scholarly journals Post partum headache: a case series

2018 ◽  
Vol 8 (1) ◽  
pp. 317
Author(s):  
Reema Kumar Bhatt ◽  
Rohin Kumar ◽  
L. B. Singh
Keyword(s):  
Dural Puncture ◽  
Sinus Thrombosis ◽  
Post Partum ◽  
Case Series ◽  
Diagnostic Dilemma ◽  
Post Dural Puncture Headache ◽  
Cortical Vein ◽  
First Case ◽  
Cortical Vein Thrombosis ◽  
Postpartum Headache

Postpartum headache is the complaint of head, neck, or shoulder pain occurring during the first 6 weeks following delivery. Among the women who underwent neuraxial aneasthesia Post Dural puncture headache is one of the most common presentations. However, physicians should be aware that post Dural puncture headache is not the only cause of postpartum headache. Authors present a series of four cases that had varied presentation of post partum headache with varied diagnosis, the first case was of subdural haematoma where CT scan revealed an acute on chronic SDH. The second case was diagnosed as meningitis and the CSF for culture sensitivity grew Streptococcus Pneumoniae .In our third case of cortical vein  thrombosis , NCCT followed by MR venogram  revealed left transverse venous sinus thrombosis and our last case in the series was of posterior reversible encephalopathy syndrome where MRI confirmed the findings of typical findings are symmetric edema involving the white matter of the posterior regions of the cerebral hemispheres. The diagnostic dilemma was resolved by neuroimaging because the clinical presentation was not making us reach a satisfactory diagnosis of the cause of headache. Early resort to neuroimaging and multidisciplinary team effort paved way to early diagnosis and appropriate recovery of the patients.

scholarly journals Cerebral venous thrombosis in post-lumbar puncture intracranial hypotension: case report and review of literature

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 41 ◽  
Author(s):  
Mahesh P. Kate ◽  
Bejoy Thomas ◽  
P.N. Sylaja
Keyword(s):  
Magnetic Resonance ◽  
Lumbar Puncture ◽  
Intracranial Hypotension ◽  
Sinus Thrombosis ◽  
Post Partum ◽  
Intrathecal Injection ◽  
Anticoagulation Therapy ◽  
Review Of Literature ◽  
Cortical Vein ◽  
Sagittal Sinus

The spectrum of presentation of intracranial hypotension is clinically perplexing. We report a case of 31-year-old post-partum woman who underwent an uneventful caesarean section under spinal anesthesia. From the second day of surgery she developed postural headache, the headache lost its postural character after few days. She then developed seizures and ataxic hemiparesis. Magnetic resonance imaging showed features of severe intracranial hypotension in the brain and the spinal cord, and magnetic resonance venography showed cortical vein and partial superior sagittal sinus thrombosis. Prothrombotic (etiological) work-up showed Protein C and S deficiency. She responded to anticoagulation therapy and recovered completely. On review of literature two distinct groups could be identified obstetric and non-obstetric. The non-obstetric group included patients who underwent diagnostic lumbar puncture, intrathecal injection of medications and epidural anesthesia for non-obstetric surgeries. Poor outcome and mortality was noted in non-obstetric group, while obstetric group had an excellent recovery.

scholarly journals Isolated cortical vein thrombosis: case series

2015 ◽  
Vol 123 (2) ◽  
pp. 427-433 ◽  
Author(s):  
Ranjodh Singh ◽  
William P. Cope ◽  
Zhiping Zhou ◽  
Michelle E. De Witt ◽  
John A. Boockvar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Hypotension ◽  
Vasogenic Edema ◽  
Anticoagulation Therapy ◽  
Case Series ◽  
Published Data ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Presenting Symptoms ◽  
Cortical Vein Thrombosis

OBJECT Isolated cortical vein thrombosis (ICVT) accounts for less than 1% of all cerebral infarctions. ICVT may cause irreversible parenchymal damage, rendering early and accurate diagnosis critical. This case series and literature review presents the clinical and radiological findings in 7 patients with ICVT, and highlights risk factors and imaging modalities that may be most beneficial in rendering an accurate and timely diagnosis. METHODS Patients with CT and MRI findings consistent with ICVT examined between January 2011 and June 2014 were included in this retrospective review. RESULTS Seven patients (5 females, 2 males), ranging in age from 11 months to 34 years, met the inclusion criteria. The most common clinical presentations were headaches (n = 4) and seizures (n = 3). The most common comorbidities noted in these patients were hypercoagulable states (n = 4) and intracranial hypotension (n = 3). Five patients had intraparenchymal involvement. CT suggested the correct diagnosis in 4 patients, and MRI confirmed the diagnosis in all 7 patients. All patients who received anticoagulation therapy (n = 5) experienced complete resolution of their symptoms. CONCLUSIONS The majority of these patients were adult females, consistent with published data. Seizures and headaches were the most common presenting symptoms. Hypercoagulable state and intracranial hypotension, both known risk factors for thrombosis, were the most commonly noted ICVT risk factors. Intraparenchymal involvement was prevalent in nearly all ICVT cases and presented as vasogenic edema, early intraparenchymal hemorrhage, or hemorrhagic venous infarction. Susceptibility-weighted imaging was the most sensitive imaging technique in diagnosing ICVT.

