CEREBRAL VENOUS THROMBOSIS IN PREGNANCY: CURRENT PERSPECTIVES ON DIAGNOSIS AND MANAGEMENT (LITERATURE REVIEW)
DOI:
https://doi.org/10.52340/jecm.2025.06.04Keywords:
cerebral venous thrombosis, thrombophilia, heparin, postpartum period, preeclampsiaAbstract
This paper presents a literature review examining the clinical presentation, traditional and innovative diagnostic methods, and surgical treatment methods presented in the works of Russian and international authors.
Long-term study of neurological and neurosurgical conditions in women during pregnancy has left many unanswered questions due to the low prevalence of these conditions in pregnant women and women in labor. The specificity and uniqueness of each clinical case of these conditions opens a wide range of discussions regarding the choice of pregnancy and childbirth management strategies. These conditions pose a significant risk to the life of not only the mother but also, consequently, the fetus. Therefore, the study of this problem is crucial for approaches to diagnosis, timely prognosis, and the selection of pregnancy and childbirth management strategies for patients with such extragenital comorbidities.
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Grossberg AJ, Galwankar SC. Cerebral Venous Thrombosis in Pregnant and Postpartum Women Presenting to the Emergency Department with Headaches. J Emerg Trauma Shock. 2024 Jan-Mar;17(1):3-7. doi: 10.4103/jets.jets_92_23.
Ribes M.F. Des recherches faites sur la phlebite // Rev. Med. Franc. Etrang. 1825.
Abercrombie J. Pathological and Practical Researches on Diseases of the Brain and Spinal Cord. Edinburgh: Waugh and Innes; 1828.
Symonds CP. Cerebral thrombophlebitis. Br Med J. 1940; 2: 348–52. doi: 10.1136/bmj.2.4158.348.
Camargo E. C., Singhal A. B. Stroke in pregnancy: a multidisciplinary approach. Obstetrics and Gynecology Clinics. 2021; 48(1): 75-96.
Allroggen H., Abbott R. Cerebral venous sinus thrombosis. Postgrad. Med. J. 2000;76:12—15.
Torre V. D., Bertuccio A., Robba C. Neuroanesthesia and Pregnancy //Co-existing Diseases and Neuroanesthesia. – Singapore : Springer Singapore, 2018; 211-226.
Diana Aguiar de Sousa et al Safety of Pregnancy After Cerebral Venous Thrombosis A Systematic Review. Stroke. 2016; 47:713-718. DOI: 10.1161/ STROKEAHA.115.011955.
Игнатьева А. С., Абасова Г. Б., Кайшибаева Г. С. Церебральный венозный тромбоз и беременность: этиология, клинико-эпидемиологическая характеристика и методы диагностики. Журнал «Нейрохирургия и неврология Казахстана». 2016; 3 (44): 15-20.
Cauldwell M., Rudd A., Nelson-Piercy C. Management of stroke and pregnancy. Eur Stroke J. 2018;3(3):227–236. https://doi.org/: 10.1177/2396987318769547.
Cantu-Brito C., Arauz A., Aburto Y., Barinagarrementeria F., Ruiz-Sandoval J.L., Baizabal-Carvallo J.F. Cerebrovascular complications during pregnancy and postpartum: clinical and prognosis observations in 240 Hispanic women. Eur J Neurol. 2011;18:819–825. doi:10.1111/j.1468-1331.2010.03259.x.
Dicpinigaitis AJ, Sursal T, Morse CA, Briskin C, Dakay K, Kurian C, Kaur G, Sahni R, Bowers C, Gandhi CD, Mayer SA, Al-Mufti F. Endovascular Thrombectomy for Treatment of Acute Ischemic Stroke During Pregnancy and the Early Postpartum Period. Stroke. 2021; 52:3796–804.
Ясинская А. С. и др. Церебральный венозный тромбоз у молодой женщины в послеродовом периоде. Практическая медицина. 2022; 20(2): 117-120.
Максимова М.Ю., Дубовицкая Ю.И. Брюхов В.В., Кротенкова М.В. Диагностика тромбоза мозговых вен и венозных синусов. РМЖ. 2017;(21):1595–1601.
