INTRODUCTION
Cerebral venous sinus thrombosis (CVST) is a cerebrovascular disease characterized by thrombosis intracranial veins and sinuses. It is an unusual and unrecognized form of stroke that accounts for approximately 0.5 to 1% of strokes.1 CSVT can occur among all age groups, but peak incidence is observed in new-borns, neonates, and middle-aged individuals in their third decade of life, with female to male ratio of 3:1. 2
The etiology of CSVT is multifactorial. Once the diagnosis is confirmed, it warrants a further detailed approach to identify the cause. In comparison to arterial ischemic strokes, CSVT may progress over days. Based on the involved venous sinus location, there is a broad spectrum of clinical presentation, such as seizures, headache, altered level of consciousness, and focal neurological signs/symptoms. According to the most extensive cohort study on CSVT, the International Study on Cerebral Venous and Dural Sinuses Thrombosis (ISCVT), 37% of patients present with acute onset (<48 hours), 56% as subacute (>48 hours to 30 days), and chronic (>30 days) in 7% of patients . 2
Simultaneous cerebral arterial and venous infarction has been reported in very few case reports. We describe a young lady who presented with headache, dizziness, memory disturbance while on OCP, found to have persistently elevated serum Factor VIII. Neuroimaging confirms the diagnosis of CSVT and PICA thrombosis.