COEXISTENCE OF CEREBRAL VENOUS SINUS AND INTERNAL CAROTID-ARTERY THROMBOSIS ASSOCIATED WITH EXOGENOUS SEX-HORMONES - A CASE-REPORT

A forty-six-year-old premenopausal woman developed headache, nausea an d vomiting, left hemiparesis, and seizure two days after parenteral us e of progesterone and estradiol. Diabetes mellitus (DM) was found duri ng admission. Computed tomography showed a hemorrhagic infarct in the right frontal lobe and increased density in the superior sagittal sinu s (SSS). Left carotid angiography found occlusion of the left internal carotid artery (ICA). Right carotid angiograms failed to show the SSS and inferior sagittal sinus, suggestive of venous sinus thrombosis. C oexistence of the cerebral artery and the venous sinus occlusion has b een described infrequently. In this case, the authors postulate that t he use of estradiol and progesterone and the underlying DM increased v ascular thrombogenicity, which provided a common denominator for throm bosis of both the ICA and the venous sinus.