title: Cerebral venous thrombosis presenting with subarachnoid hemorrhage after spinal anesthesia.
abstract: A 22-year-old male had a meniscopathy operation using spinal anesthesia. After the operation, the patient reported a throbbing headache. His brain computed tomography (CT) showed subarachnoid hemorrhage (SAH) and hyperdense dural venous sinuses suspicious for thrombosis. Filling defects were observed in the superior sagittal and right transverse sinuses on the contrast-enhanced magnetic resonance images. The patient was diagnosed with cerebral venous sinus thrombosis (CVST). On the tenth day of his admission, his clinical findings progressed and heparin therapy was initiated after resorption of hemorrhage was observed in a second non-contrast CT scan. The patient developed decreased consciousness the day after heparin administration. A subsequent brain CT revealed intraparenchymal hemorrhage in the right anteroinferior frontal region. Heparin therapy was discontinued, and anti-edema therapy was started. The presentation of CVST with SAH is a rare condition. Furthermore, development of CVST after spinal anesthesia is very rare. In this case, CVST developed after spinal anesthesia, and its first clinical presentation was SAH. To our knowledge, this is the first case CVST presenting with SAH after spinal anesthesia.
authors.affiliation: Department of Neurology, Gülhane Military Medical Academy, Ankara, Turkey. oz_oguzhan@yahoo.com
authors.forename: Oğuzhan
authors.initials: O
authors.lastname: Oz
authors.forename: Hakan
authors.initials: H
authors.lastname: Akgun
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yücel
authors.forename: Bilal
authors.initials: B
authors.lastname: Battal
authors.forename: Hüseyin Ilker
authors.initials: HI
authors.lastname: Ipekdal
authors.forename: Umit Hidir
authors.initials: UH
authors.lastname: Ulaş
authors.forename: Seref
authors.initials: S
authors.lastname: Demírkaya
authors.forename: Zeki
authors.initials: Z
authors.lastname: Odabaşi
mesh_terms: D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000925:Anticoagulants / Q000627:therapeutic use; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000070600:Tibial Meniscus Injuries; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D006493:Heparin