A lady delivered a normal vaginal delivery and was discharged. On third day she came back with fever, tachycardia and seizures. Fundus showed papilledema with no focal deficits. What is the most likely diagnosis?
(A) Coical vein thrombosis (B) Meningitis (C) Subarachnoid hemorrhage (D) Acute migraine
(A) Answer- A. Coical vein thrombosisCoical Vein Thrombosis (CVT)Incidence of CVT is increased during pregnancy & in puerperiumIncidence appears higher in developing countries.Predisposing Factors:Prothrombotic conditions, OCPs, pregnancy, puerperiumMalignancy, infection & head injuryClinical Features:MC presenting symptom: Headaches (of gradual, acute, or thunderclap onset)Associated features may include focal neurological sings, seizures and coma.Diagnosis:Diagnosis is done with MR venography.Treatment:Anticonvulsants for seizures; heparinization is recommended by most, its efflcacy is controversial.Antimicrobials for septic thrombophlebitisFibrinolytic therapy is reserved for those women failing systemic anticoagulation