Cerebral Venous Thrombosis in the Users of Hormonal Contraceptives

Czech version

Authors: M. Procházka ¹; V. Procházka ² ; M. Lubušký ¹; J. Procházková ³; T. Hrbáč ⁴
Authors‘ workplace: Porodnicko-gynekologická klinika LF UP a FN Olomouc ¹; Radiodiagnostický ústav FN Ostrava-Poruba ²; Hemato-onkologická klinika LF UP a FN Olomouc ³; Neurochirurgická klinika FN Ostrava-Poruba ⁴
Published in: Cesk Slov Neurol N 2007; 70/103(6): 678-684
Category: Short Communication

Poděkování: Autoři si dovolují poděkovat školiteli a příteli doc. MUDr. Pavlu Drábkovi z Neurochirurgické kliniky Fakultní nemocnice Ostrava-Poruba za odbornou pomoc a podporu při zpracovávání tohoto náročného tématu.

Overview

Cerebral venous thrombosis (CVT) is a dangerous disease with a difficult diagnosis. We present a retrospective analysis of 8 cases of CVT in young women who were hospitalised between April 2004 and October 2005. Thrombophilic markers were examined in all patients. The most common symptoms included headache (100%), vertigo (87.5%), hemiparesis or quadruparesis (62.5%). CT and MRI showed different types of parenchymal lesion infarction or vasogenic inflation in 62.50% and petechial haemorrhage in 25%. DSA venography confirmed the site of occlusion in the lateral and sigmoide sinus in 75%, and superior sagittal sinus (62.5%). We found 3 cases of the homozygous form of methylenetetrahydrofolate reductase (MTHFR-C677T), two patients had a plasminogen activator inhibitor-1 (PAI-1) homozygous mutation. Coexisting thrombophilic risk factors are usually involved in the onset of CVT. Early diagnosis and application of thrombolytic therapy can improve the clinical outcome.

Key words:
cerebral venous thrombosis – hormonal contraception – thrombophilia – local fibrinolysis

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