Add like
Add dislike
Add to saved papers

Cerebral venous sinus thrombosis associated with oral contraceptives: the case for neurosurgery.

Neurosurgical Focus 2009 November
OBJECT: The goal of this study was to provide data about neurosurgical management of cerebral venous sinus thrombosis in young women after use of oral contraceptives.

METHODS: Between 1990 and 2007, the authors treated 15 women (age range 23-45 years) in whom neurosurgical management was used for overt thrombosis of cerebral sinus. All were healthy, with a history of use of oral contraceptives. Severe headache was the most common symptom, followed by motor focal deficits and comatose state. Deep infarcts were located in the thalamic and basal ganglia region in 11 cases. Seven women had associated intracerebral hemorrhage, and 3 had ventricular dilation. Angiographic MR imaging was done in 10 patients, and conventional angiography was done in 7. Genetic analysis of chromosomal abnormalities associated with stroke was done in 5 cases.

RESULTS: The intracranial pressure (ICP) was monitored in all cases. Three patients underwent external ventricular drainage, and 1 had a decompressive craniotomy. All had absence of signal in the cerebral sinus rectus, with associated thrombosis of the transverse sinus in 7 cases. Angiograms were negative for additional vascular malformation. Medical treatment included sodium heparin and mannitol in 9 cases, and enoxaparin in the other 6 patients. Genetic analysis was positive for prothrombin mutation G20210A (factor II variant) in 2 cases. The mean follow-up duration of 53 months demonstrated no neurological deficit in 10 patients, hemiparesis in 3, and severe hemiparesis with aphasia in 1 case. One woman died 5 days after a decompressive craniotomy.

CONCLUSIONS: Cerebral venous sinus thrombosis secondary to oral contraception in young women, including lesions in critical and deep regions, can be treated medically with acceptable morbidity. In spite of this, a subgroup of patients needed basic neurosurgical management of the lesions, including surgical measures for controlling raised ICP.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

Related Resources

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app