Cerebral venous thrombosis in the puerperium: a reflective case study
Evidence and practice    

Cerebral venous thrombosis in the puerperium: a reflective case study

Lorraine Esther Lloyd Lorraine Esther Lloyd, advanced clinical practitioner, Emergency Department, Countess of Chester Hospital NHS Foundation Trust, Chester, England

Why you should read this article
  • To enhance your knowledge of the diagnosis and treatment of cerebral venous thrombosis (CVT)

  • To understand the involvement of CVT in many pregnancy and puerperium-related strokes

  • To learn how the multiple clinical manifestations of CVT can be confused with other acute neurological conditions in the emergency department

The increased risk of stroke during pregnancy and the puerperium – defined as being the first six weeks post-partum – has been well documented. The incidence, however, is still very low and has been estimated at 30 per 100,000 pregnancies. Strokes can result from several causes, including ischaemia, intracerebral bleeds, subarachnoid bleeds and venous thrombosis. Cerebral venous thrombosis (CVT) – a complete or partial occlusion of the major cerebral venous sinuses or cortical veins – accounts for 27%-57% of all pregnancy and puerperium-related strokes, which would equate to an incidence of 8-16 episodes per 100,000 deliveries.

This article discusses the case of a young woman who presented to the emergency department complaining of bilateral eye pain. It considers the causes, the variability of presenting symptoms, diagnosis and treatment options for CVT. Given the variability of the condition’s presentation, this article aims to assist nurses in identifying at-risk patients and promotes the benefits of collaboration with colleagues to improve patient outcomes.

Emergency Nurse. doi: 10.7748/en.2021.e2115

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Conflict of interest

None declared

Lloyd LE (2021) Cerebral venous thrombosis in the puerperium: a reflective case study. Emergency Nurse. doi: 10.7748/en.2021.e2115

Correpondence llloyd1@nhs.net

Acknowledgement

With thanks to my emergency department colleagues Dr Mohamed Salah Salem and Dr Alex Walker for their invaluable knowledge

Published online: 26 October 2021

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