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Arachnoid granulation

Case contributed by Dr Nikola Todorovic
Diagnosis almost certain

Presentation

The patient was admitted to the emergency department complaining of a severe headache. CT shows a filling defect in the left transversal sinus. A radiologist suspected transversal sinus thrombosis, so an MRI brain was advised.

Patient Data

Age: 40 years
Gender: Male
mri

There is an oval filling defect in the left transversal sinus with signal intensity of the CSF in all sequences, with no post-contrast signal intensity enhancement.

There are calcifications in the cerebral falx. Otherwise, MRI brain is unremarkable.

Case Discussion

The area of interest had signal characteristics similar to CSF, was located adjacent to the entrance of the cortical vein into the sinus, and also was in the transverse sinus. There were no pathological changes in the brain parenchyma and it was felt most likely to represent an incidental arachnoid granulation. No treatment was indicated.

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