Cerebral venous infarct

Case contributed by Dr Mostafa El-Feky

Presentation

Convulsions.

Patient Data

Age: 30 years
Gender: Female

MRI Brain

MRI

There is diffusion restriction and blooming at the right internal cerebral vein (deep cerebral vein thrombosis).

T2 hyperintense signal noted at the posterior aspect of the right lentiform, lateral aspect of the right thalamus and body of the right caudate.

T2 hyperintense signal noted at the left frontal cortical and subcortical region with diffusion restriction related to a bloomed cortical vein. A small T2 hypointense parenchymal hemorrhage, with blooming on SWI sequence (hemorrhagic cerebral venous infarction).

Diffuse pachymeningeal enhancement noted at contrast-enhanced T1 WI.

MR venography

MRI

Non-opacified thrombosed anterior segment of the superior sagittal venous sinus and the related frontal cortical veins bilaterally, right vein of Trolard, right internal cerebral vein, straight venous sinus and left transverse and sigmoid venous sinuses.

Partial thrombosis of posterior segment of the superior sagittal sinus, right transverse and sigmoid venous sinuses.

Case Discussion

This case demonstrates deep cerebral venous thrombosis with a related venous infarct, left frontal cortical vein thrombosis with a related hemorrhagic venous infarct as well as dural venous sinus thrombosis.

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