skip to main content

Cerebral venous sinus thrombosis — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardStrokeCerebral venous sinus thrombosisSCE Neurology

MR venography confirms superior sagittal sinus thrombosis with a small haemorrhagic venous infarct. Platelets and coagulation are adequate. What disease-directed treatment should begin?

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

Reveal the answer and explanation

Correct answer: C — Start therapeutic low-molecular-weight heparin in the setting of the haemorrhagic venous infarct

The best answer is “Start therapeutic low-molecular-weight heparin in the setting of the haemorrhagic venous infarct”. Haemorrhage caused by venous congestion is not a contraindication to therapeutic heparin in cerebral venous thrombosis. “Withhold anticoagulation until every intracranial blood product resolves” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Use aspirin alone because venous thrombosis is platelet mediated” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Give routine systemic thrombolysis before anticoagulation” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Treat intracranial pressure without addressing the venous thrombus” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here.

Reference: European Stroke Organization guideline for cerebral venous thrombosis: https://pmc.ncbi.nlm.nih.gov/articles/PMC6454824/