Central venous thrombosis in a patient with post-dural puncture headache: predictable? A case report
DOI:
https://doi.org/10.34119/bjhrv8n5-058Keywords:
sinus thrombosis, intracranial, spinal anesthesia, post-dural puncture headache, anticoagulantsAbstract
Central venous thrombosis (CVT) is a rare and sometimes serious complication after spinal anesthesia, and also for other reasons. There are lots of predisposing factors, like hormone therapy and pro-coagulation disorders. In our case, a young female ASA1 was operated on under spinal anesthesia and developed post-dural puncture headache 24hours after the operation. The only questionable predisposing factor was vigorous aspiration during the block, as all her medical tests were within normal levels. A resonance magnetic image showed CTV and she was treated with anti-coagulants and had no sequelae. Being aware of this complication is a must because early treatment can prevent sequelae and be life-saving.
References
Saposnik G, Bushnell C, Coutinho JM, Field TS, Furie KL, Galadanci N, et al. Diagnosis and Management of Cerebral Venous Thrombosis: A Scientific Statement from the American Heart Association. Vol. 55, Stroke. Wolters Kluwer Health; 2024. p. E77–90.
Chambers DJ, Bhatia K, Columb M. Postpartum cerebral venous sinus thrombosis following obstetric neuraxial blockade: a literature review with analysis of 58 case reports. Vol. 49, International Journal of Obstetric Anesthesia. Churchill Livingstone; 2022.
Kabore RM, Ouiminga HAK, Lompo L, Sankara HD, Dabilgou A, Drave A, et al. Cerebral Venous Thrombosis: A Rare Complication of Spinal Anesthesia. World J Neurosci. 2021;11(01):1–7.
Cunha A, Marques J, Afiliação I. Accidental Subarachnoid Position of an Epidural Catheter Colocação Subaracnoideia Acidental de um Catéter Epidural. 30. Available from: http://revistas.rcaap.pt/anestesiologiahttps://dx.doi.org/10.25751/rspa.20577
Oh MK, Ryu JH, Jeon WJ, Lee CW, Cho SY. Case report: Postpartum cerebral venous thrombosis misdiagnosed as postdural puncture headache. BMC Anesthesiol. 2020 Apr 7;20(1).
Fettes PDW, Jansson JR, Wildsmith JAW. Failed spinal anaesthesia: Mechanisms, management, and prevention. Vol. 102, British Journal of Anaesthesia. Oxford University Press; 2009. p. 739–48.
Martins RT, Toson B, De Souza RKM, Kowacs PA. Post-dural puncture headache incidence after cerebrospinal fluid aspiration. A prospective observational study. Arq Neuropsiquiatr. 2020 Apr 1;78(4):187–92.
Bisinotto FMB, Dezena RA, Abud TMV, Martins LB. Cerebral venous thrombosis after spinal anesthesia: case report. Brazilian Journal of Anesthesiology (English Edition). 2017 May;67(3):305–10.


