Cerebral Venous Sinus Thrombosis Following IVF Treatment Presenting with Migraine-like Headache: A Case Report

Cerebral venous sinus thrombosis (CVST) is a relatively rare subtype of stroke that occurs as a result of hypercoagulability. It is more common in women than men, with a ratio of three to one. Gender-specific risk factors for women include oral contraceptives, pregnancy, puerperium, and assisted reproductive methods such as hormone therapy. We report a 38-year-old female patient with a history of migraine attacks, presenting with a migraine-like headache following in-vitro fertilization (IVF) treatment and diagnosed with CVST. The thrombophilia panel showed a homozygous methylenetetrahydrofolate reductase (MTHFR) A1298C mutation. Hereby, we aim to highlight the importance of evaluating thrombotic risk factors in women before initiating IVF treatment and the assessment of proper dosage for thromboprophylaxis. Especially those with a mechanical heart valve, antiphospholipid antibody syndrome (APS), antithrombin-3 deficiency, MTHFR, and factor V Leiden mutation are at high risk. Thromboprophylaxis should be started right after the initiation of IVF treatment and should be continued during pregnancy.