title: Cerebral venous sinus thrombosis in a woman using the etonogestrel-ethinyl estradiol vaginal contraceptive ring: a case report.
abstract: BACKGROUND
  The vaginal contraceptive ring is a hormonal contraceptive that releases etonogestrel and ethinyl estradiol. Cerebral venous sinus thrombosis (CVST) is a rare but serious complication of hormonal contraceptive use.
  
  
  METHODS
  We present a case of CVST in a 33-year-old nulligravid woman who was using a vaginal contraceptive ring. At the time of presentation, she had been using the ring for 18 months, having previously used oral contraceptives for 13 years. She had no additional risk factors for thrombosis apart from cigarette smoking. Despite vigorous management, the patient died from the effects of the CVST.
  
  
  CONCLUSIONS
  The serious adverse effects of the vaginal contraceptive ring are not well known, although deep vein thrombosis, pulmonary embolism, and aortic thrombosis in association with use of the ring have been reported to Health Canada. Continuing post-market surveillance of thrombotic risk in users of the vaginal contraceptive ring is critical.
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Dunne
authors.forename: Doug
authors.initials: D
authors.lastname: Malyuk
authors.forename: Tabassum
authors.initials: T
authors.lastname: Firoz
mesh_terms: D000328:Adult; D001926:Brain Death; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects*; D004967:Estrogens / Q000008:administration & dosage / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D012851:Sinus Thrombosis, Intracranial / Q000139:chemically induced* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
chemical_list: D003271:Contraceptive Agents, Female; D004967:Estrogens; C044815:etonogestrel; D004997:Ethinyl Estradiol; D017135:Desogestrel