Cerebral Venous Sinus Thrombosis during Early First Trimester of Pregnancy

Cerebral venous sinus thrombosis is a rare condition. The most frequent symptoms and signs are headache, focal seizures with or without secondary generalization, unilateral or bilateral paresis and papilledema. We report a case of a 30-year-old woman, gravida-4, parity-3, at 8weeks of pregnancy who was admitted for one episode of tonic-clonic seizures and altered sensorium. A magnetic resonance scan of her brain showed the presence of acute venous infarct magnetic resonance venography ultimately revealed left sigmoid, transverse and superior sagittal sinus and cortical vein thrombosis. The pregnancy was terminated and she was treated with low molecular weight heparin (LMWH) followed by warfarin. Though patient developed monoparesis later on and there was evidence of hemorrhagic transformation of the infarct, she had excellent recovery a few weeks after admission and was regularly followed up. Due to its diverse neurological presentation, cerebral venous sinus thrombosis should be considered in all brain syndromes even during pregnancy and should be treated with anti-coagulation.