Perinatal superior sagittal sinus venous thrombosis.
The initial clinical findings that form the basis for the diagnosis of puerperal SSSVT are frequently quite subtle. It is essential to a favorable outcome that clinicians maintain a high index of suspicion in relation to physical complaints of puerperal women. Meticulous, comprehensive, multisystem assessment is indicated to explore fully the presentation of headache, weakness, or other subjective data when discovered. Headaches can easily be attributed to a multitude of factors associated with birth. These include fatigue, stress, complications of anesthesia, fluid and electrolyte imbalances, and muscle tension and strain. It is imperative that clinicians not assume a benign etiology for headache. Rather, ongoing assessment focused on describing the problem in its entirety is indicated. Irritability, too, can easily be attributed to stress and exhaustion. Ongoing evaluation of responses to medication, nutrition, and rest will prevent overlooking a fulminant process such as SSSVT. Patients frequently need advocates when symptoms are vague and inconsistent. Careful documentation of findings as well as open, ongoing communication with members of the clinical team will best serve the patient. Retrospective analysis of vague complaints and subtle clinical findings frequently forms the basis for diagnosis of SSSVT and for clinical management to follow. In the face of cost constraints and restrictive third party reimbursement, there is significant incentive for early discharge. For this reason, identifying fulminant processes is an increasingly significant role of the perinatal nurse. Data collected in routine assessments and then verified and aggregated by the members of the health care team will be critical to prevent a rise in morbidity and mortality in the early days following discharge. In a more hopeful tone, detecting and resolving complications will help to set up the newly established family for a positive start. Quite simply put, a healthy woman has more energy to take on the new role of mother and maintain her present roles of wife, mother, worker, member of a family, and member of a community.
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D000328:Adult; D002561:Cerebrovascular Disorders / Q000503:physiopathology; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010347:Patient Care Planning; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000451:nursing*; D012851:Sinus Thrombosis, Intracranial / Q000451:nursing* / Q000503:physiopathology / Q000628:therapy