Cerebral thrombosis in woman receiving oral contraceptives: report of two cases
Maruyama, I.; Kazama, M.; Abe, T.
Japanese Journal of Clinical Hematology 21(6): 822-827
1980
ISSN/ISBN: 0485-1439 PMID: 7463738 Document Number: 468765
It is well known that thromboembolism is 1 of the most serious side effects of oral contraceptives (OCs). In Japan, however, reports of thromboembolism following use of OCs are rare, since their clinical use in Japan is restricted to treatment of menstrual irregularities. We reported here on 2 patients affected with cerebrovascular occlusive diseases associated with the administration of OCs. The 1st case was that of a 32-year old woman who developed headaches, paresis, and dysesthesia of the right limbs following daily intake for 20 days of OCs (0.15 mg mestranol and 5 mg lynestrenol). Neurological symptoms as well as examinations led to the diagnosis of a kind of thalamic syndrome due to cerebral thrombosis. The 2nd case was that of a 37-year old woman who developed right hemiparesis following daily consumption over a 21 day period of OCs as administered above. Clinical symptoms and neurological examinations led to the diagnosis of right hemiparesis due to cerebral thrombosis. The pathogenesis of cerebral thrombosis caused by taking OCs was discussed mainly in connection with coagulation and fibrinolysis. Certain evidence suggesting that hypercoagulability may play a major role in the pathogenesis of thromboembolism during OC ingestion has been derived from the works of other investigators. It is true that estrogen in this compound may induce a state in which an increase in coagulation factors together with a decrease of antithrombin 3 combine to produce hypercoagulation; laboratory tests with our patients, however, produced nothing compatible with a state of hypercoagulability. (author's modified)