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Predisposing factors, diagnosis, treatment and prognosis of cerebral venous thrombosis during pregnancy and postpartum: a case-control study.
MedLine Citation:
PMID:  22340387     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Previous investigations have demonstrated a relatively low incidence of stroke among young women, though both pregnancy and delivery can substantially increase the risk. Cerebral venous thrombosis may manifest different characteristics during pregnancy and postpartum as a result of their specific physiological statuses. This study aimed to identify the clinical manifestations, diagnosis, treatment, and prognosis of cerebral venous thrombosis during pregnancy and postpartum.
METHODS: We conducted a retrospective analysis of 22 patients with cerebral venous thrombosis who were assigned to either group A (during pregnancy) or group B (during postpartum). The relevant risk factors, initiation and development of the disease, clinical presentations, diagnosis, treatment, and prognosis were compared between the two stages.
RESULTS: Cerebral venous thrombosis occurred during both pregnancy and postpartum, but was more common postpartum. Patients in group A had a longer hospitalization period than those in group B. Confirmed predisposing factors in 85.7% of patients of group A were dehydration, infection, and underlying cerebrovascular disorders. No obvious predisposing factors were identified in group B. The most frequent symptom was headache, with epileptic seizures, hemiparalysis and aphasia being less frequent symptoms. Focal neurological symptoms (P = 0.022) and cerebral infarction (P = 0.014) occurred more frequently in group A than in group B. Anticoagulation therapy proved to be safe for cerebral venous thrombosis patients during puerperium, regardless of parenchymal hemorrhage. However, more attention should be paid to spontaneous in-site placental hemorrhage in pregnant patients. Both groups had similar prognoses (P = 1.000), with 36.3% patients suffering from consequential dysfunction or recurrent intracranial hypertension. Delayed diagnosis was associated with a poorer prognosis.
CONCLUSIONS: Cerebral venous thrombosis manifests different clinical characteristics during pregnancy and postpartum, though both have a good prognosis. Early diagnosis and prompt anticoagulation therapy are essential.
Authors:
Hui Gao; Bao-Jun Yang; Li-Ping Jin; Xiao-Fang Jia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese medical journal     Volume:  124     ISSN:  0366-6999     ISO Abbreviation:  Chin. Med. J.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-02-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513795     Medline TA:  Chin Med J (Engl)     Country:  China    
Other Details:
Languages:  eng     Pagination:  4198-204     Citation Subset:  IM    
Affiliation:
Department of Obstetrics & Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
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