Cranial venous sinus thrombosis following early spontaneous abortion: a case report and literature review.

Abstract

Background: Pregnancy/puerperium cranial venous sinus thrombosis (CVST) is rare, mainly occurring in perinatal/late pregnancy, and less frequently in early pregnancy. None has been reported after early spontaneous abortion.

Case report: This study reports a case of CVST following early pregnancy spontaneous abortion in a patient with no known risk factors such as hypertension, diabetes, coagulopathy, or antiphospholipid syndrome. Following aggressive endovascular thrombectomy and thrombolytic treatment with 300,000 units of urokinase administered through a catheter, the patient experienced marked improvement in headache symptoms, with nausea and vomiting completely resolving. Four days later, a repeat magnetic resonance venography scan demonstrated successful recanalization of the intracranial venous sinuses, accompanied by a notable decrease in D-dimer levels upon reassessment.

Conclusion: For young patients with early pregnancy bleeding, comprehensive coagulation function and D-dimer tests could be conducted. Even after a spontaneous abortion, if the patient presents with symptoms such as headache, vomiting, or visual impairment, the possibility of pregnancy-associated CVST should be considered, and an immediate head CT or MRI should be arranged. In cases complicated by cerebral hemorrhage, endovascular thrombectomy and thrombolysis can be performed.