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May 2016

Obesity, Oral Contraceptive Use, and Cerebral Venous Thrombosis in Women

Author Affiliations
  • 1Department of Neurology, Medical University of South Carolina, Charleston
JAMA Neurol. 2016;73(5):512-513. doi:10.1001/jamaneurol.2015.5107

Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that primarily affects young adults. A unique risk factor profile and plurality of presenting features make it an elusive diagnosis unless a high index of suspicion is maintained. It comprises approximately 0.5% to 1% of all strokes,1 and widespread availability of magnetic resonance imaging has made recognition easier. The International Study on Cerebral Vein and Dural Sinus Thrombosis is the largest prospective, multinational, observational study2 of patients with CVT to date, including 624 consecutive patients with symptomatic CVT at 89 centers between May 1998 and May 2001. Of these patients, 465 were women (74.5%), and they tended to be younger than men at diagnosis (median age, 34 vs 42 years). A total of 301 (65.0%) of these women had an identified sex-specific risk factor, such as oral contraceptive (OC) use, pregnancy, puerperium, or hormonal therapy. It was also observed that women with sex-specific risk factors who develop CVT tend to have better outcomes than women without sex-specific risk factors, which was thought to be owing to younger age and shorter onset to diagnosis period.

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