CLINICAL CASES Free

Minerva Anestesiologica 2004 December;70(12):831-6

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Post gravidic superior sagittal sinus thrombosis with elevated levels of homocystinemia

Vignazia G. L. ¹, La Mura F. ¹, Gaidano G. ², Della Corte F. ¹

¹ Departments of Anaesthesia and Intensive Care Amedeo Avogadro University School of Medicine Ospedale Maggiore della Carità, Novara, Italy 2 Section of Haematology Unit of Internal Medicine “Amedeo Avogadro” University School of Medicine Ospedale Maggiore della Carità Hospital Novara, Italy

Cerebral ischemia in the young (less than 45 years) is an uncommon finding, its ethiology remaining undefined in up to half of cases even if all the common diagnostic paths have been followed. Pregnancy and puerperium are characterised by an increased risk of ischemic stroke and intracranial venous thrombosis. We present a case of a young woman with post gravidic thrombosis of the superior sagittal sinus, occurred 10 days after eutocic delivery. She presented elevated plasma levels of homocystinemia, a sulphur containing amino acid that induce complex changes within the blood vessel wall, acting with an oxidative stress and with a reduction of nitric oxide availability. This clinical case suggests that a complete screening for thrombophilic risk factors should be an integral part in the diagnostic path of central venous thrombosis in young patients also in the puerperium, because it allows to identify thrombophilic risk factors requiring specific treatment.