Dural venous sinus thrombosis extending into the right internal jugular vein
Presentation
Febrile with headache for 10 days. Left blurred vision and right lateral rectus palsy. New left-sided ptosis.
Patient Data
Dual phase contrast enhanced CT demonstrates extensive dural venous sinus thrombosis involving the superior sagittal sinus, right transverse and sigmoid sinus with extension to right IJV.
Long-segment occlusive thrombus demonstrated within the right internal jugular vein, causing marked distension of the vessel. Non-occlusive thrombus extends proximally from the origin of the right brachiocephalic vein at the SVC confluence. Occlusive thrombus extends proximally within the sigmoid sinus, transverse sinus and superior sagittal sinus. The right subclavian vein, left internal jugular vein and tributaries appear patent.
The single non-contrast key image shows a hyperdense right transverse sinus/torcula.
Case Discussion
CT neck performed to assess extent of cerebral thrombosis seen on prior MRI brain. Case demonstrates the empty delta sign in the superior sagittal sinus.
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