379 Ch 378. Cerebral Venous Sinus Thrombosis (CVST) and Transient Ischemic Attack (TIA)

CVST = thrombosis of cerebral venous sinuses (superior sagittal, transverse, sigmoid, cavernous) and/or deep cerebral veins；rare (~ 3-4/million/yr) but underdiagnosed；risk factors: hypercoagulable states (genetic + acquired) + pregnancy/postpartum + OCP/HRT + infection (mastoiditis, sinusitis, meningitis) + malignancy + dehydration + head trauma；presentation variable: headache (most common, often progressive, may be thunderclap) + papilledema + focal deficits + seizures + altered LOC；diagnosis: MRV (gold standard) or CTV; MRI shows venous infarcts (don’t fit arterial territory) + hemorrhage；treatment: anticoagulation (heparin or LMWH, then warfarin/DOAC) — even with hemorrhage; mechanical thrombectomy for severe/refractory (TO-ACT 2020 mixed)；TIA = transient neurological deficit with no acute infarct on imaging (tissue-based definition, ~ 1 hr typical); ABCD2 score stratifies short-term stroke risk; urgent workup within 24-48 hr — same etiology workup as stroke; dual antiplatelet 21 days (CHANCE/POINT) for high-risk minor stroke/TIA。