Cerebrovascular Diseases Associated with the Use of Oral Contraceptives

Clinical reports suggest that the use of oral contraceptives predisposes to migraine-like headache and transient or completed cerebral ischemic syndromes in otherwise healthy young women. Vertebrobasilar artery distribution stroke, previously considered rare in young women, was reported in about one fourth of idiopathic stroke patients using oral contraceptives. Limited autopsy studies of previously healthy women dying from stroke and other thromboembolic diseases while using oral contraceptives indicate significant changes in the vascular system as the primary lesion. Controlled retrospective studies of previously healthy young women diagnosed as having cerebral thrombosis indicate an estimated sixfold increased risk of such morbidity and mortality with the use of the oral contraceptives. However, data on cerebrovascular mortality in women of childbearing age indicate no significant change. This lack of overall change may be due to a concurrent reduction in cerebrovascular mortality from other causes.