Stroke, Vol 24, 1880-1884, Copyright © 1993 by American Heart Association
C Cantu and F Barinagarrementeria
BACKGROUND AND PURPOSE: Cerebral venous thrombosis is characterized by its
clinical pleomorphism and pathogenetic variability. We studied 67 patients
with cerebral venous thrombosis associated with pregnancy and puerperium
and compared them with 46 other cases unrelated to obstetric causes to
disclose differences in their clinical presentation, neuroradiological
findings, clinical course, and prognosis. METHODS: In this retrospective
study, we analyzed the clinical, laboratory, and neuroimaging findings of
113 patients collected consecutively at our institute. The diagnosis of
cerebral venous thrombosis was confirmed by angiography, magnetic resonance
imaging, or neuropathological study. RESULTS: Patients with cerebral venous
thrombosis associated with pregnancy and puerperium were younger (average
age, 26 versus 36 years), and in most, the onset of symptoms was acute (82%
versus 54%; P = .003). The evolution of symptoms reached a plateau within
10 days in 70% of patients with thrombosis from obstetric causes, compared
with only 45% in those from other causes (P = .01). Anemia was more
frequent in the obstetric group (64% versus 26%; P = .00001). There were no
differences regarding neurological and neuroradiological findings. Although
the initial severity of illness was similar in both groups, the final
outcome was considered good in 80% of patients with obstetric causes,
compared with 58% of patients with other causes (P = .01); mortality rates
were 9% and 33%, respectively (P = .002). CONCLUSIONS: Cerebral venous
thrombosis associated with pregnancy and puerperium has a more acute onset
and a better prognosis than thrombosis due to other causes. These findings
might be helpful in the diagnostic and therapeutic strategies for patients
with cerebral venous thrombosis.
ARTICLES
Cerebral venous thrombosis associated with pregnancy and puerperium. Review of 67 cases
Stroke Clinic, National Institute of Neurology and Neurosurgery, Mexico City, DF, Mexico.
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