Oral Contraceptive-Induced Cerebral Venous Thrombosis: A Case Report

Cerebral venous thrombosis (CVT) is a rare, potentially life-threatening condition that occurs when blood clots form in the venous sinuses of the brain, leading to impaired venous drainage, increased intracranial pressure, and neurological deficits. We discuss the case of a 32-year-old female who presented with a four-day history of worsening headache, nausea, vomiting, and right-sided weakness. She was on oral contraceptive pills (OCPs) for two years for menstrual regulation. Neuroimaging, including non-contrast CT, CT venography, and MRI with MR venography, confirmed the diagnosis of CVT involving the superior sagittal sinus and right transverse sinus, with evidence of venous infarction. Laboratory investigations showed elevated D-dimer, but thrombophilia testing was negative. The patient was immediately started on anticoagulation therapy with low-molecular-weight heparin (LMWH), later transitioned to warfarin, and received supportive care. Symptoms improved significantly within days, and follow-up imaging at three months showed partial recanalization. The patient was advised to discontinue OCPs permanently and provided counseling on alternative contraceptive methods. This report emphasizes the importance of early recognition, timely neuroimaging, and appropriate anticoagulation in the management of OCP-associated CVT. Long-term follow-up is crucial to monitor for recanalization and to reduce the risk of recurrence.