Cerebral venous thrombosis is a rare but potentially life-threatening condition that is particularly prevalent in young women (ie, mean age 44 years) and accounts for 0·5–3% of all strokes. The condition is associated with a substantial risk of long-term disability occurring in up to 10–15% of patients and a substantial mortality risk.1 Given the growing evidence for the safety of direct oral anticoagulants for the treatment of cerebral venous thrombosis from clinical trials2–4 and a large retrospective analysis,5 a scientific statement from the American Heart Association deemed it reasonable to transition to vitamin K antagonists or direct oral anticoagulants after initial parenteral anticoagulation.