Cerebral venous sinus thrombosis in the first trimester of pregnancy: A case report
Year: 2025
Type: article
Study design: Case Report
Abstract: Cerebral venous sinus thrombosis (CVST) is a rare but potentially life-threatening cause of stroke, with increased incidence in pregnancy due to hypercoagulability, particularly during the third trimester and the postpartum period. First-trimester presentations are exceedingly rare. A 37-year-old woman, gravida 2, para 0, at 7 weeks of gestation, presented with severe, progressive headache, nausea, and vomiting. Her obstetric history was significant for intrauterine fetal demise (IUFD) at 22 weeks of gestation. Neurologic examination was nonfocal. Computed tomography venography (CTV), performed because magnetic resonance imaging (MRI) was contraindicated, demonstrated thrombosis of the left transverse and sigmoid sinuses extending into the left internal jugular vein. Therapeutic low-molecular-weight heparin resulted in clinical improvement. Evaluation during pregnancy was negative for acquired and inherited thrombophilias. The patient underwent an uncomplicated suction dilation and curettage and remained clinically stable on anticoagulation. This case illustrates the diagnostic challenges of CVST in early pregnancy and highlights CTV as a reliable alternative to MRI. Additionally, this case is notable for CVST presenting in the first trimester, a rare occurrence, with few cases reported in the literature. The combination of early pregnancy, prior IUFD without a known thrombophilia represents a unique risk factor constellation for CVST. Clinicians should maintain a high index of suspicion for CVST in patients presenting with severe, atypical headache in the first trimester, to enable timely diagnosis, anticoagulation, and optimized maternal outcomes. • Cerebral venous sinus thrombosis presenting in the first trimester of pregnancy. • Early pregnancy stroke symptoms in a patient with prior intrauterine fetal death. • Computed tomography venography enabled diagnosis when MRI was contraindicated. • Anticoagulation with low molecular weight heparin is safe in early pregnancy. • Unique early pregnancy CVST case with prior IUFD and no known thrombophilia.
Source: Case Reports in Women s Health
Authors: Morolayo Ilori, Saachi Mittal, Mousa Eissa
Institutions: Wayne State University, Hutzel Women's Hospital
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,080
OpenAlex ID: W4415534702