Superior sagittal sinus thrombosis as unusual cause of headache: case report |
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Authors: | Enrico Tessitore Claudio Schonauer Francesco Fera Alessandro Tessitore |
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Institution: | (1) Operative Unit of Neurotraumatology, Department of Neurosurgery, Second University of Naples, Naples, Italy, IT;(2) Institute of Experimental Medicine and Biotechnology, National Research Council, Cosenza, Italy, IT;(3) Via Astalonga 180, I-80047, San Giuseppe Vesuviano (NA), Italy, e-mail: tessenri@libero.it, Tel.: +39-081-5295438, Fax: +39-081-5296353, IT |
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Abstract: | Headache is the most frequent symptom in patients with cerebral venous thrombosis. However, patients presenting with headache
due to cerebral venous thrombosis are uncommon. The association between oral contraceptives and cerebral venous thrombosis
is well known. We report the case of a young woman who was admitted to our department for sudden onset of headache. She had
been taking oral contraceptives for 6 months. Early pharmacological approach with analgesics failed to elleviate symptoms.
Magnetic resonance imaging (MRI) showed thrombosis of the posterior and middle thirds of the superior sagittal sinus (SSS).
Because the patient was oligosymptomatic, medical treatment with high-dose heparin was started. A clinical follow-up showed
headache regression after 2 weeks of therapy. Subsequent MRI showed partial recanalization of the SSS. The patient continued
oral anticoagulants for 3 months. Eighteen months after discharge, the patient was symptom-free. We conclude that new, persistent
or atypical headaches in patients taking oral contraceptives should be carefully evaluated for cerebral venous thrombosis.
Received: 9 May 2001 / Accepted in revised form: 4 September 2001 |
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Keywords: | Cerebral venous thrombosis Headache Oral contraceptives Heparin |
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