Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum Patient
Abstract Introduction Cerebral venous sinus thrombosis is a potentially high-morbidity condition that can be difficult to diagnose given its nonspecific and variable presentations. Pregnancy and the immediate postpartum period are relatively high-risk periods for a number of medical conditions, incl...
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| Format: | Article |
| Language: | English |
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Association of American Medical Colleges
2014-08-01
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| Series: | MedEdPORTAL |
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| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.9890 |
| _version_ | 1818942899018006528 |
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| author | Kriti Bhatia |
| author_facet | Kriti Bhatia |
| author_sort | Kriti Bhatia |
| collection | DOAJ |
| description | Abstract Introduction Cerebral venous sinus thrombosis is a potentially high-morbidity condition that can be difficult to diagnose given its nonspecific and variable presentations. Pregnancy and the immediate postpartum period are relatively high-risk periods for a number of medical conditions, including neurological entities. It is therefore important for providers to consider etiologies for seizures in this period beyond eclampsia. Methods The case involves a patient who is 12 days postpartum and presents with diarrhea, weakness, and a headache. A careful history and examination reveal that the patient has left-sided weakness. She has a witnessed seizure in the emergency department, caused by cerebral venous sinus thrombosis from dehydration and being postpartum. The scenario demonstrates that seizures in the postpartum period can have causes other than eclampsia. One should perform a thorough history and physical examination, consider a broad differential, and maintain a high index of suspicion for other entities that can result in morbidity and even mortality. Results We implemented this case with emergency medicine residents and medical students. All levels of residents thought that the case was highly educational and valuable in depicting a “can't miss” diagnosis that is rarely seen. The case served as a reminder of this diagnosis, and participants commented that it would prompt them to consider cerebral venous sinus thrombosis on their differential diagnosis in relevant patient scenarios. Discussion This case highlights many of the risk factors for cerebral venous sinus thrombosis and emphasizes its consideration in high-risk populations. It allows participants to learn about its recognition, diagnosis, and treatment in a lifelike setting. The case was originally written for emergency medicine residents but is suitable for neurology, obstetrics, family practice, and internal medicine residents since they may possibly encounter the case scenario in their practice. |
| first_indexed | 2024-12-20T07:18:45Z |
| format | Article |
| id | doaj.art-dc017119f91548fba63c3bdd0ac47d52 |
| institution | Directory Open Access Journal |
| issn | 2374-8265 |
| language | English |
| last_indexed | 2024-12-20T07:18:45Z |
| publishDate | 2014-08-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj.art-dc017119f91548fba63c3bdd0ac47d522022-12-21T19:48:44ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652014-08-011010.15766/mep_2374-8265.9890Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum PatientKriti Bhatia01 Brigham and Women's HospitalAbstract Introduction Cerebral venous sinus thrombosis is a potentially high-morbidity condition that can be difficult to diagnose given its nonspecific and variable presentations. Pregnancy and the immediate postpartum period are relatively high-risk periods for a number of medical conditions, including neurological entities. It is therefore important for providers to consider etiologies for seizures in this period beyond eclampsia. Methods The case involves a patient who is 12 days postpartum and presents with diarrhea, weakness, and a headache. A careful history and examination reveal that the patient has left-sided weakness. She has a witnessed seizure in the emergency department, caused by cerebral venous sinus thrombosis from dehydration and being postpartum. The scenario demonstrates that seizures in the postpartum period can have causes other than eclampsia. One should perform a thorough history and physical examination, consider a broad differential, and maintain a high index of suspicion for other entities that can result in morbidity and even mortality. Results We implemented this case with emergency medicine residents and medical students. All levels of residents thought that the case was highly educational and valuable in depicting a “can't miss” diagnosis that is rarely seen. The case served as a reminder of this diagnosis, and participants commented that it would prompt them to consider cerebral venous sinus thrombosis on their differential diagnosis in relevant patient scenarios. Discussion This case highlights many of the risk factors for cerebral venous sinus thrombosis and emphasizes its consideration in high-risk populations. It allows participants to learn about its recognition, diagnosis, and treatment in a lifelike setting. The case was originally written for emergency medicine residents but is suitable for neurology, obstetrics, family practice, and internal medicine residents since they may possibly encounter the case scenario in their practice.http://www.mededportal.org/doi/10.15766/mep_2374-8265.9890HeadacheSeizuresBrainPostpartum PeriodCerebralVenous |
| spellingShingle | Kriti Bhatia Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum Patient MedEdPORTAL Headache Seizures Brain Postpartum Period Cerebral Venous |
| title | Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum Patient |
| title_full | Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum Patient |
| title_fullStr | Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum Patient |
| title_full_unstemmed | Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum Patient |
| title_short | Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting With Headache and Seizure in a Postpartum Patient |
| title_sort | beyond eclampsia cerebral venous sinus thrombosis presenting with headache and seizure in a postpartum patient |
| topic | Headache Seizures Brain Postpartum Period Cerebral Venous |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.9890 |
| work_keys_str_mv | AT kritibhatia beyondeclampsiacerebralvenoussinusthrombosispresentingwithheadacheandseizureinapostpartumpatient |