Abstract
Cerebral venous sinus thrombosis (CVT) is a rare cause of stroke and the clinical presentation is variable, thus mimicking other neurologic pathologies. One of the more common acquired risk factors of venous sinus thrombosis is oral contraceptive medications such as Yaz. While the prognosis for CVT is favorable, it is important to identify and treat early to prevent neurologic deficits. We report two cases of young female patients who presented with sinus thrombosis and review the current literature on this topic. CVT 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 CVT is favorable but, further research is needed to outline optimal treatment options including the duration of anticoagulation therapy and the role of thrombolytic therapy to prevent serious neurologic deficits.
Highlights
Cerebral venous sinus thrombosis (CVT) is a rare cause of cerebral injury, accounting for approximately 0.5% of all strokes [1,2,3,4,5,6]
CT scans of patients with sinus thrombosis depict a hyperatenuating thrombus in the occluded sinuses; this sign is only present in approximately 25% of patients [4,17, 29]
Filling defects in the sinus known as the “empty delta sign” suggest thrombosis; this sign is only present in 29% of patients [4,5,22,29]
Summary
Cerebral venous sinus thrombosis (CVT) is a rare cause of cerebral injury, accounting for approximately 0.5% of all strokes [1,2,3,4,5,6]. The World Health Organization recommends avoiding using OCPs in women who have thrombogenic mutations, who smoke, are older than 35 years of age, and who have given birth 21 days prior to starting an OCP to prevent thromboembolic complications [8]. Despite these risks, 64% of women in their reproductive age use some method of contraception, most commonly OCPs [8,9]. We describe two low risk patients taking Yaz who presented with sinus thrombosis and review the current literature on this topic
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