Cerebral venous thrombosis after total knee arthroplasty: clinical case report

Abstract

Introduction. Cerebral venous thrombosis (CVT) represents a rare subtype of stroke involving cerebral veins and sinuses, characterized by challenging diagnosis due to its atypical clinical presentations and low occurrence. Emphasis on thrombosis prophylaxis post-prosthesis surgery is essential due to increased risk in these patients. Case statement. This case study focuses on a 66-year-old female who developed CVT following total knee arthroplasty, a scenario that heightens thrombosis risk. We detail her clinical progression, diagnostic imaging, and laboratory results, alongside a comparative analysis of similar cases in existing literature. The case underscores the importance of preemptive measures against venous thrombosis in postoperative care. The patient, presenting with altered consciousness, convergent strabismus, and left-sided hemiparesis, was admitted three days postsurgery of total knee replacement. Initial CT findings showed a significant cerebellar lesion, with subsequent CTA confirming right transverse sinus thrombosis. Emergency EVD placement and prompt anticoagulant therapy was administered, leading to her discharge with minimal residual impairments after 36 days of comprehensive treatment. Discussions. CVT diagnosis demands high clinical suspicion and an integrated approach between clinical and radiological teams due to its diverse manifestations and rarity. This case particularly highlights the importance of vigilant thrombosis prophylaxis in post-prosthesis surgery patients, a demographic with elevated risk. Conclusion. CVT is an uncommon yet critical condition that manifests diversely, necessitating a multidisciplinary approach for timely diagnosis and management. The presented case illustrates the importance of thrombosis prophylaxis in postoperative care, particularly following prosthesis surgery. Adhering to established treatment protocols and preventive measures significantly improves outcomes, as evidenced in this patient's recovery. cerebral veins and sinuses, characterized by challenging di agnosis due to its atypical clinical presentations and low occurrence. Emphasis on thrombosis prophylaxis post-prosthesis surgery is essential due to increased risk in these patients. Case statement. This case study focuses on a 66-year-old female who devel oped CVT following total knee arthroplasty, a scenario that heightens thro mbosis risk. We detail her clinical progression, diagnostic imaging, and laboratory results, a longside a comparative analysis of similar cases in existing literature. The case underscore s the importance of preemptive measures against venous thrombosis in postoperative care. The patie nt, presenting with altered consciousness, convergent strabismus, and left-sided hemipa resis, was admitted three days postsurgery of total knee replacement. Initial CT findings sh owed a significant cerebellar lesion, with subsequent CTA confirming right transverse sinus thrombosis. Emergency EVD placement and prompt anticoagulant therapy was administered, leading to h er discharge with minimal residual impairments after 36 days of comprehensive treatment. Discussions. CVT diagnosis demands high clinical suspicion and an integr ated approach between clinical and radiological teams due to its diverse manifest ations and rarity. This case particularly highlights the importance of vigilant thrombosis prophylaxis in post-prosthesis surgery patients, a demographic with elevated risk. Conclusion. CVT is an uncommon yet critical condition that manife sts diversely, necessitating a multidisciplinary approach for timely diagnosis and manage ment. The presented case illustrates the importance of thrombosis prophylaxis in postoperative care, particularly following prosthesis surgery. Adhering to established treatment protocols and preven tive measures significantly improves outcomes, as evidenced in this patient's recover y.