Fatal headache of pregnancy: a case report and review of literature

ABSTRACT

Due to its variable clinical presentation cerebral venous sinus thrombosis [CVST] is a rare, potentially fatal and challenging condition that is more common in females, with pregnancy, puerperium and the use of oral contraceptive being the risk factors identifiable in up to 80% of cases. Hereditary prothrombotic conditions such as protein C and S, antithrombin III deficiency, and anticardiolipin antibodies are responsible for the condition in many patients. Severe headache is the presenting symptom in most cases. A high index of suspicion is needed for diagnosis although newer imaging procedures have led to earlier diagnosis and management with improved outcomes; magnetic resonance imaging with venography is the investigation of choice. The first line of therapy is intravenous heparin and local thrombolysis can be done in cases deteriorating despite adequate heparinization. Decompression craniotomy may be helpful. Here we report a fatal case of CVST in a pregnant lady with severe headache and anticardiolipin antibody syndrome