A case of cerebral venous sinus thrombosis that occurred in the early period of pregnancy; the patient recovered totally without any complications after anticoagulation therapy

  • LEE Hyangsang
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
  • TSUJIE Tomoko
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
  • IKEDA Kayo
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
  • FUJITANI Mayumi
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
  • TAKAHASHI Kayoko
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
  • KAMACHI Keiichi
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
  • TOKUHIRA Atsushi
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
  • WAKIMOTO Akinori
    Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital

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Other Title
  • 妊娠初期に重篤な神経症状を呈する脳静脈洞血栓症を発症したが抗凝固療法により良好な経過をたどった1例
  • 症例報告 妊娠初期に重篤な神経症状を呈する脳静脈洞血栓症を発症したが抗凝固療法により良好な経過をたどった1例
  • ショウレイ ホウコク ニンシン ショキ ニ ジュウトク ナ シンケイ ショウジョウ オ テイスル ノウ ジョウミャクドウ ケッセンショウ オ ハッショウ シタ ガ コウギョウコ リョウホウ ニ ヨリ リョウコウ ナ ケイカ オ タドッタ 1レイ

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<p>Most cases of cerebral venous sinus thrombosis (CVST) associated with pregnancy occurs in the third trimester or puerperium period. We report a case of CVST that occurred in the early period of the pregnancy, which was treated by anticoagulation therapy; the patient recovered totally without any complications. A 38 year-old nulliparous woman was transferred to our hospital because of loss of consciousness seven weeks of gestation. She had taken an intracytoplasmic sperm injection (ICSI) and hormonal administrations; even though vomiting and headaches had been observed ahead of the onset, these were considered to be symptoms of hyperemesis. At the time of admission, she was in a coma. CT and MRI studies showed that she had CVST, so we started anticoagulation therapy. At first, she presented severe neural symptoms including coma and systemic seizure, which were associated with her poor prognosis. The treatment was successful and no symptoms remained 14 weeks of gestation. Finally, she gave live birth at 40 weeks of gestation by Caesarean section. Many specialists of Neurology say that it is difficult to diagnose CVST quickly because it shows various symptoms; but it is very important to diagnose it quickly, otherwise prognosis can worsen. The risk of CVST can be increased by dehydration due to hyperemesis, hormonal administrations due to fertility treatments or congenital coagulation diseases such as Protein S deficiency (which is relatively common in the Japanese).[Adv Obstet Gynecol, 68 (3) : 261-268, 2016 (H28.8)]</p>

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