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Deep cerebral vein thrombosis

Case contributed by Ali Hekmatnia
Diagnosis certain

Presentation

Young woman on the contraceptive pill presented with severe headache and vomiting.

Patient Data

Age: 35 years
Gender: Female

Non-contrast CT demonstrates hyperdense internal cerebral veins, vein of Galen and straight sinus with low attenuation in the left deep grey matter.

mri

Axial T2 demonstrates high signal intensity involving the left-sided thalamus and basal ganglia and sagittal T1 shows hyperintense straight sinus, vein of Galen and internal cerebral veins and MRV demonstrate lack of flow.

Four days later

mri

More progressive signal changes involving both thalami.

Case Discussion

10% of cerebral vein thromboses (CVTs) are because of deep cerebral vein thrombosis (DCVT). The diagnosis of DCVT is often missed due to its heterogenous clinical presentation.

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