Headache in cerebral venous sinus thrombosis revisited: Exploring the role of vascular congestion and cortical vein thrombosis

Cephalalgia ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 503-510 ◽  
Author(s):  
Ravinder-Jeet Singh ◽  
Jitender Saini ◽  
Shriram Varadharajan ◽  
Girish Baburao Kulkarni ◽  
Mustare Veerendrakumar
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Dural Sinus ◽  
Dural Sinus Thrombosis ◽  
Venous Sinus Thrombosis ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
Vascular Congestion

Background and purpose Headache constitutes the most common symptom of cerebral venous sinus thrombosis (CVST), but its pathophysiology is unclear. We sought to investigate the potential mechanism for headache genesis in patients with CVST based on its imaging correlates. Methods A subgroup of CVST patients having headache as the predominant symptom without significant parenchymal lesion were retrospectively analysed for imaging features of vascular congestion (VC), in addition to cortical venous (CVT) and dural sinus thrombosis (DST) on magnetic resonance imaging. Headache and imaging patterns were classified into lateralized and nonlateralized phenotypes and their correlation was sought. Results Among 41 patients included, 28 had lateralized headache (LH group; 15 males; mean age 32.25 ± 9.19 years) while 13 had nonlateralized headache (non-LH group; six males; mean age 27.15 ± 8.65 years). Headache characteristics in both the groups were quite similar. Imaging showed VC in 39 of 41 and CVT among 35 of 41 patients, which were lateralized in 23 of 39 and 18 of 35 patients, respectively. Nearly all lateralized imaging patterns (21 of 23 for VC and 17 of 18 for CVT) occurred in the LH group and ipsilateral to (concordant) headache, while the non-LH group showed lateralized VC and CVT in only two and one patient respectively. Sinus thrombosis was lateralized in both groups irrespective of headache laterality. Whole cohort headache-imaging laterality (including patients with nonlateralized headache and nonlateralized imaging) concordance was 31 of 39, 24 of 35 and 18 of 41 for vascular congestion, cortical vein thrombosis and dural sinus thrombosis respectively. Conclusion Co-localization of VC and CVT with overlying headache might provide a possible explanation of headache and its laterality in patients with CVST.

Acupuncture for treatment of therapy-resistant post-dural puncture headache: a retrospective case series

2013 ◽  
Vol 111 (eLetters) ◽  
Author(s):  
Taras I. Usichenko ◽  
Joanna Dietzel ◽  
Torsten Witstruck ◽  
Stefanie Adler
Keyword(s):  
Dural Puncture ◽  
Case Series ◽  
Retrospective Case ◽  
Post Dural Puncture Headache ◽  
Retrospective Case Series

FIVE CASES OF ACUTE HYPOACUSIA/DEAFNESS SECONDARY TO ARTERIAL AND VENOUS CEREBROVASCULAR DISEASE

2020 ◽  
Vol 6 (1-2) ◽  
pp. 3-9
Author(s):  
Carlo Canepa-Raggio
Keyword(s):  
Cerebrovascular Disease ◽  
Sinus Thrombosis ◽  
Post Partum ◽  
Vertebral Artery Dissection ◽  
Initial Presentation ◽  
Superior Cerebellar Artery ◽  
Artery Dissection ◽  
Anterior Inferior Cerebellar Artery ◽  
First Case ◽  
Cerebellar Artery

I present five cases of acute onset hypoacusia (four unilateral and one bilateral), all of different physiopathological mechanisms and vascular territories, secondary to either arterial or venous causes. First case is a 39-year-old male with Left Middle Inferior Pontine Syndrome (Foville Syndrome) with associated Vertebro-Basilar Insufficiency (VBI) secondary to Spontaneous Vertebral Artery Dissection (SVAD) and secondary hypoacusia. Case two, is a 76-year-old female with right Anterior Inferior Cerebellar Artery (AICA) Syndrome generating a lateral pontine infarct with hypoacusia as an initial presentation. Case three, is a 77-year-old male presenting a left Superior Cerebellar Artery (SCA) infarct with hypoacusia as an initial presentation. Case four, a 79-year-old female patient presenting sudden onset bilateral hypoacusia secondary to Basilar Artery (BA) thrombosis. Finally, case five, is a 23-year-old post-partum female presenting a right Transverse Venous Sinus Thrombosis (CVST) presenting with acute hypoacusia as only clinical manifestation. Keywords: hypoacusia, deafness, cerebrovascular disease.

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