Empirical research has established the fact that the use of oral contraceptives in young women with the Factor V Leiden mutation increases the relative risk of cerebral venous sinus thrombosis. Cerebral venous sinus thrombosis is a rare cerebral vascular injury whose ambiguous presentation contributes to delayed and often-inaccurate diagnosis. This case report presents a 21-year-old White woman with a severe headache who presented to the emergency department and was diagnosed with cerebral venous sinus thrombosis. The purpose of this article is to educate advanced practice emergency care nurses on the importance of understanding genetic and acquired risk factors in diagnosing cerebral venous sinus thrombosis. A genetic risk assessment tool is introduced that advanced practice nurses may incorporate into their routine assessments to evaluate the likelihood of a genetic predisposition for illness, such as shown in this case study.