Cerebral Venous Sinus Thrombosis — SCE Neurology MCQ

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HardCerebrovascular DiseaseCerebral Venous Sinus ThrombosisSCE Neurology

A 35-year-old woman presents with sudden severe headache and left hemiparesis. She is 36 weeks pregnant. MRI brain shows a right-sided cortical venous sinus thrombosis with venous infarction. What is the most appropriate treatment?

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Correct answer: B — Low-molecular-weight heparin at treatment dose

Cerebral venous sinus thrombosis should be treated with anticoagulation, even in the presence of haemorrhagic venous infarction. In pregnancy, LMWH at treatment dose is the anticoagulant of choice as DOACs and warfarin are contraindicated. A: Antiplatelet therapy is insufficient. C: Thrombolysis is not first-line for CVST. D: DOACs are contraindicated in pregnancy. E: Surgery is reserved for cases with significant mass effect or herniation.

Reference: EAN/EFNS CVST Guidelines (2017); RCOG Green-top Guideline No. 37b