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Antithrombin III deficiency is a rare hereditary thrombophilia. It is associated with 2-4 fold higher risks for venous thrombosis and starts as early as 21-40 years old. By the age of 50 years, approximately 50% of affected individuals would have experienced the first episode of thrombosis, with women having an earlier average peak incident compared to men (1,2). Thrombosis in patients with antithrombin III deficiency predominantly occurs in venous circulation. Commonly, the thrombosis occurs at deep veins of limbs with subsequent embolus to pulmonary circulations, but it can also occur in unusual sites, such as cerebral, retinal, mesenteric, portal, hepatic, and splenic veins (3). Women with hereditary thrombophilia during pregnancy have higher risks of thrombosis if no thromboprophylaxis is given. The prevalence of a thrombosis seems to be higher during the first trimester of pregnancy as compared to advanced stages of pregnancy or puerperium (4). Here, we report a case of massive cerebral venous sinus thrombosis (CVST) with intracerebral hemorrhage in a young woman in her first trimester pregnancy, with underlying antithrombin III deficiency that leads to a fatal maternal outcome.

international journal of women's health and reproduction sciences

A Case Report of Fatal Outcome of Cerebral Venous Sinus Thrombosis With Cerebral Hemorrhage During Early Pregnancy Secondary to Antithrombin III Deficiency