Oral contraceptive drugs, hyperhomocysteinaemia and cerebral ischaemic events in a 31-year-old woman--a case report

We present a case of a 31-year-old female who was admitted to the hospital due to recurrent syncope. Transoesophageal echocardiography revealed the presence of an interventricular septum defect with insignificant left-to-right shunt and excluded intracardiac thrombi. Magnetic resonance of brain showed several ischaemic areas of vascular origin. Tests for arrhythmias or vaso-vagal reflex as the causes of syncope were negative. Further examinations revealed hyperhomocysteinaemia which, together with prolonged oral contraceptive treatment, might have caused cerebral arterial thrombosis.