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.