{"id":521,"date":"2014-08-18T11:34:32","date_gmt":"2014-08-18T15:34:32","guid":{"rendered":"http:\/\/scholarblogs.emory.edu\/curbsideconsult\/?p=521"},"modified":"2014-08-18T11:34:32","modified_gmt":"2014-08-18T15:34:32","slug":"pregnant-with-headache","status":"publish","type":"post","link":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/2014\/08\/18\/pregnant-with-headache\/","title":{"rendered":"Pregnant with headache"},"content":{"rendered":"<p><b><span style=\"text-decoration: underline\">Presentation:<\/span><\/b>\u00a0 37 yo F with progressive headache, R hand tingling, and incidentally found on this ER visit to be pregnant.<\/p>\n<p><b><span style=\"text-decoration: underline\">\u00a0<\/span><\/b><b><span style=\"text-decoration: underline\">Top 5 Teaching Points Cerebral Vein Thrombosis (1):\u00a0<\/span><\/b><\/p>\n<p>1)\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s rare:\u00a0 about 1:100,000 in a year (but about 11:100,000 in pregnant women)<\/p>\n<p>2)\u00a0\u00a0\u00a0\u00a0\u00a0 Pt\u2019s present with a progressively worsening localizing headache over days (as venous pressure builds, capillaries leak and CSF reabsorption is impaired)<\/p>\n<p>3)\u00a0\u00a0\u00a0\u00a0\u00a0 As the disease progresses, global features (SZ, depressed consciousness) present, however, focal deficits occur as well.<\/p>\n<p>4)\u00a0\u00a0\u00a0\u00a0\u00a0 Non contrast CT and CT venogram, when combined, are sensitive and specific for the diagnosis and equivalent to MRV.<\/p>\n<p>5)\u00a0\u00a0\u00a0\u00a0\u00a0 Fractionated heparin (Lovenox) performs better than unfractionated heparin, and anticoagulation is not contraindicated in patients with intracerebral hemorrhage related to cerebral venous thrombosis (2).<\/p>\n<p>&nbsp;<\/p>\n<p>1) \u00a0Ferraro JM, Canhao P.\u00a0 Etiology, clinical features, and diagnosis of cerebral venous thrombosis In: UpToDate, Kassner SE. (Ed), UpToDate,\u00a0Waltham, MA. (Accessed on August 18, 2014.)<\/p>\n<p>2) Einh\u00e4upl K, Stam J, Bousser MG, De Bruijn SF, Ferro JM, Martinelli I, Masuhr F, EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. \u00a0European Federation of Neurological Societies Eur J Neurol. 2010;17(10):1229.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Presentation:\u00a0 37 yo F with progressive headache, R hand tingling, and incidentally found on this ER visit to be pregnant. \u00a0Top 5 Teaching Points Cerebral Vein Thrombosis (1):\u00a0 1)\u00a0\u00a0\u00a0\u00a0\u00a0 It\u2019s rare:\u00a0 about 1:100,000 in a year (but about 11:100,000 in pregnant women) 2)\u00a0\u00a0\u00a0\u00a0\u00a0 Pt\u2019s present with a progressively worsening localizing headache over days (as venous &hellip; <\/p>\n<p><a class=\"more-link btn\" href=\"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/2014\/08\/18\/pregnant-with-headache\/\">Continue reading<\/a><\/p>\n","protected":false},"author":1935,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_s2mail":"yes","footnotes":""},"categories":[24,4],"tags":[131],"class_list":["post-521","post","type-post","status-publish","format-standard","hentry","category-clinical-questions","category-neurology","tag-cerebral-vein-thrombosis","item-wrap"],"_links":{"self":[{"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/posts\/521","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/users\/1935"}],"replies":[{"embeddable":true,"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/comments?post=521"}],"version-history":[{"count":1,"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/posts\/521\/revisions"}],"predecessor-version":[{"id":522,"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/posts\/521\/revisions\/522"}],"wp:attachment":[{"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/media?parent=521"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/categories?post=521"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/scholarblogs.emory.edu\/curbsideconsult\/wp-json\/wp\/v2\/tags?post=521"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}