Abstract
A 39-year-old primipara delivered a healthy baby by a category 2 caesarean section as there was thick meconium and variable decelerations in the cardiotocogram (CTG). She had an uncomplicated hospital stay and was sent home on day 2. On post-partum day 18 she presented to the hospital with focal fits which had secondary generalization. The Magnetic Resonance Imaging (MRI) showed L/ anterior parietal venous haemorrhagic infarction secondary to superior sagittal sinus thrombosis. She was immediately started on low molecular weight heparin and following a repeat MRI she was discharged on warfarin with further follow up plan.
Highlights
A 39-year-old primipara delivered a healthy baby by a category 2 caesarean section as there was thick meconium and variable decelerations in the cardiotocogram (CTG)
On post-partum day 18 she had a fit at home and was brought to the local hospital
It is commonly seen in women of 25–35 years of age and it occurs more frequently during puerperium than during pregnancy.[5]
Summary
Cerebral venous thrombosis (CVT) is a rare disease, with an annual incidence of 3-4 per million population.[1]. Later she developed convulsions on post-partum day 18 These features combined with the focal origin of the convulsions favour the most likely diagnosis as cerebral venous thrombosis. The headache from CVT is often misdiagnosed as post dural puncture headache In this case it was not considered as the patient presented late, on day 18. MRV will show non-visualization of vessel, flow defects and new collaterals Both in combination are sensitive and specific enough to provide the best noninvasive method of diagnosing cerebral venous thrombosis.[6, 7]. The outcome can result from total recovery to death, independent survival rates of approximately 80% have been stated.[8] The risk of recurrent cerebral venous sinus thrombosis in future pregnancies and puerperium is said to be low.[8]. Our patient had no neurological complications and she was discharged home following successful anticoagulation with further follow up plans
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