Cerebral Venous Sinus Thrombosis Presenting with Seizure in Pregnancy

Yıl 2014, Cilt: 5 Sayı: 3, 93 - 96, 01.03.2014

Hesna Bektaş Murat Türkarslan Nurettin Özgür Doğan Çiğdem Hacıfazlıoğlu Yunsur Çevik

Öz

Introduction: Cerebral venous sinus thrombosis is a rare condition. The most frequent symptoms and signs are headache, focal seizures with or without secondary generalization, unilateral or bilateral paresis, and papilledema. We report a case of left transverse sinus and sigmoid sinus thrombosis that presented with seizure in a pregnant woman.Case Report: A 31-year-old woman at 33 weeks of pregnancy was admitted with sudden onset of seizure to the emergency department. The magnetic resonance scan of her brain showed the presence of a cortical-subcortical infarction in the cerebellar hemisphere, and magnetic resonance venography ultimately revealed left transverse sinus and sigmoid sinus thrombosis. The patient was treated with phenytoin and enoxaparin; the fetus was delivered after an urgent cesarean section.Conclusion: In pregnant women presenting with seizure, cerebral venous sinus thrombosis should be also considered in the differential diagnosis

Anahtar Kelimeler

Cerebral venous sinus thrombosis, pregnancy, emergency medicine

Gebelikte Nöbet Geçirme Sonrasında Başvuran Serebral Sinüs Ven Trombozu

Öz

Giriş: Serebral sinüs ven trombozu nadir bir durumdur. En sık
semptom ve bulguları; sekonder jeneralizasyon gösteren ve göstermeyen
fokal nöbetler, tek veya çift taraflı güçsüzlük ve papilödemdir.
Bu olguda, nöbet geçirme sonrasında başvuran gebe
bir kadında saptanan sol transvers ve sigmoid sinüs trombozunu
sunuyoruz.
Olgu Sunumu: Gebeliğinin 33. haftasında olan, 31 yaşında kadın
hasta acil servise nöbet şikayeti ile başvurdu. Beyin manyetik
rezonans görüntülemesinde; serebellar hemisferlerde kortikal –
subkortikal enfarkt ile manyetik rezonans venografide sol transvers
sinüs ve sigmoid sinüs trombozu saptandı. Hasta fenitoin ve
enoksaparinle tedavi edildi; fetüs ise acil sezaryen girişimi sonrasında
doğurtuldu.
Sonuç: Nöbet sonrasında başvuran gebe kadın hastalarda, serebral
sinüs ven trombozu da ayırıcı tanıda düşünülmelidir.

Anahtar Kelimeler

Serebral sinüs ven trombozu, gebelik, acil tıp

Kaynakça

• Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005; 352: 1791-8. [CrossRef]
• Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol 2007; 6: 162-70. [CrossRef]
• de Bruijn SF, de Haan RJ, Stam J. Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 pati- ents. J Neurol Neurosurg Psychiatry 2001; 70: 105-8. [CrossRef]
• Munira Y, Sakinah Z, Zunaina E. Cerebral venous sinus thrombosis pre- senting with diplopia in pregnancy: a case report. J Med Case Rep 2012; 6: 336. [CrossRef]
• Bousser MG, Crassard I. Cerebral venous thrombosis, pregnancy and oral contraceptives. Thromb Res 2012; 130 Suppl 1: S19-22. [CrossRef]
• Ozucelik DN, Kunt MM, Karaca MA, Çobanoglu M. Intracerebral hemorr- hage during pregnancy: Case report. AKATOS 2010; 1: 40-3.
• Lanska DJ, Kryscio RJ. Risk factors for peripartum and postpartum stroke and intracranial venous thrombosis. Stroke 2000; 31: 1274-82. [CrossRef]
• de Bruijn SF, Stam J, Kappelle LJ. Thunderclap headache as first symptom of cerebral venous sinus thrombosis. Lancet 1996; 348: 1623- 5. [CrossRef]
• Wasay M, Saadatnia M, Venketasubramanian N, Kaul S, Menon B, Gu- naratne P, et al. Predictors of cerebral venous thrombosis and arterial ischemic stroke in young Asian women. J Stroke Cerebrovasc Dis 2012; 21: 689-94. [CrossRef]
• Coutinho JM, Ferro JM, Canhão P, Barinagarrementeria F, Cantş C, Bous- ser MG, et al. Cerebral venous and sinus thrombosis in women. Stroke 2009; 40: 2356-61. [CrossRef]