1/5. Dural puncture and corticotherapy as risks factors for cerebral venous sinus thrombosis.Dural puncture with corticosteroid could be a predisposing factor for cerebral venous thrombosis (CVT). A 35-year-old woman using oral contraception was treated with corticosteroid epidural infiltration for L5 radiculalgia. The following day a postural headache developed and accidental dural puncture was suspected. Four days later, she presented with fever and consciousness impairment requiring mechanical ventilation. magnetic resonance angiography (MRA) confirmed thrombosis of the superior sagittal sinus. Recanalization was observed three weeks later and the patient fully recovered. blood tests for thrombophilia showed a moderate decrease in the C protein level (chronometric activity 44%, N = 65-130). CVT has been reported after spinal anaesthesia or peridural anaesthesia with accidental puncture. After dural puncture the decrease of cerebrospinal fluid pressure induces a rostrocaudal sagging effect with traumatic damage to the fragile venous endothelial wall, and may trigger a venous vasodilatation with resultant stasis. CVT has also been described in patients after lumbar puncture and oral corticoid treatment for multiple sclerosis and after corticosteroid intrathecal infiltration. Therefore, corticosteroids can be considered as a potential additional procoagulant stimuli.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
2/5. Cerebral venous and sinus thrombosis with cerebrospinal fluid circulation block after the first methotrexate administration by lumbar puncture.We report a patient treated for small lymphocytic lymphoma/leukemia with cerebral venous and sinus thrombosis (CVST) after lumbar puncture with intrathecal administration of methotrexate (MTX). He also developed a cerebrospinal fluid flow block. This is the first report of an association between lumbar puncture and intrathecally administered MTX and the development of CVST. Intrathecal treatment in this patient was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously.- - - - - - - - - - ranking = 0.66666666666667keywords = puncture (Clic here for more details about this article) |
3/5. Superior sagittal sinus thrombosis in a patient with postdural puncture headache.BACKGROUND AND OBJECTIVES: The occurrence of concomitant intracranial pathology in a patient with postdural puncture headache (PDPH) is rare. We present a patient who had a superior sagittal sinus thrombosis in addition to his PDPH. The signs and symptoms of intracranial pathology in patients with dural puncture headache, in addition to their postural headache, are discussed. CASE REPORT: A 32-year-old man with lymphoblastic lymphoma received treatment with daunorubicin, vincristine, and prednisone. He developed postural headache and severe nausea and vomiting after a diagnostic lumbar puncture. magnetic resonance imaging (MRI) showed superior sagittal sinus (SSS) thrombosis and meningeal enhancement. An epidural blood patch was performed and enoxaparin was prescribed for 6 months. He has remained asymptomatic. CONCLUSIONS: patients with PDPH have classic postural headache. The occurrence of additional signs and symptoms should alert the clinician to the presence of intracranial pathology. patients with lymphoblastic lymphoma who had treatment with L-asparaginase and steroid are predisposed to the development of cortical venous thrombosis and may have this syndrome in addition to a dural puncture headache.- - - - - - - - - - ranking = 0.88888888888889keywords = puncture (Clic here for more details about this article) |
4/5. hydrocephalus due to superior sagittal sinus thrombosis.The great variability of clinical appearance is one of the main features of superior sagittal sinus thrombosis. However, hydrocephalus associated with cerebral sinus thrombosis is rare. We report on a patient presented with thunderclap headache, accompanied by nausea, vomiting, and drowsiness. Lumbar puncture ruled out subarachnoid hemorrhage, whereas CT revealed marked hydrocephalus. In addition, magnetic resonance venography then confirmed the diagnosis of cerebral sinus thrombosis. It is a rare occurrence but clinically important, since it entails disastrous sequels if unrecognized, and hydrocephalus is treated in the usual fashion with ventricular drainage.- - - - - - - - - - ranking = 0.11111111111111keywords = puncture (Clic here for more details about this article) |
5/5. Superior sagittal sinus thrombosis associated with raised intracranial pressure in closed head injury with depressed skull fracture.A case of delayed signs of intracranial hypertension following closed head injury with a depressed cranial fracture and superior sagittal sinus thrombosis is reported. Conservative treatment of intracranial hypertension, including just repeated lumbar puncture and oral acetazolamide, was performed. Spontaneous recanalization of the superior sagittal sinus was observed. Pathogenesis and different modalities of treatment are discussed.- - - - - - - - - - ranking = 0.11111111111111keywords = puncture (Clic here for more details about this article) |