Cerebral venous haemorrhagic infarct from venous sinus thrombosis

Case contributed by Dr Ian Bickle

Presentation

Acute dense left hemiparesis. Subsequent partial seizure. 6 weeks pregnant. SOL?

Patient Data

Age: 35
Gender: Female

Moderate sized parenchymal haemorrhage with moderate surrounding low attenuation at the junction of the right frontoparietal lobes (watershed territory).  Minimal mass effect.

Separate smaller more subtle haemorrhage in the right frontal lobe.

Prominent dense cortical veins at the right vertex.

CTV

Slight progression in the right frontoparietal haemorrhage.

The low attenuation in the frontoparietal region has increase and a new focus has developed symmetrically in the left paramidline.

Small filling defect in the mid portion of the sagittal sinus highly suggestive of thrombosis.

Case Discussion

The key aspect of this case from the initial presentation scan is the odd location of the haemorrhage. This should be an alert to undertake further investigations.

This combined with a previously well young adult and potential risk factors for venous sinus thrombosis of pregnancy was a indicator of this being a venous haemorrhage.

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Case information

rID: 55433
Case created: 6th Sep 2017
Last edited: 7th Sep 2017
Inclusion in quiz mode: Included

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