AlSerehi AA, Al Mufarrih BM, Abu-Shaheen A, Saleh A, AlSheef M. Safety of pregnancy after cerebral venous thrombosis: A case-control study. Health Sci Rep. 2024 Feb 15;7(2):e1872. https://doi.org/10.1002/hsr2.1872.
Ferro JM, Aguiar de Sousa D. Cerebral venous thrombosis: an update. Curr Neurol Neurosci Rep. 2019;19(10):74. 10.1007/s11910-019-0988-x
Alshoabi SA. Cerebral venous sinus thrombosis: A diagnostic challenge in a rare presentation. Brain Circ. 2017;3(4):227-230. doi:10.4103/bc.bc_27_17.
Kular S, Ram R, Balian V, Tse G, Coley S, Jivraj S, Nagaraja S. Mechanical thrombectomy for acute stroke in pregnancy. Neuroradiol J. 2020 Apr;33(2):134-139. https://doi.org/10.1177/1971400919900635.
Hassan MA, Omar AA, Mohamed IA. Postpartum Cerebral Venous Sinus Thrombosis: A Case Report. Vasc Health Risk Manag. 2023 Jan 30;19:63-67 https://doi.org/10.2147/VHRM.S390098.
Ferro JM, Bousser MG, Canhão P, Coutinho JM, Crassard I, Dentali F, di Minno M, Maino A, Martinelli I, Masuhr F, Aguiar de Sousa D, Stam J; European Stroke Organization. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology. Eur J Neurol. 2017; 24(10): 1203-1213. doi: 10.1111/ene.13381.
Gazioglu S, Dinc G. Cerebral venous sinus thrombosis in pregnancy and puerperium. Acta Neurol Belg. 2021;121(4):967-972.
Макацария А. Д., Акиньшина С. В., Бицадзе В.О. Тромбоз церебральных вен в акушерско-гинекологической практике. Акушерство, гинекология и репродукция. 2014; 8(1):54-59.
Лукина O.В., Бубнова E.В., Амосов В.И., Фиалковский Г.A. Церебральные венозные тромбозы: возможности современных высокотехнологичных методов лучевой диагностики. Лучевая диагностика и терапия. 2019; (1):26-32. doi: http://dx.doi.org/10.22328/2079-5343-2019-10-1-26-3.
Moriyama T, Sugiura Y, Hayashi Y, Kinoshita F, Yamamura R, Moriya M, Tatsumi C, Yokoe M, Nagatsuka K, Ishihara M, Goto T, Nishio M, Watanabe Y. Thrombolysis and Mechanical Thrombectomy for Acute Ischemic Stroke in Pregnancy: A Case Report. J Neuroendovasc Ther. 2021;15(2):124-128. doi: 10.5797/jnet.cr.2020-0102.
LR, Mandzia J, Menon B, Pikula A, Poppe A, Saposnik G, Sharma M, Bhogal S, Smitko E, Lindsay MP. Canadian Stroke Best Practice Consensus Statement: Acute Stroke Management during pregnancy. Int J Stroke. 2018 Oct;13(7):743-758. doi: 10.1177/1747493018786617.
Cen N, Horeczko J, Iyengar P. Acute ischemic stroke in the third trimester of pregnancy: a case of successful treatment with tenecteplase and thrombectomy. Practical Neurology (US). 2025;24
Soydinc HE, Ozler A, Evsen MS, Sak ME, Turgut A, Basaranoglu S, Dusak A, Cetincakmak MG. A case of cerebral sinus venous thrombosis resulting in mortality in severe preeclamptic pregnant woman. Case Rep Obstet Gynecol. 2013;2013:402601.
Ахвледиани К.Н., Логутова Л.С., Травкина А.А., Будыкина Т.С., Мельников А.П. Церебральный венозный тромбоз у беременных. Российский вестникакушера-гинеколога.2020;20(2):41-46. https://doi.org/10.17116/rosakush20202002141
Shaikh, Safiya Imtiaz; Kumari, R. Vasantha; Hegade, Ganapati; Marutheesh, M.. Perioperative Considerations and Management of Patients Receiving Anticoagulants. Anesthesia: Essays and Researches 2017;11(1):10-16, https://doi.org/10.4103/0259-1162.179313.
