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BMJ Case Rep ; 20182018 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-29592984

RESUMO

Postpartum women can develop headache, and their assessment requires a thorough and multidisciplinary approach. If the headache is unresponsive to treatment and accompanied by neurological deficit, neuroimaging needs to be undertaken to rule out other life-threatening causes. 1 We present a case of 35-year-old woman with pre-eclampsia and diet-controlled gestational diabetes mellitus, who had normal vaginal delivery at 40 weeks. She had an epidural analgesia for pain relief during labour, but had inadvertent dural puncture during the procedure and developed headache 24 hours after delivery. The headache was managed conservatively and she was discharged home, but was readmitted 8 days later with worsening headache. The headache was postural on admission but became continuous, developed neurological symptoms in the form of ataxic hemiparesis and convulsions. After neuroimaging, she was found to have cerebral venous sinus thrombosis. She was commenced on anticoagulants and anticonvulsants and made a complete recovery.


Assuntos
Veias Cerebrais/diagnóstico por imagem , Cefaleia/etiologia , Transtornos Puerperais/diagnóstico por imagem , Transtornos Puerperais/etiologia , Trombose dos Seios Intracranianos/diagnóstico por imagem , Punção Espinal/efeitos adversos , Adulto , Analgesia Epidural/métodos , Anticoagulantes/uso terapêutico , Anticonvulsivantes/uso terapêutico , Feminino , Cefaleia/diagnóstico por imagem , Cefaleia/tratamento farmacológico , Heparina/uso terapêutico , Humanos , Período Pós-Parto , Transtornos Puerperais/tratamento farmacológico , Trombose dos Seios Intracranianos/tratamento farmacológico , Trombose dos Seios Intracranianos/etiologia , Tomografia Computadorizada por Raios X/métodos , Varfarina/uso terapêutico
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