Cerebral venous sinus thrombosis in the setting of combined vaginal contraception.
We present a case of a 27-year-old women admitted to the hospital with migraine and left upper extremity weakness. Subsequent imaging with computed tomography and magnetic resonance angiography/venography demonstrated an acute-appearing central venous sinus thrombosis. Her only risk factor for venous thromboembolism (VTE) was the use of etonogestrel/ethinyl estradiol vaginal contraceptive ring (NuvaRing). The contraceptive ring was removed and the patient was treated according to the current guidelines. She achieved full neurologic recovery at 6 months' follow-up. Here, we describe this unusual case and review the risk of VTE between combined vaginal contraception and combined oral contraception.
aSUNY Upstate Medical University, Syracuse, New York bUniversity of Utah Health Sciences Center, Salt Lake City, Utah, USA.
Timothy L
TL
Vo
Rhett M
RM
Cook
Matthew T
MT
Rondina
David
D
Kaplan
D000328:Adult; D017135:Desogestrel / Q000009:adverse effects / Q000031:analogs & derivatives*; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D012307:Risk Factors; D012851:Sinus Thrombosis, Intracranial / Q000209:etiology* / Q000628:therapy; D054556:Venous Thromboembolism / Q000209:etiology* / Q000628:therapy
D004338:Drug Combinations; C516519:NuvaRing; D004997:Ethinyl Estradiol; D017135:Desogestrel