Haemodynamics: cerebral venous sinus thrombosis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haemodynamics: cerebral venous sinus thrombosis

Sample item

A 26-year-old woman taking combined oral contraceptives has three days of worsening headache, then a generalised seizure. MR venography shows a filling defect in the superior sagittal sinus, and CT shows a haemorrhagic lesion in the parasagittal cortex. What is the underlying pathology of the cortical lesion?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Venous outflow obstruction causing a haemorrhagic venous infarct

Thrombosis of a dural venous sinus raises venous pressure and blocks drainage of the cortex, so blood still enters but cannot leave. The result is a haemorrhagic (red) infarct, often bilateral and parasagittal. Oestrogen-containing pills are a recognised hypercoagulable risk.

Option by option

  • A. Rupture of a berry aneurysm into the subarachnoid space

    Aneurysm rupture produces subarachnoid blood, not a cortical lesion with a sinus filling defect.

  • B. Arterial embolic occlusion causing a pale infarct

    Arterial occlusion gives a pale infarct, and there is no arterial source here.

  • C. Hypertensive rupture of a lenticulostriate artery

    Hypertensive vessel rupture gives a deep basal ganglia haemorrhage, not a sinus thrombosis.

  • D. Venous outflow obstruction causing a haemorrhagic venous infarct (correct)

    Correct. Blocked venous drainage leads to congestion and a haemorrhagic infarct.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Venous outflow obstruction causing a haemorrhagic venous infarct. Thrombosis of a dural venous sinus raises venous pressure and blocks drainage of the cortex, so blood still enters but cannot leave.

Why is "Rupture of a berry aneurysm into the subarachnoid space" not the answer?

Aneurysm rupture produces subarachnoid blood, not a cortical lesion with a sinus filling defect.

Why is "Arterial embolic occlusion causing a pale infarct" not the answer?

Arterial occlusion gives a pale infarct, and there is no arterial source here.

Why is "Hypertensive rupture of a lenticulostriate artery" not the answer?

Hypertensive vessel rupture gives a deep basal ganglia haemorrhage, not a sinus thrombosis.

What concept does this question test?

It tests Haemodynamics: cerebral venous sinus thrombosis in Pathology. The result is a haemorrhagic (red) infarct, often bilateral and parasagittal. Oestrogen-containing pills are a recognised hypercoagulable risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haemodynamics: cerebral venous sinus thrombosis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.