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Diffuse cerebral blood vessel hyperdensity

Case contributed by Hidayatullah Hamidi
Diagnosis certain

Presentation

Headache, seizure, fever and vomiting for 8 days.

Patient Data

Age: 8 years
Gender: Male

All cranial vessels (arteries and veins) appear abnormally hyperdense on non-enhanced CT images, however, after IV contrast injection, normal opacification is seen without evidence of thrombosis.

Hypodensity in the left cerebellar hemisphere without post contrast enhancement. No intraparenchymal hemorrhage. No hydrocephalus.

Case Discussion

Hyperdense cranial vessels with normal opacification on post-contrast images - these findings can be seen in entities such as:

  • elevated hematocrit
  • polycythemia
  • severe dehydration

Hypodensity in the left cerebellar hemisphere without post contrast enhancement suspicious for ischemic/infectious insult rather than mass lesion. MRI can give additional information.

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