Guarin-Rivera Syndy, Gil-Lancheros María, Castillo-Ramírez Cristian, Utria-Munive Jesus
Internal Medicine Service, Méderi Barrios Unidos University Hospital, Bogota, COL.
Epidemiology and Biostatistics, University Foundation of Health Sciences (FUCS), Bogota, COL.
Cureus. 2025 Jun 23;17(6):e86576. doi: 10.7759/cureus.86576. eCollection 2025 Jun.
Cerebral venous thrombosis (CVT) is a condition that may affect women of childbearing age and is, in some cases, associated with risk factors such as oral contraceptive use. This case describes the presentation of a case of cerebral venous sinus thrombosis in a woman of childbearing age who uses oral contraceptives. A 28-year-old woman presented to the internal medicine service with a clinical picture of intense right temporo-occipital headache of eight days of evolution associated with flashes of light and vertigo without improvement with analgesics. She has a history of use of cyproterone acetate and ethinylestradiol for acne management initiated one month prior, with cerebral MR venography revealing venous thrombosis of the right transverse, petrosal, and sigmoid sinuses, requiring anticoagulation with low-molecular-weight heparin (LMWH). Autoimmune diseases and thrombophilia were ruled out. Therefore, CVT can be considered in the differential diagnosis of all headaches of recent onset and refractory to treatment, especially in women of childbearing age, with cerebral resonance angiography being essential for the diagnosis. Anticoagulation is the cornerstone of treatment.
脑静脉血栓形成(CVT)是一种可能影响育龄女性的疾病,在某些情况下,与口服避孕药等危险因素有关。本病例描述了一名使用口服避孕药的育龄女性发生脑静脉窦血栓形成的情况。一名28岁女性因内科就诊,临床表现为右颞枕部剧烈头痛,病程8天,伴有闪光和眩晕,使用镇痛药后无改善。她有在一个月前开始使用醋酸环丙孕酮和炔雌醇治疗痤疮的病史,脑部磁共振静脉造影显示右侧横窦、岩窦和乙状窦静脉血栓形成,需要使用低分子肝素(LMWH)进行抗凝治疗。排除了自身免疫性疾病和易栓症。因此,在近期发作且治疗难治的所有头痛的鉴别诊断中都应考虑CVT,尤其是育龄女性,脑部磁共振血管造影对诊断至关重要。抗凝是治疗的基石。