Pearls & Oy-sters: Postdural Puncture Headache, Cerebral Sinus Venous Thrombosis, and Reversible Cerebral Vasoconstriction Syndrome in the Peripartum Period.

Details

Serval ID
serval:BIB_32A323838A00
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Pearls & Oy-sters: Postdural Puncture Headache, Cerebral Sinus Venous Thrombosis, and Reversible Cerebral Vasoconstriction Syndrome in the Peripartum Period.
Journal
Neurology
Author(s)
Caranzano L., Fenter H., Maeder P., Michel P., Strambo D.
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
10/10/2022
Peer-reviewed
Oui
Volume
99
Number
15
Pages
665-668
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Abstract
We report the case of a 34-year-old female patient complaining of headaches 1 day after childbirth, initially interpreted as postdural puncture headache (PDPH) and treated successfully with an epidural blood patch. Five days later, she presented with an acute proportional right sensorimotor hemisyndrome and a new-onset left-sided headache, attributed to a venous stroke from left-sided cerebral sinus venous thrombosis (CSVT). Simultaneously, we found radiologic signs of reversible cerebral vasoconstriction syndrome (RCVS), considered asymptomatic. We administered anticoagulant therapy to the patient, and she showed full motor recovery at 3-month clinical follow-up. PDPH, CSVT, and RCVS are well-known neurologic complications during the peripartum period. All 3 conditions present with headaches, and headache features may overlap, masking co-occurrence and making accurate diagnosis (differentiation) of these diseases difficult. Each disease can potentially lead to disabling deficits, but all respond to specific treatment. Knowledge of the causes of headaches in the peripartum period, their specific clinical characteristics, and potential complications helps to prioritize and interpret diagnostic tests to offer appropriate therapy.
Keywords
Female, Humans, Adult, Post-Dural Puncture Headache/therapy, Peripartum Period, Vasoconstriction, Headache/therapy, Cerebrovascular Disorders/complications, Blood Patch, Epidural/adverse effects, Venous Thrombosis/etiology, Venous Thrombosis/complications
Pubmed
Web of science
Open Access
Yes
Create date
17/02/2023 17:26
Last modification date
11/01/2024 8:14
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