Puerperal cerebral venous thrombosis associated with decreased free protein S: a case report.

BACKGROUND: Cerebral venous thrombosis is a rare event with multiple risk factors. This condition can be associated with a hypercoagulable state, such as that seen with dysfunctional or decreased plasma protein C and protein S. Both plasma proteins are naturally occurring, vitamin K-dependent anticoagulants that are important for regulation of the clotting cascade. CASE: A postpartum patient presented with complaints of a severe headache and hypertension and later developed status epilepticus. She was found to have superior sagittal sinus and right internal jugular vein thrombosis and protein S deficiency. CONCLUSION: The combination of protein S deficiency and the further reduction due to pregnancy may enhance the risk of major thrombotic episodes in the peripartum period.