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Cerebral Venous Sinus Thrombosis — RACP Adult Medicine MCQ

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HardNeurologyCerebral Venous Sinus ThrombosisRACP Adult Medicine

A 30-year-old woman on the OCP presents with progressive headache over 1 week, papilloedema, left-sided focal seizures, and a right hemiparesis. CT brain shows a left frontoparietal haemorrhagic infarct not conforming to an arterial territory. D-dimer is elevated. What is the most likely diagnosis?

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Correct answer: D — Cerebral venous sinus thrombosis

Subacute headache with papilloedema, seizures, and haemorrhagic infarct not in an arterial territory in a young woman on OCP is highly suggestive of cerebral venous sinus thrombosis. Elevated D-dimer supports the diagnosis. CT venography or MR venography confirms the diagnosis. Treatment is therapeutic anticoagulation despite the haemorrhagic component.

Reference: Stroke Foundation Australia – 2024; EFNS 2017 CVT Guidelines