Dural sinus thrombosis due to hormonal contraception

Headache is a common complaint encountered in outpatient clinics and emergency rooms. It can be due to a wide variety of diseases, ranging from a simple tension headache to more serious intracranial pathologies. Dural sinus thrombosis is an uncommon cause of headache that can rarely complicate the use of hormonal contraception. Herein, we present a 42-year-old woman with a 2-month history of headache resistant to usual treatment regimens. The recent introduction of monthly injections of combined estrogen and progesterone for contraception provoked further workup that confirmed the presence of dural sinus thrombosis. Warfarin therapy was initiated and the patient later required a ventriculoperitoneal shunt for symptom relief. Clinicians should maintain a high index of suspicion when evaluating a patient with resistant headache while on hormonal contraception. Cardiovasc Endocrinol 00:000–000 c 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.