Cerebrovascular disease in young women taking oral contraceptives.

6 women aged 22-39 developed neurological disorders after using oral progestational drugs for periods up to 14 months. They had no other neurological disease were free of hypertensive diabetic and collagen diseases and had no cardiac disorders. All experienced a prodrome of recurrent vascular headache lasting at least several weeks. In 5 this represented a new headache pattern. In 5 patients cerebral infarction occurred. In 4 of these the lesion developed after many days of transient focal symptoms. The last patient developed cerebral migraine with left-sided numbness had a generalized seizure and did not stop the drug until she developed thrombophlebitis with pulmonary emboli 2 months later. Although the other patients stopped taking the drug when the neurological symptoms developed the latter continued to to progress and the headaches persisted. Carotid arteriography performed in 1 patient 3 weeks after onset of aphasia disclosed widespread segmental narrowing or occlusion of smaller cerebral arteries as well as the intimal irregularity of the carotid siphon. Arteriography was normal when performed 20 weeks after onset in a second case. It is concluded that the cerebral symptoms preceding infarction and progression after drug withdrawal suggest that had medication been stopped earlier or anticoagulants employed immediately less severe consequences might have ensued.(AUTHORS MODIFIED)