Cerebral sinus thrombosis with intracerebral hemorrhage in pregnancy: a case report.
A 29-year-old woman who was pregnant for 12 weeks presented with headache for one week and drowsiness for two days. Computed tomography of the brain revealed multifocal hematomas with mass effect. Decompressive craniectomy was done to relieve the increased intracranial pressure. Magnetic resonance angiography and cerebral angiography were subsequently performed, both demonstrating thrombosis of the left transverse sinus. Treatment of sinus thrombosis generally includes correction of increased intracranial pressure and administration of anticoagulants, such as heparin. However, in this case heparin was contraindicated for the presence of intracranial bleeding, a clinical dilemma that requires careful considerations to balance treatment risks and benefits.
Lin
Hung-Shih
HS
Division of Neurosurgery, Mackey Memorial Hospital, Taipei, Taiwan.
Lin
Jui-Feng
JF
Chang
Cheng-Kuei
CK
Tsai
Cheng-Chia
CC
Chen
Shiu-Jau
SJ
D000328:Adult; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000628:therapy