Presentation
This young patient presented with gradual onset headache followed by seizures and left sided weakness.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
Selected axial CT images of the brain demonstrate hyperdense material in some of the sulci overlying the right cerebral hemisphere. A hyperdense cortical vein is also present. The superior sagittal sinus, partially imaged, is also hyperdense.
There is minor swelling of the posterior frontal/parietal regions.
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Selected images form a CT venogram obtained at the same time demonstrates extensive venous thrombosis involving not only the anterior two thirds of the superior sagittal sinus but also cortical veins over the surface of the right hemisphere. Axial images demonstrate a so-called 'empty delta' sign.
Single image from a non-contrast CT demonstrates a right sided venous hemorrhage.
Single image from a non-contrast CT demonstrates further evolution of the right sided venous hemorrhage. It has a typical mulitlobulated appearance, likened to a garlic bulb.
Case Discussion
Intracranial venous thrombosis typically presents with gradually increasing headache. It is most frequently seen in patients who are generally hypercoagualable (e.g. oral contraceptive pill, malignancy) or those with adjacent infection (e.g. mastoiditis).