A Case of Cerebral Venous Sinus Thrombosis Followed by Subdural Hematoma in a Pregnant Woman
Cerebral venous sinus thrombosis (CVST) is an uncommon cause of stroke and accounts for 0.5-1% of all stroke cases. A 23-year-old pregnant (33 weeks) woman visited our hospital and complained about right temporo-parietal headache which had lasted for 5 days. The headaches were new onset, unilateral, nonthrobbing and were associated with nausea and vomiting. She had no significant past medical history. There was no history of trauma, illicit drug abuse, smoking and alcohol intake. There was no family history of coagulopathy or thrombophilia. Neurological examination demonstrated just bilateral grade ll papilledema. Brain MRI and MR Venography were performed, that showed left fronto-parietal subdural hematoma with left Transverse sinus thrombosis. Genetic analysis was showed Heterozygote mutation of MTHFR and Homozygote mutation for Angiotensin-Converting Enzyme (ACE). Screening for other hypercoagulable states were negative. Anticoagulant therapy with therapeutic dose of heparin was administered intravenously immediately and her symptoms disappeared one week after admission.