Straight sinus and internal cerebral vein thrombosis

Case contributed by Paresh K Desai
Diagnosis almost certain

Presentation

Memory disturbances, diplopia. A non-contrast CT revealed bilateral abnormalities. An MRI was thus performed.

Patient Data

Age: 40 years
Gender: Male

MRI revealed bilateral near symmetric abnormal signal on T2 and FLAIR with punctate hemorrhages on the region of basal ganglia bilaterally including both thalami.

The T1 sagittal images in midline reveal a thrombus in the straight sinus and internal cerebral veins. The venous thrombosis is also appreciated in Gradient echo axial images.

Case Discussion

The occurrence of deep venous thrombosis involving the straight sinus and the internal cerebral veins is uncommon. Bilateral symmetric basal ganglia/ thalamic hyperintensities should raise a suspicion of this entity and MR venography need to be added.

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