HEMORRHAGIC COMPLICATIONS AND CRITICAL CARE CHALLENGES DURING HEPARIN PRESCRIPTION: A CASE REPORT

Periorbital ecchymosis occurs due to head and face trauma, base skull fracture, craniotomy or ophthalmic operations. There are some less common causes including: hematologic disorders (coagulation disorders, thrombocytopenia), vascular disorders (hemangioendothelioma, varicose veins around the eyes), inflammatory diseases (myositis, amyloidosis), skin disorders (herpes simplex), migraine and increased intracranial pressure. In this paper we have presented a 31 years old lady who developed headache, diplopia and unilateral periorbital ecchymosis spontaneously during the 5th week of pregnancy without any history of head and neck trauma or surgery. Ophthalmologic exam, blood pressure and primary lab data were normal. In further evaluations, superior sagittal sinus thrombosis was diagnosed based on to the brain CT, MRI and MR venography results. Therapeutic dose of unfractionated heparin started. Some hemorrhagic complication occurred but disappeared with supportive care. The patient's symptoms gradually vanished within a week after her admission. Patient continued the pregnancy by using therapeutic dose of low molecular weight heparin without any complications. Pregnancy was terminated by cesarean section in the 38th weeks without any complication for the mother and the newborn.