Jssn Vol 17 No1_final to print copy.pdf


2JSSN Journal of Society of Surgeons of Nepal

JSSN 2014; 17 (1)

Original Article

Oral Contraceptive Consumption and Cerebral Venous 

sinuses Thrombosis

Jha Gupta Kukum1, Jha Rajiv2

1

2

Correspondence:

Abstract

Introduction: 

consumption of OCPs, treated in the department of Neurosurgery, Bir hospital and OM hospital, 

Methods

Results

found included papilloedema, fever, slurring of speech and focal neurological signs.

Conclusion

Key Words: 

Introduction

potentially deadly condition. Known conditions that 

states, dehydration, adjacent infectious processes, 

replacement therapy, pregnancy, and puerperium.1,2



3JSSN Journal of Society of Surgeons of Nepal

JSSN 2014; 17 (1)

untreated, the intracranial pressure continues to rise and 

the vascular supply is compromised, leading to ischemia. 

indicated depending on the person’s neurological status 

and diagnostic results.1

with systemic anticoagulation therapy with heparin and 
2

retrieval for rapid recanalization of the affected sinus can 

interventional neuroradiology.

with consumption of OCPs, its presentation, and early 

outcome.

Methods

This was a retrospective case series carried out in the

department of Neurosurgery, Bir hospital and OM hospital 

analyzed and complications associated with anticoagulation 

for. Follow up was made at three months. 

Results

oral contraceptive pills. Majority of the patients were 

from 3rd th

Table 1: Presenting symptoms (No of Patients)

Presenting symptoms No of Patients

headache 9

vomiting

loss of conciousness 1

seizure 1

(paresis)
1

fever 1

neck pain 1

Papilloedema 6

paresis 1

1

hemianopia 1

slurring of speech 2

(Fig. 1). One patient had Straight sinus involvement and 

managed conservatively and recovery was uneventful. 

month’s follow up.

Figure 1: Pre- and post treatment CT Scan



JSSN Journal of Society of Surgeons of Nepal

JSSN 2014; 17 (1)

Figure 2: MR Venogram Showing obliteration of left 

Transverse and Sigmoid sinus

Discussion

varied clinical presentation usually affecting middle-aged 

healthcare cost and utilization project, estimated that 

deliveries, and that increased maternal age was a major 

of the estrogenic component irrespective of the route of 

administration. More recent data showed a higher incidence 

and gestodene) rather than second-generation progestins 

(e.g. levonorgestrel and norgestrel), with an estimated 

generation preparations. The procoagulant effect of oral 

contraceptive pills (OCPs) is due to the resultant increase in 

the levels of coagulation factors and decreases in the levels 
9

than women who do not.

11

concomitant oral contraceptive use had an increased odds 

women that did not carry this defect.13

 It is generally accepted 

a graded scheme of precautions when considering which 

patients should not use hormonal contraception. Women 

given OCP.13

history of headache with focal neurological symptoms, 

concomitant vascular disease), patients with liver disease, 

intracranial hypertension. Benign intracranial hypertension 



JSSN Journal of Society of Surgeons of Nepal

JSSN 2014; 17 (1)

References

1.

2.

3.

contraceptives with differing progestagen components. 

8.

in low dose oestrogen oral contraceptives on venous 

9.

of levonorgestrel- and desogestrel-containing low 

11.

12.

13.

venous MR angiography for diagnosis and follow-up.