swinburne, L. M.

doi:10.1136/jnnp.41.8.726

Cited by 24 publications

(6 citation statements)

References 11 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only a few patients with CVST have been reported in the early pregnancy period, and CVST-related cerebral hemorrhage in the early pregnancy is extraordinarily rare. [3–6,8]…”

Section: Discussionmentioning

confidence: 99%

“…Only a few patients with CVST have been reported in the early pregnancy period, and CVST-related cerebral hemorrhage in the early pregnancy is extraordinarily rare. [3][4][5][6]8] Imaging features are extremely important in correct diagnosis of CVST. [9][10][11][12][13] Cerebral infarction, edema, and hemorrhage can be found on CT imaging, and a hyperdense lesion of thrombosis can be detected occasionally in the venous sinus.…”

Section: Discussionmentioning

confidence: 99%

“…[4,5] Only 3 cases of CVST-related cerebral hemorrhage in the early pregnancy period had been reported in the literature. [4][5][6] In this study, we reported a 27-year-old…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

Zhang

Gao

et al. 2022

Medicine

View full text Add to dashboard Cite

Rationale: The incidence of pregnancy-related cerebral venous sinus thrombosis (CVST) is rare, and cerebral hemorrhage caused by CVST in the early pregnancy period is even rarer. Only 3 cases of cerebral hemorrhage caused by CVST had been reported in the early pregnancy period in the literature. In this study, we reported successful endovascular treatment of such a case.Patient concerns: A 27-year-old woman presented with rapidly progressive neurologic decline in her second pregnancy for 8 weeks. She was afebrile and completely conscious, without neurological deficits. She did not have any previous history of venous thrombosis, hematologic, or autoimmune diseases.Diagnosis: Urgent brain computed tomography demonstrated parietal-occipital hemorrhage surrounded by a large hypodense area and full brain swelling. Magnetic resonance venography showed complete occlusion of the right sigmoid sinus, transverse sinus, and two-thirds of the superior sagittal sinus. Transvaginal sonography demonstrated early intrauterine pregnancy, with the size of gestation sac being 6 × 7 × 6 mm and the fetal heart not being detected. CVST-related cerebral hemorrhage was confirmed based on the clinical and imaging data. Interventions:The CVST in this pregnant woman was treated endovascularly with a 6 Fr Navien catheter for aspiration, thrombolysis, and anticoagulation.Outcomes: Ten days after treatment, the cerebral hemorrhage had gradually been absorbed. Follow-up angiography performed 2 weeks later demonstrated complete recanalization of her cortical veins and sinuses. Two months later, the patient was completely recovered without cognitive or neurological dysfunction.Lessons: Pregnancy-related CVST can be successfully treated with a combined endovascular approach of aspiration, thrombolysis, and anticoagulation to complete recovery.

show abstract

“…Only a few patients with CVST have been reported in the early pregnancy period, and CVST-related cerebral hemorrhage in the early pregnancy is extraordinarily rare. [3–6,8]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

Zhang

Gao

et al. 2022

Medicine

View full text Add to dashboard Cite

show abstract

“…However, in the previous cases of SSS thrombosis confirmed angiographically or pathologically, the &dquo;empty delta sign&dquo; was present in only 15 of 29 patients on CT studies. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] The appearance or disappearance of the &dquo;empty delta sign&dquo; has been described by some authors.13,14 Shinohara et al reported that the &dquo;empty delta sign&dquo; was observed only on CT films taken one to four weeks after onset and was not seen in the extremes of acute or chronic stage of the illness. '4 D'Avella et al described a patient with the &dquo;empty delta sign&dquo; on contrastenhanced CT scanning twenty-four hours after onset, but a CT scan carried out forty-six days after onset showed partial resolution of the &dquo;empty delta sign.&dquo;&dquo; He attributed the partial resolution to recanalization of the sinus.…”

