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Sinusvenenthrombose nach geburtshilflicher Epiduralanästhesie

Postpartum cerebral venous sinus thrombosis after epidural anaesthesia

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Zusammenfassung

Sinusvenenthrombosen (SVT) in der Schwangerschaft oder postpartal sind keine Seltenheit, trotzdem wird die Diagnose meist erst spät gestellt. Bei der hohen Anzahl an rückenmarknahen Anästhesien zur Entbindung fällt die Differenzialdiagnose zum postpunktionellen Kopfschmerz (PKS) oft schwer. Es wird über eine Patientin berichtet, die postpartal sowohl ein Liquorunterdrucksyndrom als auch eine SVT entwickelte.

Abstract

Cerebral venous sinus thrombosis during pregnancy or puerperium is not a rarity. Nevertheless, it is often misdiagnosed. With the increasing use of regional anaesthesia in obstetrics the differential diagnosis of postdural puncture headache is often difficult. The case of a patient is reported who suffered from both intracranial hypotension and cerebral venous sinus thrombosis in the postpartum period.

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Literatur

  1. Acharya R, Chhabra S, Ratra M, Sehgal AD (2001) Cranial subdural haematoma after spinal anaesthesia. Br J Anaesth 86(6):893–895

    Article  PubMed  CAS  Google Scholar 

  2. Albayram S, Tuzgen S, Gündüz A et al (2008) Spontaneous intracranial hypotension after labour without spinal intervention. Eur J Neurol 15:91–93

    PubMed  CAS  Google Scholar 

  3. Bansal BC, Gupta RR, Prakash C (1980) Stroke during pregnancy and puerperium in young females below the age of 40 years as a result of cerebral venous/venous sinus thrombosis. Jpn Heart J 21:171–183

    PubMed  CAS  Google Scholar 

  4. Barrett J, Alves E (2005) Postpartum cerebral venous sinus thrombosis after dural puncture and epidural blood patch. J Emerg Med 28(3):341–342

    Article  PubMed  Google Scholar 

  5. Borum SE, Naul LG, McLeskey CH (1997) Postpartum dural venous sinus thrombosis after postdural puncture headache and epidural blood patch. Anesthesiology 86:487–490

    Article  PubMed  CAS  Google Scholar 

  6. Busse O, Forsting M, Haberl R et al (2003) Leitlinie der Deutschen Gesellschaft für Neurologie. http://www.uni-duesseldorf.de/AWMF/ll/030-098.htm

  7. Chisholm M, Campbell D (2001) Postpartum postural headache due to superior sagittal sinus thrombosis mistaken for spontaneous intracranial hypotension. Can J Anesth 48(3):302–304

    Article  PubMed  CAS  Google Scholar 

  8. Bruijn SF de, Haan RJ de, Stam J (2001) Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients. For the cerebral venous sinus thrombosis study group. J Neurol Neurosurg Psychiatry 70:105–108

    Article  PubMed  Google Scholar 

  9. Ergün U, Say B, Ozer G, Tunc T et al (2008) Intravenous theophylline decreases post-dural puncture headaches. J Clin Neurosci 15:1102–1104

    Article  PubMed  CAS  Google Scholar 

  10. Fernández E (1990) Headache associated with low spinal fluid pressure. Headache 30:122–128

    Article  PubMed  Google Scholar 

  11. Fink J, McAuley DL (2001) Cerebral venous sinus thrombosis: a diagnostic challenge. Int Med J 31:384–390

    Article  CAS  Google Scholar 

  12. Flender HJ, Knipprath R, Opitz A (1994) Blutblombe zur Therapie des postspinalen Kopfschmerzes. Anaesthesist 43:355–358

    Article  PubMed  CAS  Google Scholar 

  13. Gaiser R (2006) Postdural puncture headache. Curr Opin Anaesthesiol 19:249–253

    Article  PubMed  Google Scholar 

  14. Iqbal J, Davis LE, Orrison WW (1995) A MRI study of lumbar puncture headache. Headache 35:420–422

    Article  PubMed  CAS  Google Scholar 

  15. Khelani B, Mapari U, Sikandar R (2006) Obstetric cerebral venous thrombosis. J Pak Med Assoc 56(11):490–493

    Google Scholar 

  16. Kueper M, Goericke SL, Kastrup O (2008) Cerebral venous thrombosis after epidural blood patch: coincidence or causal relation? A case report and review of the literature. Cephalalgia 28:769–773

    Article  PubMed  CAS  Google Scholar 

  17. Lalive PH, Moerloose P de, Lovblad K et al (2003) Is measurement of D-dimer useful in the diagnosis of cerebral venous thrombosis? Neurology 61:1057–1060

    PubMed  CAS  Google Scholar 

  18. Lanska DJ, Kryscio RJ (2000) Risk factors for peripartum and postpartum stroke and intracranial venous thrombosis. Stroke 31:1274–1282

    PubMed  CAS  Google Scholar 

  19. Lockhart EM, Baysinger CL (2007) Intracranial venous thrombosis in the parturient. Anesthesiology 107:652–658

    Article  PubMed  Google Scholar 

  20. Milhaud D, Heroum C, Charif M, Saulnier P et al (2000) Dural puncture and corticotherapy as risks factors for cerebral venous sinus thrombosis. Eur J Neurol 7:123–124

    Article  PubMed  CAS  Google Scholar 

  21. Nazziola E, Elkind M (2003) Dural sinus thrombosis presenting three months postpartum. Ann Emerg Med 42(4):592–595

    Article  PubMed  Google Scholar 

  22. Schwarz U, Schwan C, Strumpf M et al (1999) Postpunktioneller Kopfschmerz. Schmerz 13:332–340

    Article  PubMed  CAS  Google Scholar 

  23. Thew M, Paech MJ (2008) Management of postdural puncture headache in the obstetric patient. Curr Opin Anaesthesiol 21:288–292

    Article  PubMed  Google Scholar 

  24. Kooten F van, Oedit R, Bakker SL, Dippel DW (2008) Epidural blood patch in post dural puncture headache: a randomised, observer-blind, controlled clinical trial. J Neurol Neurosurg Psychiatry 79:553–558

    Article  PubMed  Google Scholar 

  25. Verdú MT, Martínez-Lage JF, Alonso B et al (2007) Non-surgical management of intracranial subdural hematoma complicating spinal anesthesia. Neurocirugía 18:40–43

    PubMed  Google Scholar 

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Correspondence to M. Silomon.

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Herrn Prof. Dr. R. Larsen zum 65. Geburtstag gewidmet.

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Jungmann, V., Werner, R., Bergmann, J. et al. Sinusvenenthrombose nach geburtshilflicher Epiduralanästhesie. Anaesthesist 58, 268–272 (2009). https://doi.org/10.1007/s00101-008-1490-z

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  • DOI: https://doi.org/10.1007/s00101-008-1490-z

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