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Cerebral venous thrombosis — RCPSC EM MCQ

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HardNeurological emergenciesCerebral venous thrombosisRCPSC EM

Ten days postpartum, a patient has progressive headache, focal seizure and mild arm weakness. Non-contrast CT shows a small parasagittal hemorrhage. Which imaging test should follow?

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

Reveal the answer and explanation

Correct answer: B — Perform contrast-enhanced CT venography or contrast-enhanced MR venography urgently

Explanation lettering: E = shown as B · D = shown as C · B = shown as D · C = shown as E

E evaluates suspected CVT despite associated hemorrhage. A ignores a common presentation of venous infarction. B can miss cortical venous thrombosis and generate flow artefact. C delays etiologic diagnosis. D examines the wrong vascular territory.

Reference: Canadian Stroke Best Practices, Diagnosis of Cerebral Venous Thrombosis: https://www.strokebestpractices.ca/recommendations/cerebral-venous-thrombosis/1-diagnosis-and-initial-clinical-assessment-of-symptomatic-cerebral-venous-thrombosis