Polycystic Ovary Syndrome (PCOS) an Emerging Risk Factor of Cerebral Venous Sinus Thrombosis (CVST): A Case Report and Literature Review

Cerebral venous sinus thrombosis (CVST) is responsible for about 0.5% to 3% of all strokes, with a markedly higher frequency noted in young women. This condition is determined by several factors; in addition to established risk factors, new contributors that have become better recognized but less well-documented in the tropics include obesity, polycystic ovary syndrome (PCOS), COVID-19 infection, and vaccine-associated thrombocytopenia and thrombosis. We describe the third known case, and the first described in Africa, of CVST in a woman with PCOS and no recognizable pro-thrombotic disorder. A 42-year-old female patient, right-handed, nulligest, and obese presented with a history of infertility and menstrual cycle disorders. She was admitted to our department due to the onset of atypical headaches that progressed subacutely and were associated to generalized tonic-clonic seizures. Neurological assessment upon admission revealed intracranial hypertension syndrome. Brain MRI showed extensive CVST on the left side, involving the lateral sinus and the internal jugular vein. The diagnosis of PCOS was made according to the Rotterdam criteria. A multidisciplinary management strategy was implemented. Comprehensive studies are essential to elucidate the factors associated with CVST in women diagnosed with PCOS, which will facilitate risk assessment and the formulation of preventive measures.