Decompressive craniectomy in cerebral venous sinus thrombosis during pregnancy: a case report

We present a 22-year-old pregnant lady, who was transferred at the emergency department with a reduced level of consciousness, headache, and nuchal rigidity. Her MRI study showed CVST, causing hemorrhagic infarct and midline shift. She underwent decompressive craniectomy with partial removal of the hemorrhagic parenchyma. Remarkably, she recovered without any neurological deficits regardless of the substantial temporal lobe damage, while the thrombus nearly resolved using anticoagulation. Decompressive craniectomy can be life-saving in selected CVST patients, followed by anticoagulantion to augment the recanalization process.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research

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AbstractPregnancy can be seen as a positive time for women migraineurs because the elevated estrogen and endogenous opioid levels raise the pain threshold and the stable hormone levels, which no longer fluctuate, eliminate a major trigger factor for the attacks. In a great majority of cases, indeed, migraine symptoms spontaneously improve throughout pregnancy. Generally, migraine without aura (MO) improves better than migraine with aura (MA), which can occur ex novo in pregnancy more frequently than MO. After childbirth, the recurrence rate of migraine attacks increases, especially during the first month; breastfeeding exe...
Source: Neurological Sciences - Category: Neurology Source Type: research
Purpose of review To summarize recent research findings and current concepts related to care of neurologic diseases in pregnancy and the risks of pregnancy to the mother–infant dyad. Recent publications related to best practices for neurologic care, risks of pregnancy, rate of relapse during and after pregnancy, as well as medication safety in pregnancy and lactation for more commonly used neurologic medications are reviewed. Recent findings Data continues to grow that women with neurologic conditions can experience pregnancy with minimal risks. Additionally, as more data is being published on medication safety ...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy, and Martha Rode Source Type: research
Introduction: A venous sinus thrombosis is a thrombotic occlusion of the cerebral venous drainage. Patients present with unspecific symptoms such as headache, vision disturbances, or altered consciousness. Complications include intracerebral bleeding and/or increased intracranial pressure leading to poor neurological outcome. Besides clotting disorders, pregnancy and puerperium constitute risk factors for this rare condition. Roughly 0.004 –0.01% of pregnancies are complicated by cerebral venous sinus thrombosis (CVST).
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Session 18 – Complications and cases gone wrong Source Type: research
Abstract PURPOSE OF REVIEW: To summarize recent research findings and current concepts related to care of neurologic diseases in pregnancy and the risks of pregnancy to the mother-infant dyad. Recent publications related to best practices for neurologic care, risks of pregnancy, rate of relapse during and after pregnancy, as well as medication safety in pregnancy and lactation for more commonly used neurologic medications are reviewed. RECENT FINDINGS: Data continues to grow that women with neurologic conditions can experience pregnancy with minimal risks. Additionally, as more data is being published on medi...
Source: Epilepsy Curr - Category: Neurology Authors: Tags: Curr Opin Obstet Gynecol Source Type: research
Rationale: Risk factors of cerebral venous sinus thrombosis (CVST) are usually divided into acquired risks (e.g., trauma and pregnancy) and genetic risks (inherited thrombophilia). It is essential but not easy to identify the exact one for each patient. Patient concerns: A 14-year-old male patient was admitted in our hospital because of progressively exacerbated severe headache and vomiting for 3 days, accompanied by transient weakness once in his right leg. Diagnosis: CVST due to hyperhomocysteinemia with cystathionine-β-synthase (CBS) gene mutation. Interventions: Persistent oral anticoagulant therapy. O...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We report the case of a woman with severe headache associated with visual disturbances, without hypertension or proteinuria at 32 weeks of pregnancy. MRI revealed multiple recent cerebral vascular accidents. An echocardiogram detected a papillary fibroelastoma of 5mm. Maternal fetal experts determined it safe to continue the pregnancy. Childbirth at 39 weeks was normal uneventful for the newborn and mother. In the postpartum, despite the theoretical operative indication to resect the small residual papillary fibroelastoma, the patient was followed expectantly because of the stable neuro-cardiologic state. A fibroelastoma c...
Source: Annales de Cardiologie et d'Angeiologie - Category: Cardiology Authors: Tags: Ann Cardiol Angeiol (Paris) Source Type: research
Publication date: December 2018Source: Chinese Medical Sciences Journal, Volume 33, Issue 4Author(s): Xuefang Zhang, Zhenyu Zhang, Nan LiAbstractCerebral venous sinus thrombosis (CVST) is a rare condition in early pregnancy. A 22-year-old Chinese woman at 10 weeks of pregnancy requested induced abortion and was diagnosed as CVST for a severe headache accompanying with nausea and vomiting. The patient was treated successfully with anticoagulation, followed by amniocentesis, and finally succeeded in induction of labor safely. The diagnosis, treatment and prognosis for this rare condition are discussed in this paper.
Source: Chinese Medical Sciences Journal - Category: General Medicine Source Type: research
Authors: Darmawan G, Hamijoyo L, Oehadian A, Bandiara R, Amalia L Abstract A 38-year-old woman presented with general weakness and vaginal bleeding. One month prior, she had been diagnosed with Evans syndrome (haemolytic anemia with positive Coombs test and thrombocytopenia) and was given oral steroid as maintenance therapy. Her serology examination was negative for hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). Her obstetrical history was marked by miscarriage in second pregnancy and preeclampsia in third pregnancy. She used hormonal contraceptives until 5 months prior to admission. On physical ...
Source: Acta medica Indonesiana - Category: Internal Medicine Tags: Acta Med Indones Source Type: research
Semin Neurol 2018; 38: 627-633 DOI: 10.1055/s-0038-1673681Headache is a neurologic disorder that displays gender dichotomy. It is well established that there is a strong link between migraine headache and sex hormones, specifically estrogen, which influences the severity of migraines during the menstrual cycle, pregnancy, and menopause. Furthermore, the epidemiology of headaches during pregnancy and the postpartum period is very distinct from that in males or nonpregnant females, in part due to the hemodynamic and hematologic changes that occur during pregnancy. These changes put women at higher risk for cerebral venous th...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
This article discusses pregnancy-related considerations for meningioma, pituitary disorders, demyelinating disease, myasthenia gravis, thyroid eye disease, idiopathic intracranial hypertension, cerebral venous sinus thrombosis, stroke, migraine, and cranial neuropathies. The article also details the potential neuro-ophthalmic complications of preeclampsia and eclampsia and reviews the use of common diagnostic studies during pregnancy.
Source: Neurologic Clinics - Category: Neurology Authors: Source Type: research
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