Presentation
The patient presented with acute lower limb weakness, paresthesia and ataxia.
Patient Data
There is a small herniation of the right temporal lobe parenchyma into the right transverse sinus. The brain herniation sac is causing stenosis in the right transverse sinus.
Multiple variable sizes callosal, periventricular white matter, cortical, bilateral temporal subcortical, optic tracts, brainstem, cerebellar peduncles and bilateral cerebellar hyperintense T2 and FLAIR lesions are noted, perpendicular to the lateral ventricles. Features are consistent with demyelinating disease (multiple sclerosis).
After contrast administration, most of these lesions showed rim enhancement, indicating active MS plaques.
Selected images focused on the area of the right temporal lobe herniation into the right transverse sinus. Note that the herniated part has the same signal intensity and continuation with the adjacent temporal lobe.
Case Discussion
Brain herniation into the dural venous sinus is an incidental finding, which is rarely seen and must not be confused with dural sinus thrombosis, arachnoid granulations, and tumors 1.
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