Post-partum transverse sinus thrombosis presenting as acute psychosis.
Whilst cerebral vascular disease and mental illness in the post-partum period are well recognised, their co-existence and the concept of organic psychoses in pregnancy, parturition and the puerperium remains poorly appreciated (Brockington 2006; Brockington Arch Women's Ment Health 10: 177-178, 2007a; Brockington Arch Women's Ment Health 10: 305-306, b). We report a woman who was referred to the Medical team on-call with a mixed presentation of euphoria, mutism and aggressive behaviour but ultimately demonstrated to have a transverse sinus thrombosis and recovered well with anti-coagulation. This serves an important reminder of the implications of a missed medical diagnosis in this high-risk and vulnerable group of patients.
Dhasmana
Devesh Janardan
DJ
Queen Elizabeth II Hospital, East & North Hertfordshire NHS Trust, Welwyn Garden City, UK. d.dhasmana@rbht.nhs.uk
Brockington
Ian F
IF
Roberts
Ann
A
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000209:etiology*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D020227:Lateral Sinus Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D018810:Magnetic Resonance Angiography; D049590:Postpartum Period; D011247:Pregnancy; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D011644:Puerperal Disorders / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome
D000925:Anticoagulants; D006493:Heparin