1/2. cavernous sinus thrombosis following manipulation of fractured nasal bones.Septic cavernous sinus thrombosis is a serious infective condition with a high mortality and morbidity. We report the first case to our knowledge of septic cavernous sinus thrombosis following manipulation of fractured nasal bone under general anaesthesia. The patient later developed complications of pneumonia with pleural effusion, a vegetative lesion of the mitral valve, and blindness.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. Dural puncture and activated protein c resistance: risk factors for cerebral venous sinus thrombosis.OBJECTIVES: Dural puncture is regarded a safe procedure when contraindications are carefully excluded and has so far not been recognised as a risk factor for cerebral venous sinus thrombosis (CVST). Five patients are described with CVST after dural puncture in the presence of additional risk factors. methods: In four out of five patients complete investigations for thrombophilia were performed at least one month after withdrawal of oral anticoagulation. RESULTS: In three out of four patients tested, activated protein C (APC) resistance due to heterozygous coagulation factor v R506Q mutation (factor v Leiden) was found. One patient was using oral contraceptives as a circumstantial risk factor and three had had spinal anaesthesia for surgical procedures. family history of venous thromboembolism was negative in all patients. Retrospective evaluation of 66 patients with CVST disclosed that dural puncture was the fourth most common risk factor (8%) possibly contributing to thrombosis. CONCLUSION: Dural puncture may constitute an additional risk factor for CVST especially in patients with APC resistance or surgery. In such patients a thrombophilia screen is indicated.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |