Recurring headache during pregnancy may be due to a blood clot in brain

Cerebral venous sinus thrombosis

(CVST) is a rare but potentially life-threatening medical condition in pregnant women. CVST is a rare form of stroke caused by blood clots formed in the brain’s venous sinuses. Pregnancy may cause changes in the coagulation system that persist into the puerperium and lead to hypercoagulation, thus raising the risk of CVST. Caesarean section, systemic infection, vomiting, and anaemia increase the risk. The highest-risk period is the third trimester and the first 4 weeks postpartum. Risk factors for the disease include pregnancy, oral contraception, and dehydration, or more permanent ones such as thrombotic disease, genetic thrombophilia, and cancer.
According to Dr. Kunal Bahrani, Clinical Director & HOD-Neurology, Marengo Asia Hospitals Faridabad, “Headache is the most common symptom frequently complained about by patients with cerebral venous sinus thrombosis. Other symptoms patients present include headache, blurred vision, fainting or loss of consciousness, loss of control over movement in part of the body, seizures, and coma. If CVST is left untreated, it can lead to complications including speech problems, difficulty moving parts of the body, problems with vision, headaches, increased fluid pressure inside the skull, pressure on nerves, and brain injury. In some cases, it may turn fatal for the patients.”

Who is at risk?

Women with certain risk factors, such as being overweight, smoking, diabetes, or prior traumas or surgeries, are at higher risk of developing blood clots in the brain during pregnancy.
Dr. Tarun Sharma, Program Clinical Director-Brain & Spine Surgery, Marengo Asia Hospitals Faridabad says, Pregnancy is a hyperdynamic and hypercoagulable state. In simple words, during pregnancy, ladies are prone to high blood pressure and blood clotting. This clot can form anywhere in body. This is technically called Deep Venous Thrombosis (DVT). When this clot forms inside brain, this is called Cerebral Venous Sinus Thrombosis (CVST). The clinical presentation is commonly headache, vomiting and may be seizures. Women ignore the common symptoms, headache and vomiting during the phase of pregnancy and get altered on seizures. So, public awareness is important for timely reporting to Doctor and further treatment.

Diagnosis of blood clot in the brain

To diagnose CVST, areas of blood flow in the brain are identified. To evaluate the blood flow in the brain, patients are advised to undergo imaging tests such as MRI brain, MR venogram, CT venogram, & blood tests. When CVTS is suspected, the patient should promptly seek medical attention and see a neurologist.

Treatment of CVST

To manage CVST, anticoagulation is followed as the first-line therapy. If a patient is observed with neurological deterioration or coma despite medical treatment, endovascular therapy or surgical intervention can be considered to manage further.

Prevention of CVST

To reduce the risk of CVST, people are advised to eat a low-fat diet, including lots of fruits and vegetables. They should exercise daily. Refrain from cigarette smoke. Control chronic health conditions such as diabetes.