Cerebral Venous Sinus Thrombosis (CVST) Correlation to Oral Contraceptive Pills (OCP) Use: A Case Report

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon form of intracranial thrombosis characterised by the formation of a blood clot within the cerebral venous drainage system, including the dural venous sinuses, cortical veins, and the deep venous structures such as the vein of Galen system. Which is considered a subtype of venous thromboembolism. Common presenting features of CVST are symptoms of raised intracranial pressure, headaches, seizures, focal neurological deficits and altered sensorium. Seventy percent of CVST cases result from a hypercoagulable state.It also refers to acute Thrombosis or blood clots that can lead to strokes. Oral contraceptive pills (OCPs) are extensively utilised both for contraception and for the treatment of various gynaecological disorders, providing substantial benefits to women’s health. Nevertheless, their administration is also linked to a spectrum of potential adverse health effects. We report a case of female patient presented with intermittent fever, headache, dizziness, generalized weakness, and gastrointestinal symptoms. She had a history of hypothyroidism and was recently diagnosed with PCOS, for which she was on combined oral contraceptives. Initial evaluation indicated anemia and minor metabolic abnormalities. Persistent neurological symptoms followed by seizures prompted further evaluation with contrast-enhanced CT (Computed Tomography) of the brain, which showed haemorrhagic venous infarcts in the left temporo-occipital region with surrounding edema, leading to the diagnosis of Cerebral Venous Sinus Thrombosis likely associated with oral contraceptive use. The suspected drug was discontinued, and treatment with low-molecular-weight heparin was initiated. The patient improved clinically and was discharged in stable condition. This case highlights the risk of oral contraceptive-associated CVST and the importance of early diagnosis and prompt anticoagulation.