Norethisterone-induced subacute on chronic cerebral venous sinus thrombosis with secondary intracranial hypertension in a young woman: A case report

Abstract

Background: Cerebral venous sinus thrombosis is associated with several etiologies and may present with various symptoms. Oral contraceptives are one of the potential risk factors for cerebral venous sinus thrombosis (CVST) apart from infection and genetically acquired prothrombotic states. Abnormal uterine bleeding (AUB) is one of the common clinical conditions in gynecology practice, for which hormonal therapy is prescribed. Progestogens are relatively safe compared to combined estrogen and progesterone hormonal pills and hence a preferred therapy for AUB management. Case Report: We report a subacute on chronic CVST with secondary intracranial hypertension, probably induced by norethisterone intake in a young woman for AUB management. Diagnosis: CVST is diagnosed by contrast-enhanced computed tomography, magnetic resonance imaging, or MR venography. Treatment: CVST is treated with heparin and switched to warfarin anticoagulant therapy. Conclusion: Physicians need to have a high index of suspicion of CVST and treat the condition to prevent significant morbidity and mortality.

Keywords

• cerebral venous sinus thrombosis
• headache
• norethisterone acetate