Which of the following is a primary presentation symptom of cerebral venous thrombosis?

Cerebral venous thrombosis (CVT) is a condition characterized by the formation of a thrombus in the cerebral venous system, leading to increased intracranial pressure and various neurological symptoms. One of the primary presentation symptoms of CVT is headache, which can often be described as a new, persistent headache that may worsen over time. This type of headache is particularly notable because it may differ from typical headaches in that it can be accompanied by other signs of elevated intracranial pressure, such as nausea and vomiting.

The headache associated with CVT can be due to venous congestion and the resulting pressure effects on the brain. Patients might also present with other neurological symptoms, but the headache is a hallmark symptom that prompts further investigation into the underlying cause, such as imaging studies.

While seizures, speech loss, and paresthesia can occur in cases of CVT, they are generally secondary manifestations resulting from the complications of the thrombosis, such as swelling, infarction, or hemorrhage, rather than the primary symptoms. Therefore, headache stands out as the most common initial complaint in patients with cerebral venous thrombosis.