The influence of oral contraceptives on intracranial vessels

• Published in: The European journal of contraception & reproductive health care Vol. 17; p. S71
• Main Authors: Tsikouras, P, Bouchlariotou, S, Dafopoulos, A, Ulrich, A, Velten, E, Niesigk, B, Mylonas, T, Liatsikos, S, Zografou, C, Galazios, G, Teichmann, A Tobias, Von Tempelhoff, G Friedrich
• Format: Journal Article
• Language: English
• Published: Carnforth Taylor & Francis Ltd 01-06-2012
• Subjects: Reproductive health; Stroke; Thrombosis; Ultrasonic imaging; Veins & arteries; Womens health
• ISSN: 1362-5187; 1473-0782

Cerebral Venous Thrombosis (CVT) is a rare and potentially life-threatening disease, accounting for about 0.5% of stroke cases. Transcranial Doppler (TCD) ultrasound may be valuable as a screening method to detect >50% stenosis in major intracranial arteries. Oral contraceptives (OC) seem to have a causative association with this entity. The aim of this study was to compare the haemodynamic status of the cerebral arteries between women who receive low-dose OC containing 20 μg ethinylestradiol with 0.075mg gestodene (EE/GSD) and 20 μg ethinylestradiol with 3 mg drospirenone (EE/DRSP) respectively. We evaluated 50 women of reproductive age under OC with no risk factors referred for complete TCD examination from 1 April 2007-31 October 2011. Twenty women received OC containing 20 μg EE combined with 0.075mg GSD (Group A) and 30 received 20 μg EE with 3 mg DRSP (Group B) daily intake. TCD was used to assess the haemodynamics of the intracranial arteries as well as the internal carotid arteries. The mean blood flow velocity (MFV), and pulsatility index (PI) were recorded in all the arteries. MFV was classified as normal (30-99 cm/s), high (>100 cm/s), and low (<30 cm/s) for the MCA, anterior cerebral artery, and terminal internal carotid artery. MFV in the posterior cerebral, basilar, and vertebral arteries were considered normal (20-49 cm/s), high (>50 cm/s), and low (<20 cm/s). We also calculated PI as (PSV-EDV)/MFV, where PSV is the peak systolic velocity and EDV is the end diastolic velocity. Normal values of PI are in the range of 0.6-1.1. No focal stenosis in the examined intracranial vessels was detected. The findings of the present study could not demonstrate any association of OC with stenotic lesion or any other pathology on intracranial vessels.