A 45-year-old woman on oral contraceptives presents with acute onset occipital headache, right homonymous hemianopsia, and mild left-sided weakness. Vital signs show BP 138/82, HR 94, RR 16, temperature 37.2°C, and SpO2 98% on room air. MRI brain reveals acute infarction in the left posterior cerebral artery distribution. Cardiac examination is unremarkable without murmurs. Which of the following is the most likely underlying mechanism?
- A)Atherosclerotic disease of the posterior cerebral artery
- B)Arterial dissection of the basilar artery
- C)Vasculitis from systemic lupus erythematosus
- D)Hypercoagulability from oral contraceptive use with thrombosisGABARITO
- E)Cardioembolism from atrial fibrillation
Explicação
Oral contraceptives increase thrombotic risk through altered coagulation cascade, increasing factors II, VII, IX, X and decreasing antithrombin and protein S. This is especially true with older high-dose formulations and in patients with prothrombotic states. Ver explicação completa e trilha adaptativa →