Clinical profile of postpartum cerebral venous thrombosis

Authors

  • Umesh G. Rajoor Department of Medicine, Koppal Institute of Medical Sciences, Koppal, Karnataka, India
  • Seema B. N. Department of Obstetrics and Gynecology, Koppal Institute of Medical Sciences, Koppal, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170891

Keywords:

Cerebral venous thrombosis, Prothrombotic, Puerperium

Abstract

Background: Pregnancy and puerperium are most prevalent prothrombotic states leading to cerebral venous thrombosis (CVT). Pregnancy induces several changes in coagulation system, which persists at least during early puerperium, rendering it a prothrombotic state. The objective of the study was to study the clinical profile of postpartum CVT.

Methods: A total of 32 consecutive patients admitted in medicine and obstetrics and gynecology ward between April 2012 and March 2015 with radiologically confirmed diagnosis of CVT were included in the study. Detailed history, clinical examination, and laboratory investigations were carried out in all the cases.

Results: Out of 32 patients of CVT studied, the age of patients varied from 18 to 40 years. Maximum incidence was seen in 21-30 age group comprising 74% of the cases, with mean age being 25.5 years. Two-third of the patients belongs to the low socio-economic class. The majority of them had subacute presentation with the headache in 93.75%, followed by altered sensorium (90.6%) and convulsions (75%) being the most common presenting symptoms. Radiologically the most common finding noted was hemorrhagic infarction (85.3%), followed by non-hemorrhagic infarction (15.7%).

Conclusions: Pregnancy and puerperium are most prevalent prothrombotic states leading to CVT.

References

Katrak SM. Cerebral venous thrombosis. Neurological practice: An Indian perspective. Elsevier publications; 2005:336.

Bushnell C, Saposnik G. Evaluation and management of cerebral venous thrombosis. Continuum (Minneap Minn), Cerebrovascular Disease. 2014;20(2):335-51.

Srinivasan K. Cerebral venous and arterial thrombosis in pregnancy and puerperium: a study of 135 patients. Angiology. 1984;34:731-46.

Khealani BA, Mapari UU, Sikandar R. Obstetric Cerebral Venous Thrombosis. J Pak Med Assoc. 2006;56 (11):490-91.

Aaron S, Alexander M, Maya T, Mathew V, Goel M, Nair SC, Mammen J, Vikram M. Underlying prothrombotic states in pregnancy associated cerebral venous thrombosis. Neurol India. 2010;58:555-9.

National Institutes of health consensus development conference. Prevention of venous thrombosis and pulmonary embolism. JAMA. 1986;256:744-9.

Jiann-Shing J, Sung-Chun T, Ping-Keung Y. Stroke in women of reproductive age: comparison between stroke related and unrelated to pregnancy. J Neurol Sci. 2004;221:25-9.

Clark P, Brennand J, Conkie JAC, McCall F, Greer IA, Walker ID. Activated protein C sensitivity, protein C, protein S and coagulation in normal pregnancy. Thromb Haemostas. 1998;79:1166-70.

Cerneca F, Ricci G, Simeone R, Malisano M, Alberico S, Guaschino S. Coagulation and fibrinolysis changes in normal pregnancy. Increased levels of procoagulants and reduced levels of inhibitors during pregnancy induce a hypercoagulable state, combined with a reactive fibrinolysis. Eur J Obstet Gynaecol Reprod Biol. 1997;73:31-6.

Prakash C, Bansal BC. Cerebral Venous Thrombosis. J Ind Acad Clin Med. ;5:55-61.

Nagaraja D, Taly AB, Das S. Puerperal cerebral venous thrombosis in India. In: Sinha KK, Chandra P, eds. Progress in clinical neurosciences Ranchi. Catholic press. 1989;5:165-177.

Nagaraja D, Haridas T, Taly AB, Veerendrakumar M, Subbukrishna DK. Puerperal cerebral venous thrombosis: therapeutic benefit of low dose heparin. Neurol India. 1999;47:43-6.

Bansal BC, Gupta RR, Prakash C. Stroke during pregnancy and puerperium in young females below the age of 40 years as a result of cerebral venous sinus thrombosis. Jpn Heart. 1980;21:171-83.

Downloads

Published

2017-03-30

Issue

Section

Original Research Articles