Cerebral Venous Sinus Thrombosis Associated With Contraceptive Use: A Case Report

Abstract

Cerebral venous thrombosis (CVT) is a condition that may affect women of childbearing age and is, in some cases, associated with risk factors such as oral contraceptive use. This case describes the presentation of a case of cerebral venous sinus thrombosis in a woman of childbearing age who uses oral contraceptives. A 28-year-old woman presented to the internal medicine service with a clinical picture of intense right temporo-occipital headache of eight days of evolution associated with flashes of light and vertigo without improvement with analgesics. She has a history of use of cyproterone acetate and ethinylestradiol for acne management initiated one month prior, with cerebral MR venography revealing venous thrombosis of the right transverse, petrosal, and sigmoid sinuses, requiring anticoagulation with low-molecular-weight heparin (LMWH). Autoimmune diseases and thrombophilia were ruled out. Therefore, CVT can be considered in the differential diagnosis of all headaches of recent onset and refractory to treatment, especially in women of childbearing age, with cerebral resonance angiography being essential for the diagnosis. Anticoagulation is the cornerstone of treatment.

Keywords: cerebral venous thrombosis; headache; oral contraceptives; thrombosis; women.

Figure 1. Sagittal CT slicing of the single skull

Hyperdensity of the right transverse sinus

Figure 2. Coronal CT scan of the single skull

Hyperdensity at the level of the right transverse sinus

Figure 3. Axial CT scan of the single skull

Hyperdensity in the right transverse sinus pathway

Figure 4. Sagittal section of the brain

Absence of flow from the right transverse and sigmoid sinuses

Figure 5. Coronal section of the brain

Absence of flow from the right transverse sinus

Figure 6. Coronal section of the brain

Recanalization of the affected venous sinuses

Figure 7. Sagital section of the brain

Recanalization of the affected venous sinuses