Oral Contraceptive Induced Cerebral Venous Thrombosis Treated by Local Catheter Directed Thrombolysis

Abstract

We report on a case of cerebral venous thrombosis (CVT) induced by oral contraception (OC) activated coagulopathy and its endovascular treatment. Deep venous system and dural sinuses thrombosis complicated with severe neurological deficit and coma due to right thalamic edema and ischemia in a young woman was treated by local thrombolysis with an administration of 0.6 mg/h of the rtPA and the concomitant intravenous unfractioned heparin infusion (700 IU/h). 3D-Xra digital rotational venography performed at the beginning and after treatment confirmed thrombus resolution with rapid flow restoration. Dynamic flow imaging gives interesting information on the deep venous system and the cortical venous collectors drainage. Final NIHSS (National Institute of Health Stroke Scale) and mRS (modified Rankin Scale) confirmed an excellent clinical outcome of the interventional therapy.