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Cerebral venous sinus thrombosis — SCE Acute Medicine MCQ

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EasyAcute Neurological PresentationsCerebral venous sinus thrombosisSCE Acute Medicine

A 58-year-old man presents with acute neurological symptoms. Relevant history includes vascular, infectious or neuromuscular risk factors. On assessment, neurological examination shows focal or global dysfunction. Investigations show postpartum headache, seizure and CT venogram showing sagittal sinus thrombosis. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Start therapeutic anticoagulation after specialist review

The key discriminator is that postpartum headache, seizure and CT venogram showing sagittal sinus thrombosis, which makes Start therapeutic anticoagulation after specialist review the single best answer. Arrange routine outpatient follow-up is less appropriate because it does not address the dominant acute risk in the vignette; Give targeted antidote or reversal therapy would fit a different presentation or later stage of care. Provide supportive care and close monitoring and Optimise chronic medication and discharge are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: ESO CVST guideline