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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Cerebrovascular Events and Use of NuvaRing
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Cerebrovascular Events and Use of NuvaRing

机译：脑血管事件和NuvaRing的使用

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Objective: To report 2 cases, occurring within 1 month at a single institution, in which young women experienced a cerebrovascular event while using the hormonal contraceptive product NuvaRing (etonogestrel/ethinyl estradiol vaginal ring).Case Summary: The first patient presented to the emergency department (ED) with a 10-day history of right frontal headache. A computed tomography (CT) scan and magnetic resonance imaging showed evidence for right postcentral and cortical venous thrombosis. A hypercoagulable workup identified a heterozygous factor V Leiden mutation. The second patient presented to the ED with a same-day history of left frontotemporal headache extending into her left jaw and neck, numbness and clumsiness of right hand and right foot, and inability to make a comprehensible sentence. A CT angiogram showed occlusion of the internal and external carotid arteries. A hypercoagulable workup indicated no evidence of a thrombophilic disorder and a transesophageal echocardiogram indicated no cardioembolic source, resulting in a final diagnosis of a spontaneous carotid artery dissection. Both patients reported recent use of NuvaRing. The medication was discontinued during the hospital stay.Discussion: The use of hormonal agents for contraception carries a well-known risk of venous thrombosis; however, the impact this therapy has on the risk of arterial thrombosis and ischemic brain events is less understood. We found no previous reports of an ischemic brain event in association with NuvaRing use. The Naranjo probability scale indicated a possible relationship between the ischemic events and NuvaRing exposure in both patients.Conclusions: Risk factors should be evaluated appropriately prior to initiating any form of combined hormonal contraceptives, oral or vaginal, in young women.
机译：目的：报告2例在单个机构内1个月内发生的病例，其中年轻妇女在使用激素避孕产品NuvaRing（依托孕烯/乙炔雌二醇阴道环）时发生了脑血管事件。右额头痛有10天病史的科室（ED）。计算机断层扫描（CT）扫描和磁共振成像显示右中后和皮质静脉血栓形成的证据。高凝检查发现杂合子V Leiden突变。第二名患者在当日就诊时表现为左额颞部头痛累及左下颌和颈部，右手和右脚麻木和笨拙，并且无法做出可理解的句子。 CT血管造影显示颈内动脉和外颈动脉闭塞。高凝检查表明没有证据表明有血栓形成性疾病，经食道超声心动图显示无心脏栓塞源，最终可诊断为自发性颈动脉夹层。两名患者均报告最近使用NuvaRing。讨论：使用激素类药物进行避孕具有众所周知的静脉血栓形成风险;然而，这种疗法对动脉血栓形成和缺血性脑事件风险的影响尚不清楚。我们以前没有发现与使用NuvaRing相关的缺血性脑事件的报道。 Naranjo概率量表表明了这两名患者的缺血性事件和NuvaRing暴露之间可能存在关系。结论：在年轻女性中，在开始口服或阴道联合激素避孕之前，应适当评估危险因素。

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