TITLE:
Cerebral Venous Thrombosis: A Rare Complication of Spinal Anesthesia
AUTHORS:
Raphael M. Kabore, Habib A. K. Ouiminga, Labodi Lompo, H. Desire Sankara, Anselme Dabilgou, Alassane Drave, Svetlana Barro Cherban, Christian Napon, Athanase Millogo, Jean Kabore
KEYWORDS:
Spinal Anesthesia, Post Spinal Puncture Headache, Cerebral Venous Thrombosis
JOURNAL NAME:
World Journal of Neuroscience,
Vol.11 No.1,
February
1,
2021
ABSTRACT: Introduction: Cerebral venous
thrombosis (CVT) is a rare complication of spinal anesthesia. The diagnosis is
difficult when it occurs by isolated headache, following post spinal puncture
headache (PSPH). We report a case of cerebral venous thrombosis complicating
PSPH, following a spinal anesthesia. Observation: A 23-year-old man was admitted to the emergency room for PSPH
appeared 6 hours after a spinal aesthesia for removal of osteosynthesis equipment from the right tibial plateau. The
headache was fronto-occipital, relieved
by lying down. Six days later, headache became permanent, not relieved by morphine, associated with vomiting. The
neurological examination was normal. Brain magnetic resonance Magnetic
venography showed superior sagittal sinus and right transverse sinus
thrombosis. After administration of low molecular weight heparin at curative
dose, and warfarin under INR control, the evolution was marked by a rapid
regression of headaches on the same day. After a 1-year setback, the patient was asymptomatic. Conclusion: CVT is a
rare complication of spinal anesthesia and potentially severe if diagnosed lately.
Urgent brain imaging must be performed for any atypical headache or the onset
of neurological disorders so as not to misunderstand cerebral vein thrombosis.
Controlling the spine anesthesia would reduce the inadvertent perforation of
the dura-mother that would lead to CVT complicating post spinal puncture
headaches.