Title: Cranial Venous Sinus Thrombosis Following Early Spontaneous Abortion: A Case Report
and Literature Review
Version: 2 Date: 14 Jun 2024
Reviewer's report:
This case report significantly contributes to medical knowledge by highlighting a rare but
serious complication: cerebral venous sinus thrombosis (CVST) following an early spontaneous
abortion. The well-organized manuscript provides a thorough description of the patient's case
and a comprehensive discussion. However, there are areas where it could be improved.
Introduction
Rarity Emphasis: Expand the discussion on how rare CVST is following early spontaneous
abortion. Cite any available statistics or studies that highlight this rarity.
Objectives: State clearly that the objective of this case report is to present a novel occurrence
of CVST in this context, and to contribute to the understanding of potential triggers for this
condition.
Gap in Literature: Briefly summarize what is currently known about CVST risk factors and
emphasize that there is limited information on the association with early spontaneous abortion.
Case Presentation
Differential Diagnosis: Add a paragraph or subsection dedicated to the differential diagnosis.
Clearly list the alternative diagnoses that were considered (e.g., migraine, stroke, etc.) and
describe the specific findings (clinical or laboratory) that ruled them out in favor of CVST.
Discussion
Rewrite this section with a more balanced approach. Start by acknowledging that while a causal
relationship is possible, it cannot be definitively established based on a single case. Discuss the
following:
Potential Mechanisms: How could spontaneous abortion theoretically increase the risk of
CVST? (e.g., hypercoagulability, hormonal changes)
Alternative Risk Factors: Could the patient have had other predisposing factors that were not
detected?
Coincidence: Could the CVST occurrence have been entirely unrelated to the abortion?
Gestational Hyperthyroidism: Dedicate a paragraph to analyzing this condition in more detail.
Discuss how it could have potentially contributed to CVST (if at all) based on the current
literature.
Updated Literature Review:
Thoroughly search for and incorporate the latest studies on CVST, especially those published
in the last 2-3 years. Focus on any advancements in diagnostic techniques (e.g., new imaging
modalities), treatment options (e.g., novel anticoagulants), and insights into risk factors.
Conclusion
Summary of Findings:
Clearly restate the key points of the case: a woman with no other apparent risk factors developed
CVST shortly after an early spontaneous abortion.
Implications: Emphasize the clinical importance of being aware of this potential association,
even if it is rare.
Limitations: Explicitly acknowledge the limitations of a single case report in establishing
causality.
Call for Research: Conclude by advocating for prospective studies to investigate the link between
early spontaneous abortion and CVST, as well as research on other potential risk factors.
Additional Revisions
Table: Consider adding a table summarizing the key features of other reported cases of CVST
in pregnancy (if any exist), to provide further context for your case.
Language and Formatting: Thoroughly proofread for any grammatical errors or inconsistencies
in formatting.
Thank you .