Behind the Headache: A Case of Cerebral Venous Thrombosis Associated With Hormonal Contraceptive Use.

Cerebral venous thrombosis is an uncommon but potentially life-threatening condition. We present the case of a previously healthy 26-year-old woman who developed cerebral venous thrombosis while using a combined hormonal contraceptive. She presented with progressive headaches unresponsive to analgesics. Imaging confirmed thrombosis in the left transverse and sigmoid sinuses and the left internal jugular vein. Anticoagulation was initiated with full resolution of symptoms and thrombus. Extensive thrombophilia screening was negative, and combined hormonal contraceptive use was identified as the main risk factor. The patient transitioned to a progestogen-only method. This case highlights the need to consider cerebral venous thrombosis in women with atypical headaches using combined hormonal contraceptives. It also emphasizes the importance of personalized contraceptive counseling based on thrombotic risk factors.