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

TL;DR

A 28-year-old woman developed cerebral venous sinus thrombosis after using oral contraceptives, highlighting the condition's link to contraceptive use and the importance of early diagnosis.

Contribution

This case report adds to the understanding of CVT's association with oral contraceptive use in women of childbearing age.

Findings

CVT was diagnosed in a woman using cyproterone acetate and ethinylestradiol for acne.

Anticoagulation with LMWH was effective in treating the thrombosis.

Autoimmune and thrombophilic causes were excluded in this case.

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.

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