# Behind the Headache: A Case of Cerebral Venous Thrombosis Associated With Hormonal Contraceptive Use

## TL;DR

A 26-year-old woman developed a rare brain vein blood clot linked to hormonal birth control, highlighting the need for careful contraceptive choices.

## Contribution

This case report emphasizes the association between combined hormonal contraceptives and cerebral venous thrombosis.

## Key findings

- A 26-year-old woman on combined hormonal contraceptives developed cerebral venous thrombosis.
- Anticoagulation treatment resolved the thrombosis and symptoms.
- Combined hormonal contraceptives were identified as the main risk factor despite negative thrombophilia screening.

## Abstract

Cerebral venous thrombosis is an uncommon but potentially life-threatening condition. We present the case of a previously healthy 26-year-old woman who developed cerebral venous thrombosis while using a combined hormonal contraceptive. She presented with progressive headaches unresponsive to analgesics. Imaging confirmed thrombosis in the left transverse and sigmoid sinuses and the left internal jugular vein. Anticoagulation was initiated with full resolution of symptoms and thrombus. Extensive thrombophilia screening was negative, and combined hormonal contraceptive use was identified as the main risk factor. The patient transitioned to a progestogen-only method. This case highlights the need to consider cerebral venous thrombosis in women with atypical headaches using combined hormonal contraceptives. It also emphasizes the importance of personalized contraceptive counseling based on thrombotic risk factors.