Multiple Dural Venous Sinus Thromboses in a Young Female Presenting With Refractory Headaches

Dural venous sinus thrombosis (DVST) is a condition that affects the venous sinuses of the brain. Clotting in this vasculature can lead to the presentation of headache, seizures, stroke-like symptoms, and other neurologic deficits. Proper investigation requires clinicians to understand and explore Virchow's triad and the elements that lead to a thrombus. Herein is the case of a 26-year-old female with a history of refractory headaches attributed to migraines who presented to the ER with altered mentation. Sudden unexplained seizure-like activity presented, which warranted further workup. Further investigation by analyzing serum antibodies, inheritable causes of hypercoagulability, screening for infections, and using advanced imaging like magnetic resonance venography confirmed the presence of multiple DVSTs in the peripheral straight, sagittal, and occipital sinuses. Anticoagulant heparin was administered during hospitalization, and once treated, the patient was discharged to follow up on an outpatient basis with apixaban for continuity of care.