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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Norethisterone enanthate-induced cerebral venous sinus thrombosis (CVST)
  1. Mandreker Bahall1,
  2. Manisha Santlal2
  1. 1Department of Clinical and Medical Sciences, The University of The West Indies at Saint Augustine Faculty of Medical Sciences, St Augustine, xxxx, Trinidad and Tobago
  2. 2Department of Medicine, South West Regional Health Authority, San Fernando, Trinidad and Tobago
  1. Correspondence to Dr Mandreker Bahall, vmandrakes{at}hotmail.com

Summary

A 23-year-old East Indian woman with no significant medical history, except a depot-norethisterone enanthate injection taken 3 weeks prior to admission, presented with a gradually worsening headache for the past 5 days. She had no fever, vomiting, neck stiffness, focal weakness or rash, and examination was unremarkable with no focal neurological deficits. Vasculitic, thrombophilia and sepsis screens were normal. A brain CT scan showed a left parietal lobe venous infarct, secondary to a venous dural sinus thrombosis, with MRI and Magnetic Resonance Venogram (MRV) confirming a signal void. She was diagnosed to have multiple cerebral venous sinus thrombosis due to norethisterone enanthate. She made a complete recovery following treatment with mannitol, dexamethasone and anticoagulants. A follow-up brain MRI done at 6 months was normal.

  • drugs and medicines
  • neurology (drugs and medicines)

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bcr-2017-222418

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    Footnotes

    • Contributors MB and MS contributed to the management of the case, prepared and edited the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.