Bojda M, Cimprichová A, Vavríková B, Filipková A, Gdovinová Z. Intravenous thrombolysis for stroke in pregnancy should be administered if the benefit outweighs the risk: A case report and recommended diagnostic workup. Womens Health (Lond). 2021;17:1745506521999495. https://doi.org/10.1177/1745506521999495.
Mahmoud A, Ekin U, Kania B, Shrouf A, Maroules M. Cerebral venous sinus thrombosis in pregnancy presenting with hemiplegia: A case report. Radiology Case Reports. 2022; 17(10):3713-3717. https://doi.org/10.1016/j.radcr.2022.07.006.
Zheng, M., Li, L., Chen, L. et al. Mechanical thrombectomy combined with intravenous thrombolysis for acute ischemic stroke: a systematic review and meta-analyses. Sci Re. 2023; 13, 8597. https://doi.org/10.1038/s41598-023-35532-7
EL Malky I., Abdelkhalek HM. Intravenous thrombolysis before thrombectomy in acute ischemic stroke: a dual centre retrospective cohort study. Sci Rep 2022; 12: 21071. https://doi.org/10.1038/s41598-022-25696-z.
Краснопольский В.И., Логутова Л.С., Ахвледиани К.Н., Травкина А.А., Петрухин В.А, Лубнин А.Ю., Хейреддин А.С., Будыкина Т.С., Аксенов А.Н., Головин А.А., Мельников А.П. Цереброваскулярные заболевания и беременность. Акушерство и гинекология. 2017;8:50-58.
Algahtani H, Bazaid A, Shirah B, Bouges RN. Cerebral venous sinus thrombosis in pregnancy and puerperium: A comprehensive review. Brain Circ. 2022; 8(4):180-187. https://doi.org/ 10.4103/bc.bc_50_22
Kashkoush AI, Ma H, Agarwal N, Panczykowski D, Tonetti D, Weiner GM, Ares W, Kenmuir C, Jadhav A, Jovin T, Jankowitz BT, Gross BA. Cerebral venous sinus thrombosis in pregnancy and puerperium: A pooled, systematic review. J Clin Neurosci. 2017; 39:9-15. https://doi.org/10.4103/bc.bc_50_22.
Shoewu O A, Harrison J, Auda A H, et al. (March 06, 2025) A Case Report on Cerebral Venous Sinus Thrombosis With Factor V Leiden Mutation in the Postpartum Period. Cureus 17(3): e80158. https://doi.org/10.7759/cureus.80158
Coutinho, J. M., Zuurbier, S. M., et al. Effect of Endovascular Treatment with Medical Management vs Standard Care on Severe Cerebral Venous Thrombosis: The TO-ACT Randomized Clinical Trial. JAMA Neurology. 2020. 77(8):966-973. https://doi.org/10.1001/jamaneurol.2020.1022
Meng SH, Li JH, Zuo LJ, Feng LM. The outcomes of pregnant and postpartum patients with cerebral venous sinus thrombosis after anticoagula
Шифман Е. М., Куликов А. В., Братищев И. Тромбоз венозных синусов мозга (синус-тромбоз) у беременных, рожениц и родильниц Клинические рекомендации, протокол лечения. 2015: 263.
Folkins S, Miller A, Nash CM. Risk of venous thromboembolism in pregnant patients with active malignancy: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2024;103(4):645-652. doi: 10.1111/aogs.14712.
Bleau N, Patenaude V, Abenhaim HA. Risk of venous thrombo-embolic events in pregnant patients with cancer. J Matern Fetal Neonatal Med. 2016;29(3):380-4. doi: 10.3109/14767058.2015.1009439.
Bates SM, Rajasekhar A, Middeldorp S, McLintock C, Rodger MA, James AH, Vazquez SR, Greer IA, Riva JJ, Bhatt M, Schwab N, Barrett D, LaHaye A, Rochwerg B. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv. 2018 Nov 27;2(22):3317-3359. doi: 10.1182/bloodadvances.2018024802.
Witt DM, Nieuwlaat R, Clark NP, Ansell J, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy. Blood Adv. 2018 Nov 27;2(22):3257-3291. doi: 10.1182/bloodadvances.2018024893.
Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral venous sinus thrombosis incidence is higher than previously thought: a retrospective population-based study. Stroke. 2016;47:2180-2182.
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