Diagnosis and management of obstetric cerebral venous thrombosis: a stringent challenge

Sheeba Marwah, Ritin Mohindra



Cerebral venous thrombosis is an uncommon but serious neurologic disorder in young adults with a peculiarly high preponderance for females. Diagnosis is frequently overlooked or deferred due to its subacute or lingering onset and the wide spectrum of clinical symptoms. Headache is the most frequent symptom occurring in up to 95% of all cases. One must consider stroke in all cases of neurological deterioration in pregnancy and puerperium. Imaging plays a primary role in diagnosis with magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) having proven to be the best both for diagnosis and follow-up of these women. Current therapeutic measures used include the utilization of anticoagulants such as dose-adjusted intravenous heparin or body weight adjusted subcutaneous low-molecular-weight heparin (LMWH), the use of thrombolysis and symptomatic therapy including control of seizures and elevated intracranial pressure. Recurrence in future pregnancy is usually low.


Cerebral venous thrombosis, Management, Pregnancy, Puerperium, Stroke

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