Abstract

Background: Cerebral venous sinus thrombosis (CVST) occurring during the puerperium is a rare yet life-threatening condition. The management of CVST becomes more complex when complicated by heparin-induced thrombocytopenia (HIT), a prothrombotic adverse effect of heparin therapy.
Case presentation: A case of puerperium-associated CVST with HIT is presented, in which fondaparinux was utilized as an alternative anticoagulant during the acute phase, followed by rivaroxaban. A multidisciplinary approach was employed, which included hematoma drainage, decompressive craniectomy, and endovascular recanalization. The patient achieved a favorable outcome, with a modified Rankin scale score of 2 at the 3-month follow-up.
Conclusion: This case highlights the potential safety and efficacy of fondaparinux in the management of CVST with HIT, emphasizing the critical role of a multidisciplinary approach in optimizing patient recovery.

Author Details

Authors

• Meng Qi^{1, 2, 3}
• Xuebing Feng^{1, 2, 3}
• Lidan Jiang^{1, 2, 3}
• Caikun Wu⁴
• Xiaoxia Zhang⁵
• Ping Guo⁶
• Ning Wang^{1, 2, 3}
• Yueqiao Xu^{1, 2, 3}

Departments

• ¹ Critical Care Unit, Department of Neurosurgery, Capital Medical University Xuanwu Hospital,
• ² National Center for Neurological Disorders,
• ³ China International Neuroscience Institute, Beijing,
• ⁴ Department of Neurosurgery, Xingguo People’s Hospital, Xingguo Hospital Affiliated to Gannan Medical University, Ganzhou, Jiangxi,
• ⁵ Department of Critical Care Medicine, Wuhan Fourth Hospital, Puai Hospital Affiliated to Jianghan University, Wuhan, Hubei, and
• ⁶ Stroke Ward, Xuchang Central Hospital Affiliated to Henan University of Science and Technology, Xuchang, Henan, China

Address

Yueqiao Xu, MD, PhD
Critical Care Unit, Department of Neurosurgery
Capital Medical University Xuanwu Hospital
45 Changchun Street, Xicheng District,
Beijing 100053, China
Email: [email protected]

Citation