Early Diagnosis and Prevention of Cerebral Venous Sinus Thrombosis of Pregnant Women

Abstract

Objective To investigate high risk factors, early diagnosis and prevention of cerebral venous sinus thrombosis (CVST). Methods The clinical features of cerebral venous sinus thrombosis as well as imaging examination results of 425 pregnant women with cerebral venous sinus thrombosis(hospitalization time was 1 to 90 days, average hospitalization time was 24.33 days) were searched from VIP Database and Chinese Journal Full-Text Database (CJFD) from 1989 to 2009. They were divided into three groups according to the onset of cerebral venous sinus thrombosis. There had no statistical significance of age, hospitalization time, treatment measures, and degrees of cerebral venous sinus thrombosis among three groups (P>0.05). High risk factors, clinical features, imaging changes and prognosis of cerebral venous sinus thrombosis were analyzed to discuss the way of early diagnosis and prevention. Results Preeclampsia, cesarean section, postpartum hemorrhage(PPH) were the most common risk factors of cerebral venous sinus thrombosis of pregnant women. The misdiagnosis rates of cerebral venous sinus thrombosis in early, middle and late pregnancy were 100.00% and 65.63%, respectively. The postpartum misdiagnosis rate and mortality were 29.8% and 8.6%, respectively. The positive rates of graphical changes were 54.42% and 94.04%-100% by CT and MRI/MRV inspection, respectively. Conclusion Pre-pregnancy and two weeks after delivery are susceptible to cerebral venous sinus thrombosis compared with other periods. Misdiagnosis rate is extremely high during early pregnancy, which can not be ignored. The key to prevent cerebral venous sinus thrombosis are early intervention and more attention to high risk factors. The suspected patients in prenatal and labor stage should undergo MRV inspection in order to confirm the diagnosis, conduct early treatment to reduce mortality and disability. Key words: cerebral venous sinus thrombosis(CVST); pregnant women; high risk factors; early diagnosis; prevention