International Journal of Clinical Obstetrics and Gynaecology
2025, Vol. 9, Issue 4, Part A
The silent clot: Post-abortion cerebral venous sinus thrombosis unmasked
Author(s): Priyanka Jadhav and Padmaja Kumbhar
Abstract: Cerebral venous sinus thrombosis (CVST) is an uncommon but potentially life-threatening condition that may complicate pregnancy and the postpartum period due to the hypercoagulable state associated with these stages. CVST following medical termination of pregnancy (MTP) is extremely rare and poses significant diagnostic challenges due to its variable presentation. We report the case of a 32-year-old woman who developed severe, persistent headache and vomiting after emergency dilatation and curettage for retained products of conception following medical abortion. Neurological examination revealed no focal deficits, but neuroimaging confirmed thrombosis involving the right transverse and sigmoid sinuses extending into the jugular bulb and proximal internal jugular vein. Thrombophilia screening was unremarkable except for heterozygosity for the MTHFR C677T mutation. The patient was treated promptly with anticoagulation and supportive care, resulting in complete clinical recovery and radiological resolution on follow-up. This case highlights the importance of maintaining a high index of suspicion for CVST in postpartum patients presenting with persistent headache, even in the absence of focal signs, and emphasizes the role of early neuroimaging and timely anticoagulation in achieving a favourable outcome.
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