Cerebral venous hemorrhagic infarction

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Awoke with right sided weakness and dysphasia. Background of non-small cell lung cancer, being treated with chemotherapy and radiotherapy.

Patient Data

Age: 55 years
Gender: Male

CT Brain

ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial
C+
This study is a stack
Coronal
C+
This study is a stack
Sagittal
C+
Download
Info

There are confluent hemorrhagic foci within the left temporal lobe in a peripheral subcortical distribution associated with surrounding edema. The distribution is atypical for an infarct involving the left middle cerebral artery territory. Note is made of a filling defect within the torcula Herophili (empty delta sign) and hyperdense left transverse dural venous sinus. 

MRI Brain (Venogram)

mri
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
SWI
This study is a stack
MRA
3D VR
This study is a stack
MRA
3D VR
This study is a stack
Sagittal
T1
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Sagittal
MRV
This study is a stack
Venogram
3D VR
Download
Info

MRI confirms the venous hemorrhagic infarct within the left temporal lobe and thrombosis within the left transverse and sigmoid dural venous sinuses. 

Case Discussion

This is a case that should prompt you to consider venous infarction upon reviewing the first non-contrast CT imaging. The left temporal lobe hemorrhagic infarction has a gyriform pattern within a non-arterial location/territory. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.