Cerebral venous infarct related to dural venous sinus thromboses

Case contributed by Bruno Di Muzio


Increased headache and vomiting.

Patient Data

Age: 45
Gender: Female

There is a right posterior temporal lobe parenchymal hemorrhage which measures 18 x 13 x 4 mm with surrounding vasogenic edema. It does not extend to the cortical surface. No other area of parenchymal hemorrhage.

Because of the mixed phase nature of the examination, there is partial visualization of the intracranial venous sinuses.There is an extensive, but incomplete filling defect in the middle third of the superior sagittal sinus, marked irregularity and attenuation of the left transverse sinus and a filling defect extending into the sigmoid sinus towards the jugular bulb. There is also a filling defect in the lateral aspect of the right sigmoid sinus.

Comparison is made with the previous CT brain. There is an increase in the extension of right temporal intraparenchymal hemorrhage with associated surrounding vasogenic edema, which approximately measures 4.6 x 6.8 x 3.4 cm. Tiny amount of intraventricular hemorrhage in the left occipital horn.

There is mass-effect with ongoing effacement of the right lateral ventricle and midline shift of 9 mm. No significant uncal herniation and no tonsillar herniation.

Case Discussion

Dural venous sinus thrombosis can cause a cerebral venous infarction, which is usually characterized by a cortical or peripheral heterogeneous and gyriform hemorrhage.

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