Cerebral venous sinus thrombosis (CVST) is an uncommon yet potentially life-threatening condition that affects pregnant women. It occurs when blood clots form in the brain’s venous sinuses, leading to a stroke. Pregnancy itself alters the coagulation system, which can increase the risk of hypercoagulation, particularly during the postpartum period. This heightened risk is most prominent during the third trimester and the first four weeks after childbirth.
Several factors contribute to the development of CVST during pregnancy. These include the physical changes associated with pregnancy, caesarean delivery, systemic infections, vomiting, and anaemia. Risk factors also extend beyond pregnancy, with conditions such as dehydration, oral contraception use, thrombotic disease, genetic thrombophilia, and cancer increasing the likelihood of CVST.
Symptoms and Potential Complications
Dr. Kunal Bahrani, Clinical Director and Head of Neurology at Marengo Asia Hospitals Faridabad, explains that the most common symptom of CVST is a headache. However, other signs may also be present, including blurred vision, fainting or loss of consciousness, partial paralysis, seizures, and even coma. If left untreated, CVST can lead to severe complications, such as difficulty with speech, vision problems, paralysis, brain injury, and increased intracranial pressure. In some cases, the condition can be fatal.
Who is at Risk?
Women with pre-existing risk factors are particularly vulnerable to developing CVST during pregnancy. These include individuals who are overweight, smoke, have diabetes, or have a history of trauma or surgery.
Dr. Tarun Sharma, Program Clinical Director of Brain & Spine Surgery at Marengo Asia Hospitals Faridabad, adds that pregnancy itself is a hypercoagulable state, meaning it increases the likelihood of blood clot formation. “During pregnancy, women are more prone to high blood pressure and blood clotting, which can occur in various parts of the body,” he says. “When a clot forms in the brain, it becomes CVST, presenting as symptoms like headaches, vomiting, and sometimes seizures. Unfortunately, many women ignore these common symptoms and only seek help once more serious symptoms, like seizures, occur. Raising public awareness is crucial for early detection and timely treatment.”
Diagnosing CVST
Diagnosis of CVST involves imaging tests that help identify areas of impaired blood flow within the brain. These tests may include an MRI of the brain, MR venogram, CT venogram, and blood tests. If CVST is suspected, immediate medical consultation with a neurologist is essential.
Treatment Options for CVST
The first line of treatment for CVST is anticoagulation therapy, aimed at preventing further clot formation. In cases where neurological deterioration or coma persists despite medical treatment, more aggressive options like endovascular therapy or surgery may be considered to improve outcomes.
Preventing CVST
To reduce the risk of CVST, maintaining a healthy lifestyle is key. This includes eating a balanced, low-fat diet rich in fruits and vegetables, engaging in regular exercise, avoiding smoking, and managing chronic conditions like diabetes.
In conclusion, while CVST remains a rare condition, it poses significant risks to pregnant women. Early detection, awareness of symptoms, and timely intervention can significantly improve outcomes for those affected.
