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Kate MP, Thomas B, Sylaja PN. Cerebral venous thrombosis in post-lumbar puncture intracranial hypotension: case report and review of literature. F1000Res. 2014;3:41doi: 10.12688/f1000research.3-41.v1.
Kate, M. P., Thomas, B., & Sylaja, P. N. (2014). Cerebral venous thrombosis in post-lumbar puncture intracranial hypotension: case report and review of literature. F1000Research, 341. https://doi.org/10.12688/f1000research.3-41.v1
Kate, Mahesh P, et al. "Cerebral venous thrombosis in post-lumbar puncture intracranial hypotension: case report and review of literature." F1000Research vol. 3 (2014): 41. doi: https://doi.org/10.12688/f1000research.3-41.v1
Kate MP, Thomas B, Sylaja PN. Cerebral venous thrombosis in post-lumbar puncture intracranial hypotension: case report and review of literature. F1000Res. 2014 Feb 11;3:41. doi: 10.12688/f1000research.3-41.v1. eCollection 2014. PMID: 24627803; PMCID: PMC3945949.
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F1000Res. 2014 Feb 11;3:41. doi: 10.12688/f1000research.3-41.v1. eCollection 2014.

Cerebral venous thrombosis in post-lumbar puncture intracranial hypotension: case report and review of literature.

F1000Research

Mahesh P Kate, Bejoy Thomas, P N Sylaja

Affiliations

  1. Department of Medicine, University of Alberta, Edmonton, T6G0T1, Canada.
  2. Department of Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College Campus, Medical College, Thiruvananthapuram, Kerala, 695011, India.
  3. Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College Campus, Medical College, Thiruvananthapuram, Kerala, 695011, India.

PMID: 24627803 PMCID: PMC3945949 DOI: 10.12688/f1000research.3-41.v1

Abstract

The spectrum of presentation of intracranial hypotension is clinically perplexing. We report a case of 31-year-old post-partum woman who underwent an uneventful caesarean section under spinal anesthesia. From the second day of surgery she developed postural headache, the headache lost its postural character after few days. She then developed seizures and ataxic hemiparesis. Magnetic resonance imaging showed features of severe intracranial hypotension in the brain and the spinal cord, and magnetic resonance venography showed cortical vein and partial superior sagittal sinus thrombosis. Prothrombotic (etiological) work-up showed Protein C and S deficiency. She responded to anticoagulation therapy and recovered completely. On review of literature two distinct groups could be identified obstetric and non-obstetric. The non-obstetric group included patients who underwent diagnostic lumbar puncture, intrathecal injection of medications and epidural anesthesia for non-obstetric surgeries. Poor outcome and mortality was noted in non-obstetric group, while obstetric group had an excellent recovery.

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