Cavernous Sinus Thrombosis Following the Use of Oral Contraceptive Pills in a Young Woman: A Case Report.

Cavernous sinus thrombosis (CST) is a rare and potentially life-threatening subtype of cerebral venous sinus thrombosis that often poses diagnostic challenges in emergency settings. We report a 34-year-old woman with a one-year history of oral contraceptive pill (OCP) use for polycystic ovary syndrome who presented with severe headache, seizures, decreased level of consciousness, and bilateral eyelid edema. Non-contrast brain computed tomography showed extensive intracerebral hemorrhage with findings suggestive of CST. Because of clinical instability, advanced venous imaging (CTV/MRV) could not be performed, and the diagnosis remained presumptive. The patient was treated with intravenous unfractionated heparin, intracranial pressure control and subsequent decompressive craniectomy because of progressive neurological deterioration. This case highlights the need for a high index of suspicion, prompt imaging, and early anticoagulation in patients with suspected CST and prothrombotic risk factors such as OCP use.