NEUROLOGY 2h

1.What can be  the cause of her condition ?      

The cause for the patient condition is cerebral venous thrombosis (cvst)

2.What are the risk factors for  cortical vein thrombosis?

*Prothrombotic 

conditions

Hereditary: factor V Leiden mutation, 

antithrombin III deficiency, protein C/S 

deficiency, and G20210A prothrombin gene 

mutation

Acquired: These are transient forms and are 

considered specific to females. It includes 

pregnancy, puerperium, oral contraceptive pill 

use, and hormonal replacement therapy

*Infections 

Intracranial: meningitis

Systemic: HIV, tuberculosis, and sepsis

Local: otitis media, mastoiditis, oral, sinus, and 

head and neck infections

*Mechanical trauma

Head trauma

Neurosurgical procedures

Jugular vein catheterization

LP

*Vasculitis Systemic lupus erythematosus

Sjogren’s syndrome

Temporal arteritis

Antiphospholipid syndrome

Thromboangitis obliterans

Wegener’s granulomatosis

Behcet’s disease

*Intracranial defects

Tumors

Arteriovenous malformations

Dural fistula

Venous anomalies

*Hematological: Essential thrombocythemia

Myeloproliferative malignancies

Primary and secondary polycythemia

Paroxysmal nocturnal hemoglobinuria

*Systemic diseases

Dehydration

Malignancies

Thyroid disease

Sarcoidosis

Obesity

Nephrotic syndrome

Inflammatory bowel disease

*Drugs :

Hormone therapy: tamoxifen, glucocorticoids, 

and androgens

Inhibitors of angiogenesis: thalidomide

Hemostatic therapy

Chemotherapy: cyclosporine and l-asparaginase

3.There was seizure free period in between but again sudden episode of GTCS why?resolved spontaneously  why? 

Seizures are resolved and seziure free period is acheived by medical intervention  but sudden episodes of seizures could be due to the persistence of excitable foci by abnormal firing of neurons

4) What drug was used in suspicion of cortical venous sinus thrombosis?

Clexane is low molecular weight  heparin its ablood thinner containing ,Enoxaparin as its active ingredient.

Mechanism of action:

Enoxaparin binds to and potentiates antithrombin (a circulating anticoagulant) to form a complex that irreversibly inactivates clotting factor Xa. It has less activity against factor IIa (thrombin) compared to unfractionated heparin (UFH) due to its low molecular weight.

**Clexane 40mg Injection is an anticoagulant used to prevent and treat harmful blood clots. *It stops the existing clots from getting any bigger and restricts the formation of any new clot. It is also helpful in the prevention of blood clots in veins, a condition called deep vein thrombosis, and pulmonary embolism.