Rakesh Kumar¹, Pushpanjali R Ojha²*, Uday K. J. Khasage³ and Praveen K. Biradar⁴

¹1Junior Resident, Emergency Medicine, BLDE ( Deemed to be University/ Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India
²Assistant Professor of Pathology, Ranchi University/Rajendra Institute of Medical Sciences, Jharkhand, India
³Associate Professor, Emergency Medicine, BLDE ( Deemed to be University/ Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India
⁴Assistant Professor, Emergency Medicine,BLDE ( Deemed to be University/ Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India

*Corresponding Author: Pushpanjali R Ojha, Assistant Professor of Pathology, Ranchi University/Rajendra Institute of Medical Sciences, Jharkhand, India.

Received: December 30, 2022; Published: March 13, 2023

Abstract

Vein of Labbe thrombosis is an uncommon subtype of cerebral venous thrombosis (CVT). It clinically presents as headache, focal seizures, mass effect or altered sensorium. Severity of illness is multifactorial: degree of thrombosis, patency, blockage or hypoplasia of opposite vein, presence or absence of collateral anastomosing circulation, proximity with ventricles, size of infarct etc. Though it’s a rare site to be involved by thrombosis but most frequent among young pregnant women as a subtype of CVT. There are five variants of Vein of Labbe reported in literature among which left sided type I Vein of Labbe variant is more common among young females. Therapeutic dose of Low molecular weight heparin (LMWH) is the treatment of choice in acute event of CVT during pregnancy followed by prophylactic dose till postpartum period. We present a rare and interesting case of Vein of Labbe thrombosis in which history of trauma misled the early diagnosis. A young pregnant female presented to ED with complaints of loss of consciousness, vomiting, generalized headache and right ear bleeding within 24hours of encountering a road traffic accident. The patient was evaluated as cerebral injury and Vein of Labbe (left) thrombosis was an incidental finding noticed in MRV imaging with normal platelet counts and coagulation profiles. She was managed conservatively and show drastic improvement without administration of LMWH. Antithrombotic agents were not used in this case because of her progressive clinical improvement, reduction in size of infarct with time, no evidence of development of new infarct, normal coagulation profile and post-traumatic thrombotic event. This case is presented to emphasize that CVT may develop secondary to trauma and not always as a consequence of hypercoagulable state in pregnancy, vein of Labbe thrombosis must be looked into consideration in traumatic case of CVT if patient is a young pregnant women and antithrombotic agents are not mandatory in treatment if coagulation profile is normal. This case is interesting in its clinical presentation, development of CVT in spite of normal coagulation profile, rare site of thrombosis (Vein of Labbe), clinical improvement without administration of anti-thrombotic agents, good clinical outcome and prognosis with no residual effects.

Keywords: Cerebral Venous Thrombosis (CVT); Vein of Labbe; Pregnancy; Antithrombotic Agents

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Citation

Citation: Pushpanjali R Ojha., et al. “Post-Traumatic Vein of Labbe Thrombosis Presenting as Hemorrhagic Venous Infarct in a Pregnant Female: An Interesting Rare Entity with Diagnostic Challenges". Acta Scientific Neurology 6.4 (2023): 22-27.

Copyright

Copyright: © 2023 Pushpanjali R Ojha., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.