Original Publication
Open Access

Beyond Eclampsia: Cerebral Venous Sinus Thrombosis Presenting with Headache and Seizure in a Postpartum Patient

Published: August 22, 2014 | 10.15766/mep_2374-8265.9890

Included in this publication:

  • Cerebral Venous Sinus Thrombosis Faculty Checklist.pdf
  • Cerebral Venous Sinus Thrombosis Simulation Case Scenario.pdf
  • Cerebral Venous Sinus Thrombosis Simulation Case Flow Diagram.pdf
  • Venous Sinus Thrombosis - CT Scan.jpg
  • Patient background information CSVT Case.pdf
  • Cerebral Venous Sinus Thrombosis MRI.pdf
  • Cerebral Venous Sinus Thrombosis - Radiology reports.pdf
  • Cerebral Venous Sinus Thrombosis - Debrief Notes.pdf

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

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.


Educational Objectives

By the end of this simulation, learners will be able to:

  1. Consider cerebral venous sinus thrombosis as a cause of headache.
  2. Broaden the differential diagnosis of a seizure in the immediate postpartum period beyond eclampsia.
  3. Emphasize the importance of a complete and thorough neurological examination.
  4. Recognize the risk factors for cerebral venous sinus thrombosis.
  5. Understand the treatment and disposition priorities for patients with cerebral venous sinus thrombosis.

Author Information

  • Kriti Bhatia, MD: Brigham and Women's Hospital

Disclosures
None to report.

Funding/Support
None to report.



Citation

Bhatia K. Beyond eclampsia: cerebral venous sinus thrombosis presenting with headache and seizure in a postpartum patient. MedEdPORTAL. 2014;10:9890. https://doi.org/10.15766/mep_2374-8265.9890