Section: Discussionmentioning

confidence: 99%

"Pseudo-Delta Sign" on Computed Tomography in an Extremely Acute Stage of Superior Sagittal Sinus Thrombosis—A Case Report

et al. 1990

View full text Add to dashboard Cite

A case of superior sagittal sinus (SSS) thrombosis with a "pseudo-delta sign" on computed tomography (CT) is reported. The so-called "empty delta sign," which usually appears following contrast enhancement, is reliable in the CT diagnosis of SSS thrombosis but may not appear, it is said, in the extremely acute stage. In this patient, however, the "empty delta sign" appeared with precontrast CT scans and disappeared with postcontrast CT scans, "pseudo-delta sign," in the extremely acute stage of SSS thrombosis. On the precontrast CT, blood surrounding the sagittal sinus outlined it; when contrast was given, it became dense with blood.

show abstract

“…We searched the Medline, Embase, and Google Scholar databases to identify all English literature published using the keywords "cerebral venous thrombosis", "intracranial venous thrombosis", "first-trimester pregnancy", "early pregnancy", alone or in combination. We reviewed all articles (including case reports, case series, and review articles), and this resulted in the inclusion of fourteen case reports with a total of 15 patients (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Literature Reviewmentioning

confidence: 99%

Cerebral venous thrombosis as a rare cause of nausea and vomiting in early pregnancy: Case series in a single referral center and literature review

Wang

Hu²,

Lio³

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

ObjectivesCerebral venous thrombosis (CVT) in early pregnancy is extremely rare and evidence limited to only a few published reports. This study aims to present our experience and summarize the available literature to further elucidate the clinical manifestations, treatment, and outcomes of CVT in early pregnancy.MethodsA retrospective case series of seven patients diagnosed with CVT in early pregnancy (<12 weeks of gestations) in a tertiary referral center (2018–2021), along with a review of published literature.ResultsAll the patients presented with nausea, vomiting, headaches, and neurological symptoms including aphasia (n = 5, 71.4%), limb weakness (n = 4, 57.1%), seizures (n = 2, 28.6%), altered mental status (n = 3, 42.9%), and blurred vision (n = 2, 28.6%). All the patients were diagnosed with CVT by neuroimaging, which revealed various extents of sinus involvement, with the transverse sinus being the most common site (n = 7, 100%) followed by the sigmoid sinus (n = 5, 71.4%). All the patients received subcutaneous low-molecular-weight heparin once the diagnosis was confirmed. Two patients with rapid deterioration underwent venous thrombectomy, and one patient subsequently underwent decompressive craniotomy but died despite the above interventions. All the other patients proceeded with induced abortion after stabilization and were discharged on oral anticoagulation for 1 year. On the 12-month follow-up, the MRI/magnetic resonance venography (MRV) revealed recanalization of sinuses and resolution of thrombi.ConclusionsCerebral venous thrombosis (CVT) in early pregnancy represents a diagnostic challenge given its rarity and nonspecific overlapping clinical features with nausea and vomiting of pregnancy/hyperemesis gravidarum (NVP/HG), which could lead to delay in diagnosis and result in rapid deterioration. Persistent or aggravating headaches combined with other focalizing neurological symptoms in NVP/HG patients could be an initial sign of CVT. Urgent MRI/MRV remains the cornerstone for diagnosis, and immediate anticoagulation is the key for disease prognosis. Glasgow coma scale (GCS) evaluation on admission is probably correlated with the prognosis. Early pregnancy combined with CVT is not a contraindication of continued pregnancy.

show abstract

Intracranial venous thrombosis in the first trimester of pregnancy.

Cited by 24 publications

References 11 publications

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

Endovascular recanalization of extensively-thrombosed cerebral venous sinuses in early pregnancy: A case report

"Pseudo-Delta Sign" on Computed Tomography in an Extremely Acute Stage of Superior Sagittal Sinus Thrombosis—A Case Report

Cerebral venous thrombosis as a rare cause of nausea and vomiting in early pregnancy: Case series in a single referral center and literature review

Contact Info

Product

Resources

About