{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:46:55Z","timestamp":1782406015663,"version":"3.54.5"},"reference-count":19,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Neurol"],"abstract":"<jats:p>Introduction: Cerebral venous sinus thrombosis (CVST) is a rare but serious manifestation of venous thromboembolism (VTE), accounting for 0.5\u20131% of all strokes. While typically affecting younger females, its diagnosis remains challenging due to nonspecific presentations. Risk factors include hormonal therapy, thrombophilia, and hematologic disorders, with emerging links to COVID-19\/vaccine-induced thrombotic thrombocytopenia and polycystic ovarian syndrome. Although combined oral contraceptives are known to increase thrombotic risk, the association between progestogen-only agents such as norethisterone and CVST remains less clearly defined, particularly in the presence of additional risk factors. Case Presentation: A 27-year-old female on 1 month of norethisterone for menstrual disorders (plus unsupervised levothyroxine) presented with severe headache, visual disturbances, and imbalance \u2013 initially misdiagnosed as gastritis. She had a family history of VTE and COVID-19 vaccination. CT showed hyperdense venous sinuses; MRV confirmed extensive thrombosis (superior sagittal, transverse, straight sinuses). Laboratories revealed marked TSH suppression (&lt;0.005 \u00b5IU\/mL). Management included therapeutic enoxaparin, levetiracetam prophylaxis, and levothyroxine discontinuation. The patient demonstrated rapid clinical improvement within 24 h, with near-complete radiographic resolution at 1-month follow-up after transitioning to apixaban. Conclusion: Norethisterone may precipitate early-onset CVST in patients with multiple prothrombotic risk factors, warranting cautious use and careful clinical evaluation.<\/jats:p>","DOI":"10.1159\/000552250","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T16:00:59Z","timestamp":1778256059000},"page":"249-259","source":"Crossref","is-referenced-by-count":0,"title":["Early Onset of Cerebral Venous Sinus Thrombosis in a 27-Year-Old Woman Receiving Norethisterone: A Rare Case Report"],"prefix":"10.1159","volume":"18","author":[{"given":"Mohammad Pazhman","family":"Sediqi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Jamalzai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaha","family":"Esmat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ramin","family":"Hamidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Wahed","family":"Sidiqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nommanudien","family":"Naibkhil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Sharif","family":"Sediqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1159\/000509802"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2024.08.012"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.5455\/2320-1770.ijrcog20140347"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000456"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000036366"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s42466-024-00320-9"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25105228"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)10266-0"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1212\/01.CON.0000446105.67173.a8"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000117571.76197.26"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1161\/str.0b013e31820a8364"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199806183382502"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2020-200619"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.4103\/AMJM.AMJM"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.4103\/njpt.njpt_55_25"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2017-222418"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-022-02914-z"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-022-03463-y"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.4103\/sjmms.sjmms_22_19"}],"container-title":["Case Reports in Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:01:07Z","timestamp":1782403267000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000552250","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32088729","asserted-by":"subject"}]},"ISSN":["1662-680X"],"issn-type":[{"value":"1662-680X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]}}}