CEREBRAL VENOSUS SINUS THROMBOSIS IN A HEALTHY WOMEN TAKING ORAL CONTRACEPTIVE: A CASE REPORT AND REVIEW OF LITERATURE

Abstract

SUMMARY Cerebral venous sinus thrombosis (CVST) is rare than arterial thrombosis. It can affect all age groups but is seen mostly in young women. The diagnosis of CVST is not easy because of variability of clinical symptoms and signs. The patients can present with headache, papilledema, focal deficit, seizures and coma. The most frequent symptom is severe headache. The most common causes of CVST are pregnancy, puerperium, systemic inflammatory diseases, inherited and acquired coagulation disorders, trauma, lumbar puncture, drugs and infection. The use of oral contraceptive (OC) increases the risk of cerebral sinus thrombosis. If there is an additional hereditary prothrombotic factor, the risk of CVST is more. CVST affects superior sagittal sinus and the lateral sinuses more frequently. More than one sinus is affected in one-third of cases. Computed tomografi helps to exclude other intracranial condition but diagnostic value of CT in CVST is limited. Combination of magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) have replaced cerebral angiography for diagnosis of CVST. The treatment of CVST contain supportive (hydration, antibiotheraphy, anticonvulsant) and anticoagulan treatment. Heparin is effective and safety for the treatment of CVST because of this, it is the first-line treatment. The safety of heparin treatment also has been shown in those patients who had hemorrhagic infarcts. Outcomes of CVST is variable from death to complete improvement, but in general it is favorable. Recurrence of CVT is not common. Herein we present a 33-years old previously healthy women with CVST who taking OC.