Danazol and internal carotid artery thrombosis

The case of a 47-year-old woman suffering from a CT-assessed ischemic right hemisphere stroke, which occurred after a 2-month treatment with danazol (a synthetic androgen), is reported. The patient's thrombocytosis in association with danazol treatment and its possible correlations with the thrombotic event are discussed.

[Effect of sulfinpyrazone on the platelet function and in experimental thrombosis]

The effect of sulfinpyrazone on various parameters of platelet function was studied in volunteers. The shape change, adhesivity and aggregability of thrombocytes were significantly decreased after an oral treatment with 200 mg Anturano t.d.s. for seven days. Two days after the last medication this effect was still evident. In addition an experimental thrombosis was performed in rats by chilling a standardized segment of the carotid artery. After previous application of 10 and 100 mg/kg BW of sulfinpyrazone the thrombus formation was significantly decreased in comparison with the control group.

[Ischemic cardiovascular accidents during treatment with progestins alone. Apropos of 3 cases]

Three cases of ischaemic cardio-vascular accidents are reported under progestative treatment; the drug used was chlormadinone acétate (0,5 mg daily) in one patients, and noréthistérone (5 mg daily) in two others. The accident was observed in two cases at the end of the second menstrual cycle and in one case after three years. Lipid abnormalities have been detected in the three cases: minor type IV (two patients) and mixed hyperlipidaemia (one patient).

[Brain infarctions during treatment with ovulation inhibitors (author's transl)]

392 cases of cerebrovascular disturbances in women while taking oral contraceptives are reported since 1962. There has been a remarkable change of the distribution of age among these women. Till 1970 were mostly women involved between the age of 30 and 34 years. Today this type of distribution is no more to be seen because of the growing number of reports about complications in other age-groups. Complications were till 1970 mostly reported in the period from ten days till six months after taking oral contraceptives. The publications of the last three years are showing that many women are involved, who had taken oral contraceptives more than two years. New publications and our own results are showing no changes of the clinical syndromes and of the prognosis. Our investigation shows no decrease in the number of young women suffering of thromboembolic cerebral disorders of unknown aetiology in the last years. In this group is the percentage of the women, which had taken ovulation inhibitors, no reduced. The conception, that there is a connection between oral contraceptives and cerebrovascular occlusions seems more possible as before. Especially attention in prescription of oral contraceptives should be given to the fact of a known predisposition. The rareness of these complications leads to the conclusion that one or more predisponating factors of a nature not yet known have to be existent.

Oral contraceptives and stroke in young women. Associated risk factors

Oral contraceptive use alone, in the absence of smoking, hypertension, or migraine, significantly increases the risk of stroke. Regardless of use or nonuse of these agents, hypertension is a risk factor for development of either thrombotic or hemorrhagic stroke. Regular cigarette smoking and a history of symptoms indicative of migraine also increase the likelihood of one or the other type of stroke, but more information is needed before a definite relationship can be established between these clinical factors and cerebrovascular disease.

Carotid artery occlusion following ingestion of LSD

A 20-year-old white woman developed a left hemiplegia following the ingestion of LSD. Initial angiography revealed marked constriction of the internal carotid artery at the level of the siphon which, in a few days, was converted to occlusion of the carotid artery at that level. It is suggested that LSD, an amine derivative of the ergot alkaloids, was responsible for the initial vasoconstriction and subsequent occlusion.

Coarctation of the aorta and other late sequelae of administration of thorium dioxide (thorotrast)

Coarctation of the aorta secondary to a cervicomediastinal thorotrastoma developed in a 30-year-old man 25 years after carotid arteriography. Other local manifestations of the thorotrastoma included occlusion of the left common carotid artery and partial occlusion of the left vertebral and left subclavian arteries, bilateral recurrent laryngeal nerve paresis, periesophageal adhesions, and multiple traction diverticula of the esophagus. There was no evidence of hepatic neoplasm or malignant transformation of the thorotrastoma. The major risk for this patient in the future, even though small, would be the development of a malignant hepatic neoplasm. Surgery may be indicated if local symptoms, enlarging tumor mass, or signs of increasing aortic obstruction develop.