Aseptic cerebral venous thrombosis associated with a gastric leiomyoma

In January 2015, a 38-year-old women consulted a neurologist for heavy diffuse headache, visual field defects, transient left paresthesia and seizures. She had no fever nor other complaint. She used DIV NUVARIN, an intravaginal ring, as contraceptive method. Her past medical history was only marked by an appendectomy during childhood. There was no objective neurological abnormality and the remainder of the examination was normal. CRP was slightly increased (21 mg/l) and the WBC count was 11680/mm3 with 92% neutrophils. Cerebral magnetic resonance revealed a superior sagittal sinus thrombosis without any abnormality inside the brain (Fig. 1). Standard tests of coagulation were normal. Tests for proteins S, C and antithrombin deficiency, antiphospholipid antibodies and homocysteinemia were negative. There was no factor V Leiden mutation, no biological nor clinical evidence for acquired prothrombotic condition. The patient was started on therapeutic anticoagulation with acenocoumarol and her clinical condition quickly improved.