{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:50Z","timestamp":1787755310689,"version":"build-2784847793"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>The goal of this study was to provide data about neurosurgical management of cerebral venous sinus thrombosis in young women after use of oral contraceptives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 1990 and 2007, the authors treated 15 women (age range 23\u201345 years) in whom neurosurgical management was used for overt thrombosis of cerebral sinus. All were healthy, with a history of use of oral contraceptives. Severe headache was the most common symptom, followed by motor focal deficits and comatose state. Deep infarcts were located in the thalamic and basal ganglia region in 11 cases. Seven women had associated intracerebral hemorrhage, and 3 had ventricular dilation. Angiographic MR imaging was done in 10 patients, and conventional angiography was done in 7. Genetic analysis of chromosomal abnormalities associated with stroke was done in 5 cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The intracranial pressure (ICP) was monitored in all cases. Three patients underwent external ventricular drainage, and 1 had a decompressive craniotomy. All had absence of signal in the cerebral sinus rectus, with associated thrombosis of the transverse sinus in 7 cases. Angiograms were negative for additional vascular malformation. Medical treatment included sodium heparin and mannitol in 9 cases, and enoxaparin in the other 6 patients. Genetic analysis was positive for prothrombin mutation G20210A (factor II variant) in 2 cases. The mean follow-up duration of 53 months demonstrated no neurological deficit in 10 patients, hemiparesis in 3, and severe hemiparesis with aphasia in 1 case. One woman died 5 days after a decompressive craniotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cerebral venous sinus thrombosis secondary to oral contraception in young women, including lesions in critical and deep regions, can be treated medically with acceptable morbidity. In spite of this, a subgroup of patients needed basic neurosurgical management of the lesions, including surgical measures for controlling raised ICP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2009.8.focus09158","type":"journal-article","created":{"date-parts":[[2009,10,30]],"date-time":"2009-10-30T10:00:32Z","timestamp":1256896832000},"page":"E5","source":"Crossref","is-referenced-by-count":15,"title":["Cerebral venous sinus thrombosis associated with oral contraceptives: the case for neurosurgery"],"prefix":"10.3171","volume":"27","author":[{"given":"Marcelo","family":"Galarza","sequence":"first","affiliation":[{"name":"Regional Service of Neurosurgery, \u201cVirgen de la Arrixaca\u201d University Hospital, Murcia, Spain; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Gazzeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0270005","series-title":"Cerebrovasc Dis","first-page":"331","article-title":"Heparin treatment in acute cerebral sinus venous thrombosis: a retrospective clinical and MR analysis of 42 cases","volume":"8","author":"Brucker","year":"1998"},{"key":"b2-0270005","series-title":"J Neurosurg","first-page":"347","article-title":"A transcranial approach for direct mechanical thrombectomy of dural sinus thrombosis. Report of two cases","volume":"101","author":"Chahlavi","year":"2004"},{"key":"b3-0270005","series-title":"Stroke","first-page":"1420","article-title":"Endovascular treatment of dural sinus thrombosis with rheolytic thrombectomy and intra-arterial thrombolysis","volume":"31","author":"Chow","year":"2000"},{"key":"b4-0270005","series-title":"JAMA","first-page":"1573","article-title":"Estrogen plus progestin and risk of venous thrombosis","volume":"292","author":"Cushman","year":"2004"},{"key":"b5-0270005","series-title":"Eur Neurol","first-page":"245","article-title":"Cerebral venous thrombosis and estrogen-progesterone therapy","volume":"39","author":"Duvelleroy Hommet","year":"1998"},{"key":"b6-0270005","series-title":"Lancet","first-page":"83","article-title":"Population-based study of risk of venous thromboembolism associated with various oral contraceptives","volume":"349","author":"Farmer","year":"1997"},{"key":"b7-0270005","series-title":"Eur J Neurol","first-page":"e5","article-title":"Cerebral venous thrombosis associated with repeated use of emergency contraception","volume":"14","author":"Horga","year":"2007"},{"key":"b8-0270005","series-title":"Neurology","first-page":"1216","article-title":"Oral contraceptives and stroke in young women: a clinicopathologic correlation","volume":"28","author":"Irey","year":"1978"},{"key":"b9-0270005","series-title":"Contraception","first-page":"197","article-title":"Cerebral thrombosis and oral contraceptives: a five year case-control study","volume":"65","author":"Lidegaard","year":"2002"},{"key":"b10-0270005","series-title":"Stroke","first-page":"747","article-title":"Oral contraceptives and stroke","volume":"15","author":"Longstreth","year":"1984"},{"key":"b11-0270005","series-title":"N Engl J Med","first-page":"1793","article-title":"High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives","volume":"338","author":"Martinelli","year":"1998"},{"key":"b12-0270005","series-title":"N Engl J Med","first-page":"8","article-title":"Stroke in users of low-dose oral contraceptives","volume":"335","author":"Petitti","year":"1996"},{"key":"b13-0270005","series-title":"J Neurosurg","first-page":"65","article-title":"Endovascular thrombolysis for symptomatic cerebral venous thrombosis","volume":"90","author":"Philips","year":"1999"},{"key":"b14-0270005","series-title":"Angiology","first-page":"399","article-title":"Combined protein C deficiency and protein C activated resistance as a cause of caval, peripheral, and cerebral venous thrombosis\u2014a case report","volume":"49","author":"Pugliese","year":"1998"},{"key":"b15-0270005","series-title":"Br J Haematol","first-page":"851","article-title":"Hormonal replacement therapy, prothrombotic mutations and the risk of venous thrombosis","volume":"116","author":"Rosendaal","year":"2002"},{"key":"b16-0270005","series-title":"Eur Neurol","first-page":"115","article-title":"Extended hemorrhagic infarction following isolated cortical venous thrombosis","volume":"41","author":"Rudolf","year":"1999"},{"key":"b17-0270005","series-title":"Neurosurgery","first-page":"534","article-title":"Extensive experience with dural sinus thrombosis","volume":"52","author":"Soleau","year":"2003"},{"key":"b18-0270005","series-title":"Cardiovasc Intervent Radiol","first-page":"675","article-title":"Cerebral venous congestion as indication for thrombolytic treatment","volume":"30","author":"Tsai","year":"2007"},{"key":"b1-0270005","series-title":"Cerebrovasc Dis","first-page":"331","article-title":"Heparin treatment in acute cerebral sinus venous thrombosis: a retrospective clinical and MR analysis of 42 cases","volume":"8","author":"Brucker","year":"1998"},{"key":"b2-0270005","series-title":"J Neurosurg","first-page":"347","article-title":"A transcranial approach for direct mechanical thrombectomy of dural sinus thrombosis. 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