Recurrent syncope after hysteroscopy finally diagnosed as cerebral venous sinus thrombosis: a case report.

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Tác giả: Danqing Chen, Zhanfu Li, Zhaoxia Liang, Guodong Shan, Qianhui Xie, Guohui Yan, Hongxing Ye, Yongqing Zhang

Ngôn ngữ: eng

Ký hiệu phân loại: 346.04344 Private law

Thông tin xuất bản: United States : AJOG global reports , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 176108

Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular condition that causes obstruction of venous blood flow or cerebrospinal fluid circulation, leading to intracranial hypertension symptoms such as syncope and vomiting. Transurethral Resection of the Prostate (TURP) syndrome, a complication of hysteroscopic surgery, can also present with cerebral edema and symptoms similar to CVST, making differentiation challenging. Cases of unexplained recurrent syncope posthysteroscopy diagnosed as CVST have not been previously reported. We present a case of a 33-year-old woman who underwent hysteroscopy for abnormal uterine bleeding. Five hours postoperation, she experienced syncope, which resolved spontaneously. Ten hours later, she had recurrent syncope, nausea, and vomiting. Head computed tomography suggested cerebral edema, potentially indicating TURP syndrome. However, the brief surgery and minimal fluid imbalance (200 mL) made TURP syndrome unlikely. Further investigation with cranial magnetic resonance venography revealed multiple venous sinus thromboses, explaining the recurrent syncope linked to minimal fluid volume expansion postsurgery. Subsequent screening identified hyperhomocysteinemia as a contributing factor. Treatment with anticoagulants, folic acid, and vitamin B6 led to a favorable outcome. This case involves recurrent syncope after hysteroscopy secondary to CVST. If symptoms such as recurrent syncope, nausea, and vomiting, indicating increased intracranial pressure, arise posthysteroscopy and cannot be attributed to typical TURP syndrome, primary intracranial vascular conditions like CVST should be considered, as even a minor increase in blood volume can exacerbate these intracranial pressure symptoms.
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