Emergency Department Diagnosis and Management of Cerebral Venous Sinus Thrombosis - Stroke EXTRA Supplement (Stroke CME)

Enlarge Image
Delivery Method:	Online
$99.00 ADD TO CART OR SUBSCRIBE AND SAVE Back To Store

Publication Date: October 2025 (Volume 27, Supplement 10)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 10/01/2028.

Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME credits, subject to your state and institutional approval.

Author

Peer Reviewers

Abstract

Cerebral venous sinus thrombosis is a rare cause of stroke with an overall good prognosis. It predominantly affects women of reproductive age and patients with prothrombotic conditions. It has a diverse presentation that includes headache, seizures, focal neurological deficits, and encephalopathy. A strong index of suspicion is required to make a prompt diagnosis and initiate early management. Despite aggressive care, death or functional dependence occurs in 10% to 15% of patients. This review provides an overview of the literature and recent guidelines on the emergency department approach and the therapeutic challenges in the management of patients with cerebral venous sinus thrombosis.

Case Presentations

A 25-year-old woman with a history of migraine headaches for the past 5 years presents to the ED with an “excruciating“ headache that she has had for 2 days...

Her typical migraines have been in the left and right temporal regions, but she reports that this one is different, with a global, aching sensation that is worse when lying down. She denies photophobia. Her temperature is 37°C; heart rate, 64 beats/min; blood pressure, 116/80 mm Hg; and respiratory rate, 20 breaths/min. She is taking oral contraceptive pills. What is your next diagnostic step for this patient?

A 35-year-old woman with sickle cell trait who is 10 weeks pregnant, presents to the ED with headache for 5 days and right-sided weakness for 1 day…

Two days ago, she was evaluated at another ED for this headache, for which she received diphenhydramine. She had relief of her symptoms for a few hours, but then her symptoms recurred. Given her medical conditions, what next steps should you take?

A 73-year-old woman with a history of ovarian cancer and hypertension presents to the ED with headache and slurred speech for 4 days...

Her temperature is 37°C; heart rate, 56 beats/min; blood pressure, 190/98 mm Hg; and respiratory rate, 24 breaths/min. She is obtunded, not following commands, has a left-gaze preference, and withdraws to pain in all extremities. You suspect the patient has an acute stroke. What are your management priorities for this patient?

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.