A 28-year-old woman develops severe headache, seizures, and right hemiplegia on day 7 postpartum. MR venography shows thrombosis of the superior sagittal sinus. What is the recommended anticoagulation?
- A Aspirin alone
- B Warfarin alone
- C Low-molecular-weight heparin ✓
- D Supportive care only
Correct answer: C. Low-molecular-weight heparin
Explanation
Cerebral venous sinus thrombosis is treated with anticoagulation using low-molecular-weight heparin (or unfractionated heparin) even in the presence of hemorrhagic infarction, as trials show benefit. This is then transitioned to warfarin for 3 to 6 months. Aspirin alone is insufficient. Supportive care without anticoagulation is not standard.
Reference: Stroke (journal) / AHA Guidelines, 2019 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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