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Diagnosis and Management of Mixed Transcortical Aphasia Due to Multiple Predisposing Factors, including Postpartum and Severe Inherited Thrombophilia, Affecting Multiple Cerebral Venous and Dural Sinus Thrombosis: Case Report and Literature Review

Authors :
Dragoș Cătălin Jianu
Silviana Nina Jianu
Traian Flavius Dan
Nicoleta Iacob
Georgiana Munteanu
Andrei Gheorghe Marius Motoc
Adelina Băloi
Daniela Hodorogea
Any Docu Axelerad
Horia Pleș
Ligia Petrica
Anca Elena Gogu
Source :
Diagnostics, Vol 11, Iss 8, p 1425 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

Cerebral venous and dural sinus thrombosis (CVT) is an uncommon disease in the general population, although it is a significant stroke type throughout pregnancy and the puerperium. Studies describing this subtype of CVT are limited. Most pregnancy-associated CVT happen in late pregnancy, or more commonly in the first postpartum weeks, being associated with venous thrombosis outside the nervous system. Case presentation: The current study describes a case of multiple CVT in a 38-year-old woman with multiple risk factors (including severe inherited thrombophilia and being in the puerperium period), presenting mixed transcortical aphasia (a rare type of aphasia) associated with right moderate hemiparesis and intracranial hypertension. The clinical diagnosis of CVT was confirmed by laboratory data and neuroimaging data from head computed tomography, magnetic resonance imaging, and magnetic resonance venography. She was successfully treated with low-molecular-weight heparin (anticoagulation) and osmotic diuretics (mannitol) for increased intracranial pressure and cerebral edema. At discharge, after 15 days of evolution, she presented a partial recovery, with anomic plus aphasia and mild right hemiparesis. Clinical and imaging follow-up was performed at 6 months after discharge; our patient presented normal language and mild right central facial paresis, with chronic left thalamic, caudate nucleus, and internal capsule infarcts and a partial recanalization of the dural sinuses.

Details

Language :
English
ISSN :
20754418
Volume :
11
Issue :
8
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.35a2053662e4a6baa2a6aae19353f71
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics11081425