Venous Sinus Thrombosis in Puerperium

Abstract

Introduction: Brain venous sinus thrombosis is defined as a stroke characterized by partial or total obstruction of one or more venous sinus or cerebral veins.
Case report: This is the case of a 24 -year -old patient, with a history of eutotic delivery. She had headache that appeared at 5 h of the puerperium with a burst feeling, holocranial, then it changed and made pulsatile, located in the left, intense, persistent hemicranean, and it did not relieve it with medication. On physical examination, resistance to the
previous neck was found. She presented a generalized tonic-clonic crisis. The ophthalmological examination was observed for the sixth left eye pair, and in the background, papilledema. Complete blood chemistry was indicated, immune profile and
vasculitis, abdominal ultrasound; the results were within normal parameters. Simple computerized tomography showed a sign of dense triangle at the level of the upper longitudinal sinus and diffuse cerebral edema. Treatment with low molecular weight and manitol began. Her headache worsened, due to extension of the thrombus to the right transverse and straight sinus. Acetazolamide added to treatment.
Conclusions: Venous sinus thrombosis is a diagnosis that should be considered in patients with headache during the puerperium. The neuro-ophthalmological examination to evaluate visual acuity and the presence of papilledema are the fundamental measures. Anticoagulation continues to be the pillar of treatment and the use of acetazolamide seems
to be safe and effective.