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Cerebral Venous Thrombosis in Pregnancy

  • Shobha N. Gudi
Chapter

Abstract

The increased tendency for thrombosis due to physiological changes in pregnancy is a recognised risk factor for deep vein thrombosis, stroke and pulmonary embolism during the antenatal period as well as in puerperium. One such complication is cerebral venous thrombosis, presenting with severe headache, neurological deficits and seizures. The prognosis is good when diagnosis and management is not delayed. For the obstetrician, it would also be important to rule out other causes of convulsions and headache in pregnancy. Clinical entities like thrombophilias, which can affect future pregnancies and can have an impact on the contraceptive choices, need to be identified in such cases.

Keywords

Paroxysmal Nocturnal Haemoglobinuria Posterior Reversible Encephalopathy Syndrome Superior Sagittal Sinus Cerebral Venous Thrombosis Cortical Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Srinivasan K. Cerebral venous and arterial thrombosis in pregnancy and puerperium: a study of 135 patients. Angiol J Vasc Dis. 1983;34:731–74.Google Scholar
  2. 2.
    Fehr PR. Sagittal sinus thrombosis in early pregnancy. Obstet Gynecol. 1982;59:7–9.Google Scholar
  3. 3.
    Cross JN, Castro PO, Jennett WB. Cerebral strokes associated with pregnancy and the puerperium. Br Med J. 1968;3(5612):214–8.Google Scholar
  4. 4.
    Wasay M, Bakshi R, Bobustuc G, et al. Cerebral venous thrombosis: analysis of a multicenter cohort from the United States. J Stroke Cerebrovasc Dis. 2008;17:49.CrossRefPubMedGoogle Scholar
  5. 5.
    Bansal BC, GuptaRR PC. Stroke during pregnancy and puerperium due to CVT. Jpn Heart J. 1980;21:171–83.CrossRefPubMedGoogle Scholar
  6. 6.
    Matinelli I, Sacchi E, Landi G, et al. High risk of cerebral venous thrombosis in carriers of prothrombotic gene mutation and in users of oral contraceptives. N Engl J Med. 1988;338:1793–7.CrossRefGoogle Scholar
  7. 7.
    Bousser MG, Chiras J, Bories J, et al. Cerebral venous thrombosis—a review of 38 cases. Stroke. 1985;16:199–213.CrossRefPubMedGoogle Scholar
  8. 8.
    Carhuapoma JR, Mitsias P, Levine SR. Cerebral venous thrombosis and anticardiolipin antibodies. Stroke. 1997;28:2363–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Levine SR, Kieran S, Puzio K, et al. Cerebral venous thrombosis with lupus anticoagulants. Report of two cases. Stroke. 1987;18:801–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Provenzale JM, Loganbill HA. Dual sinus thrombosis and venous infarction associated with antiphospholipid antibodies: MR findings. J Comput Assist Tomogr. 1994;18:719–23.CrossRefPubMedGoogle Scholar
  11. 11.
    Deschiens MA, Conard J, Horellou MH, et al. Coagulation studies, factor V Leiden, and anticardiolipin antibodies in 40 cases of cerebral venous thrombosis. Stroke. 1996;27:1724–30.CrossRefPubMedGoogle Scholar
  12. 12.
    Zuber M, Toulon P, Marnet L, et al. Factor V Leiden mutation in cerebral venous thrombosis. Stroke. 1996;27:1721–3.CrossRefPubMedGoogle Scholar
  13. 13.
    De Freitas GR, Bogousslavsky J. Risk factors of cerebral vein and sinus thrombosis. Front Neurol Neurosci. 2008;23:23.PubMedGoogle Scholar
  14. 14.
    Banerjee AK, Chopra JS, Sawhney BB. Puerperal cerebral venous thrombosis. Study of autopsy material. Neurol India. 1973;21:19–22.PubMedGoogle Scholar
  15. 15.
    Wilterdink JL, Easton JD. Cerebral ischaemia. In: Devinsky O, Feldmann E, Hainline B, editors. Neurological complications of pregnancy. New York: Raven; 1994. p. 1–11.Google Scholar
  16. 16.
    Piazza G. Clinician Update, Cerebral venous thrombosis, AHA J. Circulation associated with pregnancy and the puerperium. Br Med J. 1968;3:214.Google Scholar
  17. 17.
    Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352:1791–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Kothare SV, Ebb DH, Rosenburger PB, Buonanno F, Scefer PW, Krishnamoorthy KS. Acute confusion and mutism as a presentation of thalamic strokes secondary to deep cerebral venous thrombosis. J Child Neurol. 1998;13:300–3.CrossRefPubMedGoogle Scholar
  19. 19.
    Kapessidou Y, Vokaer M, Laureys M, Bier JC, Boogaerts JG. Case report: cerebral venous thrombosis after subarachnoid analgesia for labor. Can J Anaesth. 2006;53:1015–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Carhuapoma JR, Tomlinson MW, Levine SR. High risk pregnancy: management options/David K. James … [et al.].—3rd ed. p. cm. Section V, Ch. 49. Neurologic disorders.Google Scholar
  21. 21.
    Dormont D, Axionnat R, et al. MRI in cerebral venous thrombosis. J Neuroradiol. 1994;21(2):81–99.PubMedGoogle Scholar
  22. 22.
    Ehtisham A, Stern BJ. Cerebral venous thrombosis: a review. Neurologist. 2006;12:32.CrossRefPubMedGoogle Scholar
  23. 23.
    Veillon EW, Martin JN, Maternal F, et al. Critical care. In: Belfort M, editor. Obstetrics, 5th ed. USA: Wiley – Blackwell; 2010.Google Scholar
  24. 24.
    Einhaupl KM, Villringer A, Meister W, et al. Heparin treatment in sinus venous thrombosis. Lancet. 1991;338:597–600. Erratum, Lancet 1991; 338–958.CrossRefPubMedGoogle Scholar
  25. 25.
    De Bruijn SF, Stam J. Randomised placebo controlled trial of anticoagulant treatment with low molecular weight heparin in puerperal cerebral venous sinus thrombosis. Stroke. 1999;30:484–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Nagaraja D, Rao BSS, Taly AB, Subhash MN. Randomised controlled trial of heparin in puerperal cerebral venous /sinus thrombosis. Nimhans J. 1995;13:111–5.Google Scholar
  27. 27.
    Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35:664–70.CrossRefPubMedGoogle Scholar
  28. 28.
    Baker MD, Opatowsky MJ, Wilson JA, LGlazier SS, Morris PP. Rheolytic catheter and thrombolysis of dural venous sinus thrombosis: a case series. Neurosurgery. 2001;48:487–93.CrossRefPubMedGoogle Scholar
  29. 29.
    Chopra JS, Banerjee AK. Primary intracranial sinovenous occlusions in youth and pregnancy. In: Vinken PJBG, Klawans HL, editors. Handbook of clinical neurology. Amsterdam: Elsevier Science Publishers; 1989. p. 425–52.Google Scholar
  30. 30.
    Mehraein S, Ortwein H, Busch M, et al. Risk of recurrence of cerebral venous and sinus thrombosis during subsequent pregnancy and puerperium. J Neurol Neurosurg Psychiatry. 2003;74:814.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Department of OBGSt Philomena’s HospitalBangaloreIndia

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