A 30-year-old woman presented to her local hospital with an abrupt onset of left-sided headache and retro-orbital pain, dizziness, unsteadiness, vomiting, dysarthria, right facial paresis and right hemiparesis. She was otherwise well, and taking the oral contraceptive pill. MR brain imaging showed high signal intensity in the left pons (fig 1) and MR venography showed evidence of left sigmoid sinus and proximal internal jugular vein thrombosis (figs 2 and 3). She was anticoagulated with unfractionated …