International Medical Case Reports Journal (Jun 2024)
Hemiparesis Caused by Cerebral Venous Sinus Thrombosis during the Postpartum Period: A Case Report; Negelle Arsi General Hospital and Medical College, Ethiopia
Abstract
Zerihun Bogale,1 Gemechu Geleto,2 Dawit Yosef,1 Abdella Amano Abdo3 1Internal Medicine Department, Negelle Arsi General Hospital and Medical College, Negelle Arsi, Oromia, Ethiopia; 2Radiology Department, Negelle Arsi General Hospital and Medical College, Negelle Arsi, Oromia, Ethiopia; 3Research and Community Service Office, Negelle Arsi General Hospital and Medical College, Negelle Arsi, Oromia, EthiopiaCorrespondence: Zerihun Bogale, Tel +251-913-83-31-57, Email [email protected]: Although rare, cerebral venous sinus thrombosis (CVT) can result in significant neurological complications, particularly after childbirth. Early diagnosis poses a challenge due to symptom overlap with other conditions. Limited publications and underdiagnosis of CVT are prevalent in developing nations, notably in Ethiopia.Case: A 29-year-old mother, having given birth four times, presented to the emergency department in her second month postpartum with complaints of persistent headaches and blurred vision over three weeks. Additionally, she reported sudden weakness on her right side for one day. Despite previous treatments for migraine headaches, she was diagnosed with CVT after magnetic resonance imaging/venography revealed blockage in the right anastomotic vein and the posterior segment of the superior sagittal sinus. Treatment commenced with the anticoagulant enoxaparin. During hospitalization, she experienced one episode of generalized seizures, leading to transfer to the intensive care unit where phenytoin was added. Subsequent diagnosis of papilledema occurred. After a 16-day hospital stay, she was discharged with warfarin, phenytoin, and acetazolamide. Oral anticoagulation and other medications ceased after six months of treatment, considering the postpartum period as a temporary risk factor for CVT. The patient currently maintains good health and has resumed normal activities.Conclusion: Maintaining a high index of suspicion for CVT during the postpartum period and promptly conducting imaging scans are crucial for early diagnosis. This approach can halt neurological decline and facilitate immediate recovery through early therapeutic interventions.Keywords: Ethiopia, Negelle Arsi, headache, postpartum period, cerebral venous thrombosis
