Oral contraceptive consumption and cerebral venous sinuses thrombosis
Introduction: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and the clinical presentation is variable. One of the more common acquired risk factors of venous sinus thrombosis is oral contraceptive medications. While the prognosis for CVST is favorable, it is important to identify...
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| Format: | Article |
| Language: | English |
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Society of Surgeons of Nepal
2016-07-01
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| Series: | Journal of Society of Surgeons of Nepal |
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| Online Access: | https://www.nepjol.info/index.php/JSSN/article/view/15173 |
| _version_ | 1818775211937366016 |
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| author | Jha Gupta Kukum Jha Rajiv |
| author_facet | Jha Gupta Kukum Jha Rajiv |
| author_sort | Jha Gupta Kukum |
| collection | DOAJ |
| description | Introduction: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and the clinical presentation is variable. One of the more common acquired risk factors of venous sinus thrombosis is oral contraceptive medications. While the prognosis for CVST is favorable, it is important to identify and treat early to prevent neurologic deficits. CVST accounts for 0.5% of strokes and most commonly presents with headaches and in many cases focal neurologic deficits. Diagnosis is confirmed with neuroimaging including CT angiography or MR angiography. Treatment consists of anticoagulation and in some cases, thrombolytic therapy is beneficial. The overall prognosis of CVST is favorable.
The objective of the study is to describe the features of a series of patient with CVST due to consumption of OCPs, treated in the department of Neurosurgery, Bir hospital and OM hospital, and to discuss the risk factors associated with consumption of OCPs, its presentation, and outcome.
Methods: This is a retrospective case series carried out in the department of Neurosurgery, Bir hospital and OM hospital during the year September 2012 to September 2014. Demographic features like age, presenting symptoms, clinical findings and outcome were analyzed. All cases received heparin or LMWH followed by Warfarin.
Results: Nine patients were identified over a period of 2 years. The presenting symptoms included headache, vomiting, loss of consciousness, focal neurological deficit, seizure and neck pain. Signs found included papilloedema, fever, slurring of speech and focal neurological signs.
Conclusion: Dural sinus thrombosis is a rare and under-recognized cause of headache that should be considered in women with recent introduction of hormonal contraception. The absence of papilledema and a negative CT brain should not halt further workup. MRI/venogram is mandatory to confirm the diagnosis.
Journal of Society of Surgeons of Nepal Vol.17(1) 2014: 2-5 |
| first_indexed | 2024-12-18T10:53:26Z |
| format | Article |
| id | doaj.art-6937a4b820654ff88ecb8eb6a0bf680c |
| institution | Directory Open Access Journal |
| issn | 1815-3984 2392-4772 |
| language | English |
| last_indexed | 2024-12-18T10:53:26Z |
| publishDate | 2016-07-01 |
| publisher | Society of Surgeons of Nepal |
| record_format | Article |
| series | Journal of Society of Surgeons of Nepal |
| spelling | doaj.art-6937a4b820654ff88ecb8eb6a0bf680c2022-12-21T21:10:23ZengSociety of Surgeons of NepalJournal of Society of Surgeons of Nepal1815-39842392-47722016-07-0117110.3126/jssn.v17i1.15173Oral contraceptive consumption and cerebral venous sinuses thrombosisJha Gupta Kukum0Jha Rajiv1Gynaecology and Obstetrics Department, Yangtze University, Nanhuam Road, Jingzhou, HubeiDepartment of Neurosurgery, National Academy of Medical Sciences, Bir Hospital, KathmanduIntroduction: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and the clinical presentation is variable. One of the more common acquired risk factors of venous sinus thrombosis is oral contraceptive medications. While the prognosis for CVST is favorable, it is important to identify and treat early to prevent neurologic deficits. CVST accounts for 0.5% of strokes and most commonly presents with headaches and in many cases focal neurologic deficits. Diagnosis is confirmed with neuroimaging including CT angiography or MR angiography. Treatment consists of anticoagulation and in some cases, thrombolytic therapy is beneficial. The overall prognosis of CVST is favorable. The objective of the study is to describe the features of a series of patient with CVST due to consumption of OCPs, treated in the department of Neurosurgery, Bir hospital and OM hospital, and to discuss the risk factors associated with consumption of OCPs, its presentation, and outcome. Methods: This is a retrospective case series carried out in the department of Neurosurgery, Bir hospital and OM hospital during the year September 2012 to September 2014. Demographic features like age, presenting symptoms, clinical findings and outcome were analyzed. All cases received heparin or LMWH followed by Warfarin. Results: Nine patients were identified over a period of 2 years. The presenting symptoms included headache, vomiting, loss of consciousness, focal neurological deficit, seizure and neck pain. Signs found included papilloedema, fever, slurring of speech and focal neurological signs. Conclusion: Dural sinus thrombosis is a rare and under-recognized cause of headache that should be considered in women with recent introduction of hormonal contraception. The absence of papilledema and a negative CT brain should not halt further workup. MRI/venogram is mandatory to confirm the diagnosis. Journal of Society of Surgeons of Nepal Vol.17(1) 2014: 2-5https://www.nepjol.info/index.php/JSSN/article/view/15173Cerebral Venous sinus Thrombosis (CVST)HeparinOCP (Oral Contraceptive pills) |
| spellingShingle | Jha Gupta Kukum Jha Rajiv Oral contraceptive consumption and cerebral venous sinuses thrombosis Journal of Society of Surgeons of Nepal Cerebral Venous sinus Thrombosis (CVST) Heparin OCP (Oral Contraceptive pills) |
| title | Oral contraceptive consumption and cerebral venous sinuses thrombosis |
| title_full | Oral contraceptive consumption and cerebral venous sinuses thrombosis |
| title_fullStr | Oral contraceptive consumption and cerebral venous sinuses thrombosis |
| title_full_unstemmed | Oral contraceptive consumption and cerebral venous sinuses thrombosis |
| title_short | Oral contraceptive consumption and cerebral venous sinuses thrombosis |
| title_sort | oral contraceptive consumption and cerebral venous sinuses thrombosis |
| topic | Cerebral Venous sinus Thrombosis (CVST) Heparin OCP (Oral Contraceptive pills) |
| url | https://www.nepjol.info/index.php/JSSN/article/view/15173 |
| work_keys_str_mv | AT jhaguptakukum oralcontraceptiveconsumptionandcerebralvenoussinusesthrombosis AT jharajiv oralcontraceptiveconsumptionandcerebralvenoussinusesthrombosis |