Die Sinusvenenthrombose im Wochenbett

Abstract

Sinus venous thrombosis is a rare and severe disease, clinically characterised by headache, nausea, vomiting, focal deficits and epileptical seizures. We describe a case of sinus venous thrombosis 7 days post partum in a 21-year old woman. The pathogenesis symptoms, diagnosis and therapy are discussed. Advice for obstetric and gynaecological treatment after sinus venous thrombosis is given.

Heparin Treatment in Acute Cerebral Sinus Venous Thrombosis: A Retrospective Clinical and MR Analysis of 42 Cases

“…As in extracranial venous thrombosis heparin treatment is widely used for the therapy and prevention of fresh thrombosis of cerebral veins and venous sinuses [1, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24]and the results of several retrospective analyses and case reports suggest beneficial effects of heparin [4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26]. However, to date the only randomized placebo-controlled data on heparin treatment in CSVT derive from a study which had to be terminated after an interim analysis of 20 patients because of the significant advantage of heparin [10].…”

Sinusvenenthrombose im Wochenbett*

“…From a medical point of view, a subsequent pregnancy seems acceptable because the risk of another thrombosis, which is a rare event anyway, can be significantly reduced by providing anticoagulation substances. Der Ablauf und die Prognose der Erkrankung werden maûgeblich vom Grundleiden, sowie von der frühzeitigen Konsultation eines Neurologen und dem darauffolgenden Beginn der Therapie bestimmt [1].…”

“…Primär erfolgt nach dem neurologischen Befund die Ausschlussdiagnostik durch das kraniale Computertomogramm, die Diagnosesicherung durch die Angiographie[3,5,6]. Nach Diagnosestellung ist eine sofortige systemische Vollheparinisierung[1,4,6] und auch eine antikonvulsive Therapie einzuleiten. Eine Cumarintherapie sollte überlappend nach etwa 14 Tagen begonnen und für ein halbes Jahr fortgesetzt werden, lebenslang bei angeborenen Gerinnungsstörungen.…”

Recurring Short Delirium with Postpartum Onset in Two Sisters

“…Deficiency of protein C and S or an existing APC resistance can cause intracranial venous thrombosis, which is not rare during puerperium because of hormonal influences [21,22]. Often there are severe general EEG alterations, while the CT scan and the neurological examination may be normal [20,23].…”