抄録
It is well known that thromboembolism is one of the most serious side effects of oral contraceptives. In Japan, however, reports of thromboembolism following use of oral contraceptives are rare, since their clinical use in Japan is restricted to treatment of menstrual abnormalities.
We reported here on two patients affected with cerebrovascular occlusive diseases associated with the administration of oral contraceptives.
The first case was that of of 32-year-old woman, who developed headache, paresis and dysesthesia of the right limbs following daily taking over a period of 20 days of oral contraceptives, one tablet containing 0.15 mg of mestranol and 5 mg of lynestranol. Neurological symptoms as well as examinations led to the diagnosis of a kind of thalamic syndrome due to cerebral thrombosis.
The second case was that of a 37-year-old woman, who developed right hemiparesis following daily consumption over a period of 21 days of oral contraceptives as given above. Clinical symptoms and neurological examinations led to the diagnosis of right hemiparesis due to cerebral thrombosis.
The pathogenesis of cerebral thrombosis caused by taking of oral contraceptives was discussed mainly in connection with coagulation and fibrinolysis. Certain evidences suggesting that hypercoagulability may play major roles in pathogenesis of thromboembolism during taking oral contraceptives have been derived from the works of other investigators. It is true that estrogen in this compound may induce a state in which an increase of coagulation factors together with a decrease of antithrombin III combine to produce hypercoagulation; laboratory tests with our patients, however, produced nothing compatible with a state of hypercoagulability.
