Case 2
A 17-year-old Caucasian female (BMI 32.5 kg/m2)
presented with worsening headaches associated with vomiting for 2 weeks.
Head magnetic resonance venography (MRV) revealed right dural,
transverse and sigmoid sinus venous thrombosis (Figure 2 and 2b).
Patient reported the use of COC for 2 years (norethindrone 1mg -ethinyl
estradiol 35 mcg) prescribed for the management of menorrhagia.
Anticoagulation with Apixaban was continued for a total duration of 6
months with repeat MRV showing residual non-occlusive residual
thrombosis in the right transverse and sigmoid sinuses. Thrombophilia
evaluation did not reveal congenital or acquired abnormalities.